Performing a Barium meal - Learning - Home

Performing a Barium meal - Learning - Home

PERFORMING A BARIUM MEAL Department of Diagnostic Radiology 23 March 2012 M. Pieters Anatomy of the stomach J-shaped Varies in size and shape Stomach in situ

Anatomy of the stomach Anatomy of the stomach Layers of the stomach Three muscle layers, three mucosal layers Arterial supply Coeliac

artery Common hepatic artery Posterior relations Posterior relations Anterior relations Lesser sac Venous drainage

Lymph drainage of the stomach Stomach innervation Barium meal Indications

Dyspepsia Weight loss GIT haemorrhage Failed upper GIT endoscopy Assessment of perforation site Upper abdominal mass Unexplained iron deficiency anaemia Partial obstruction Contra-indications

Complete large bowel obstruction Complications Aspiration Intra-peritoneal leakage Ba appenticites Contrast agents

Barium Sulphate eg. E-Z HD 250% Carbex granules Patient preparation NPO 6hrs prior History no pharmacological contraindications Technique (Double contrast) Position

Film Action Reasoning Visualizatio n Erect/ sitting - Pt drinks

fizzing agent To distend the stomach - On left side Screen Pt drinks

barium Delays passage to duodenum Greater curve Supine, Screen tilted to the right side Cough or

swallow H2O Ba flows to Observe for GE-junction reflux Unchanged - IV muscle relaxant -

Roll to right, complete circle, end - Coating of the gastric mucosa -

Technique (Stomach Spot AP Films) Position Film Action Reasoning Visualizatio n Supine, RAO

tilted to the left - - Antrum and greater curve Supine -

- Antrum and body Supine, LAO tilted to the right - -

Lesser curve en face On right side, head up 45o - - Fundus PA

Left lateral Technique (Duodenal Spot Films) 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 (Erect Views) Fundal lesion suspected Position

Film Visualization Erect PA Fundus Erect RAO

Duodenal cap and Fundus Erect LAO Duodenal cap and Fundus Technique (Oesophageal views)

Barium swallow to conclude exam Either spot films or dynamic screening Position Film Visualization Erect RAO

Oesophagus 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/techniqu es/ugi/frame_set.htm

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