performing a barium meal department of diagnostic radiology 23 march 2012 m. pieters
TRANSCRIPT
![Page 1: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/1.jpg)
PERFORMING A BARIUM MEAL
Department of Diagnostic Radiology
23 March 2012
M. Pieters
![Page 2: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/2.jpg)
Anatomy of the stomach
J-shaped Varies in size and shape
![Page 3: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/3.jpg)
Stomach in situ
![Page 4: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/4.jpg)
Anatomy of the stomach
![Page 5: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/5.jpg)
Anatomy of the stomach
![Page 6: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/6.jpg)
Layers of the stomach
Three muscle layers, three mucosal layers
![Page 7: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/7.jpg)
Arterial supply
Coeliac artery
Common hepatic artery
![Page 8: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/8.jpg)
Posterior relations
![Page 9: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/9.jpg)
Posterior relations
![Page 10: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/10.jpg)
Anterior relations
![Page 11: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/11.jpg)
Lesser sac
![Page 12: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/12.jpg)
Venous drainage
![Page 13: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/13.jpg)
Lymph drainage of the stomach
![Page 14: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/14.jpg)
Stomach innervation
![Page 15: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/15.jpg)
Barium meal
![Page 16: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/16.jpg)
Indications
Dyspepsia Weight loss GIT haemorrhage Failed upper GIT endoscopy Assessment of perforation site Upper abdominal mass Unexplained iron deficiency anaemia Partial obstruction
![Page 17: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/17.jpg)
Contra-indications
Complete large bowel obstruction
![Page 18: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/18.jpg)
Complications
Aspiration Intra-peritoneal leakage Ba appenticites
![Page 19: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/19.jpg)
Contrast agents
Barium Sulphate eg. E-Z HD 250% Carbex granules
![Page 20: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/20.jpg)
Patient preparation
NPO 6hrs prior History – no pharmacological contra-
indications
![Page 21: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/21.jpg)
Technique (Double contrast)
Position Film Action Reasoning Visualization
Erect/sitting
- Pt drinks fizzing agent
To distend the stomach
-
On left side Screen Pt drinks barium
Delays passage to duodenum
Greater curve
Supine, tilted to the right side
Screen Cough or swallow H2O
Ba flows to GE-junction
Observe for reflux
Unchanged - IV muscle relaxant
- -
Roll to right, complete circle, end supine, left tilt
- Coating of the gastric mucosa
![Page 22: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/22.jpg)
Technique (Stomach Spot Films)Position Film Action Reasoning Visualizatio
n
Supine, tilted to the left
RAO - - Antrum and greater curve
Supine PA - - Antrum and body
Supine, tilted to the right
LAO - - Lesser curve en face
On right side, head up 45o
Left lateral - - Fundus
AP
![Page 23: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/23.jpg)
Position Film Action Reasoning Visualization
Return to supine, on left side, then prone
AP Pt on compression pad
Avoid Ba flooding duodenal loop
AP of the Duodenal loop
Roll to right side, supine, then supine tilted to the left
RAO - Avoid Ba flooding duodenal loop
RAO of the Duodenal cap
Turn supine (shortest route)
PA - - PA of the Duodenal cap
Lie supine and tilted to the right
LAO - - LAO of the Duodenal cap
Technique (Duodenal Spot Films)
![Page 24: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/24.jpg)
Technique (Erect Views)
Fundal lesion suspected
Position Film Visualization
Erect PA Fundus
Erect RAO Duodenal cap and Fundus
Erect LAO Duodenal cap and Fundus
![Page 25: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/25.jpg)
Technique (Oesophageal views) Barium swallow to conclude exam Either spot films or dynamic screening
Position Film Visualization
Erect RAO Oesophagus
![Page 26: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/26.jpg)
Bibliography
A Guide to Radiological Procedures 5th ed - Aitchison Diagnostic and Surgical Imaging Anatomy:
Chest.Abdomen.Pelvis - Federle Anatomy for Diagnostic Imaging 3rd ed – Ryan Atlas of Human Anatomy 5th ed – Netter Atlas of anatomy – Gilroy
Web references: http://www.Instantanatomy.net http://www.Dartmouth.edu http
://www.individual.utoronto.ca/ecolak/gi_techniques/techniques/ugi/frame_set.htm
![Page 27: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/27.jpg)
![Page 28: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/28.jpg)
![Page 29: PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters](https://reader038.vdocuments.site/reader038/viewer/2022102923/551673c15503469d698b58e4/html5/thumbnails/29.jpg)