Identifies lower half of oesophagus, the stomach and all of
duodenum.
Method
A)double contrast the method of choice to demonstrate mucosal
pattern
B)single contrast-used in children (not necessary to
demonstrate mucosal pattern)
And very ill adults (only gross pathology)
3. Indications
1)Dyspepsia
2)Weight
3)Upper abdominal mass
4)Gastro intestinal haemorrhage
5)suspected upper GI obstruction
6)assessment of the site of perforation(water
soluble contrast is used)
4. Contra indications
1.Complete large bowel obstruction
2.Suspected perforation (unless water soluble contrast medium
used)
Patient preparation
1. NPO after midnight(6 hrs)
2.abstain from-smoking, chewing gum or antacids-
->dec fluid in stomach which impairs barium coating.
5. Technique
1.Hypotonic agent Buscopan(hyoscine butyl bromide,20 mg i.v) or
0.1-0.2 mg i.v glucagon is injected intravenously -relax stomach
and suspend peristalsis.
A packet of effervescent granules swallowed with small amount
of water- releases CO2 and gastric distension.(approx 400ml
CO2)
High density barium is swallowed(120 ml- 250% w/v) and double
contrast views of oesophagus is obtained standing RAO.
6.
Patient faces Xray table,lowered to horizontal
Then turned onto left side and finally supine.
Patient rolled from side to side so as barium coats mucosal
surfaces properly-washes over the mucus .
Sequences of films of stomach obtained
7.
When barium enters duodenum, patient is turned RAO fills
duodenum with gas, DC films are taken.
Biphasic examinationProne swallow of thin (125%w/vlow density)
barium given after contrast view obtained to optimize compression
views of stomach and duodenum
8.
Under fluoroscopic guidance, on the compression views-filling
defects or abnormal collections are detected.
Note:young children- main indication identify cause of vomiting
eg:-pyloric
obstruction,malrotation,and GOR.single contrast technique
preferred(30% w/v Barium sulfate with no paralytic agent).
9.
Note : kV range double contrast- 70-120 kV.
single contrast-120-150kV .
Note:If partial gastrectomy or drainage procedues (eg;
pyloroplasty or gastrenterostomy), begin with prone swallow using
high density barium.Reaching duodenum or Genterostomy-turned supine
for DC films.DC of stomach and oesophagus follows.