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PRESENTED BYIFEDIORAH OLUCHUKWU DEPARTMENT OF RADIOLOGY, NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL NNEWI,ANAMBRA STATE

14th JULY 2015.

A SEMINAR PRESENTATION

On

BARIUM SWALLOW

OUTLINEINTRODUCTIONGROSS ANATOMYRADIOGRAPHIC ANATOMYINDICATIONS / CONTRAINDICATIONSEQUIPMENTS AND ACCESSORIESPATIENT PREPARATIONMAIN VIEWSADDITIONAL VIEWSPOSITION/TECHINQUERADIATION PROTECTIONCOMMON FINDING/PATHOLOGIESCONCLUIONREFERENCES

INTRODUCTIONBarium swallow is the examination of upper GIT(John Hopkins Medicine Health Library) Upper GIT pharynx and esophagusIts done under fluoroscopy

BRIFE ANATOMY

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RADIOGRAPHIC ANATOMY

indicationshigh or low dysphagiagastro-esophageal reflux disease (GORD)assessment of hiatus herniageneralised epigastric painTumorspersistent vomitingassessment of fistula Structural problems. Such as diverticula, strictures, or polyps (growths)Esophageal varices (enlarged veins)

contraindicationssuspected perforationsuspected tracheo-oesophageal or broncho-oesophageal fistulapost-operative assessment for leakageAdhesive small bowel obstruction

Adverse effects Constipation Endotoxic shock Aspiration pneumonia

baert. et al 2009

Equipment / accessoriesFluoroscopy machineA sachet of barium sulphateSterilized Cup and spoonWarm waterSterilized gloves Radiographic markers Cassette

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NAUTH, RADIOLOGY DEPARTMENTI.D.IM. CENTRO TAC srl 2013

Patient preparationPhysical preparationPsychological preparation

Main/basic viewsAPLATERAL

Additional viewRt or Lt POSTERIOR OBLIQUE

.

Dr.Shaik Farid Aug 10, 2009

Dr.Shaik Farid Aug 10, 2009

Positioning/technique

AP POSITIONINGLATERAL POSITIONINGRadiopedia 2013

lT oblique

Radiopedia 2013

Technique contd

baert. et al 2009

Radiation protectionLead apronGonad shieldGood collimination

Common findings/pathology

conclusionBarium swallow is still the best radiographic investigation of the upper GIT with the use of liquid suspension barium sulphate contrast, but contra-indicated in conditions like suspected leakage, perforation and tracheo-esophageal fistula. Water soluble contrast is best recommended and this investigation is best done under fluoroscopy.

REFeRENCES

Anatomy for Diagnostic Imaging. Saunders Ltd. ISBN:0702029718. Read it at Google Books.Branco BC, Barmparas G, Schnriger B, et al. Systematic review and meta-analysis of the diagnostic and therapeutic role of water-soluble contrast agent in adhesive small bowel obstruction. Br J Surg 2010; 97:470478(http://www.ajronline.org/doi/full/10.2214/AJR.12.8979)Baker, ME; Einstein, DM (Mar 2014). "Barium esophagram: does it have a role in gastroesophageal reflux disease?". Gastroenterology clinics of North America 43 (1): 4768. doi:10.1016/j.gtc.2013.11.008. PMID 24503359.Baert, Henrik S. Thomsen ; Judith A.W. Webb (ed.). With contributions by P. Aspelin ... Foreword by A.L. (2009). Contrast media : safety issues and ESUR guidelines ; with 24 tables (2., rev. ed.). Berlin: Springer.Dr. helen bungay; oxford radcliffe hospital NHS trust oxford; barium swallow examination, version 3,may 2010; reviewed may 2013.Dr.Shaik Farid Aug 10, 2009 barium swallow studyEngin, G; Korman, U (Sep 2011). "Gastrointestinal lymphoma: a spectrum of fluoroscopic and CT findings.". Diagnostic and interventional radiology (Ankara, Turkey) 17 (3): 25565. doi:10.4261/1305-3825.dir.3332-10.3. PMID 20725903.John Hopkins Medicine Health Library(http://www.hopkinsmedicine.org)Levine MS, Rubesin SE. Radiologic investigation of dysphagia. AJR Am J Roentgenol. 1990;154 (6): 1157-63. doi:10.2214/ajr.154.6.2110721 - Pubmed citation.Mullan CP, Siewert B, Eisenberg RL. Small bowel obstruction. AJR 2012; 198:[web]W105W117(http://www.ajronline.org/doi/full/10.2214/AJR.12.8979)

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