ESOPHAGRAM PROCEDURE

Wednesday, March 4, 2015

BARIUM SWALLOW | UPPER GASTROINTESTINAL (GI) SERIES

Two common radiographic procedure of the upper GI system involving the administration of contrast media are the esophagram, or barium swallow, as it is sometimes referred to, and the upper GI series. Each of these procedures is describe in detail, beginning with the esophagram.

What is Esophagram?

 

An esophagram, or barium swallow, is the common radiographic procedure or examination of the pharynx and esophagus in which a radiopaque contrast medium is used. Occasionally, a negative or radiolucent contrast medium may be used.

What is the Purpose of Esophagram?

 

The purpose of esophagram is to study radiographically the form and function of the swallowing aspects of the pharynx and esophagus.


CONTRAINDICATION OF ESOPHAGRAM:

 

No major contraindications exist for esophagrams, except possible sensitivity to the contrast media used. The technologist should determine whether the patient has a history of sensitivity to barium sulfate or water-soluble contrast media.


PATIENT AND ROOM PREPARATION FOR ESOPHAGRAM:

 

Because the esophagus is empty most of the time, Patients need no preparation for an esophagram unless an upper GI series is to follow. When combined with an upper GI, or if the primary interest is the lower esophagus, preparation for the upper Gastrointestinal takes procedure.
For an esophagram only, all clothing and anything metallic between the mouth and the waist should be removed, and the patient should wear a hospital gown. Before the fluoroscopy procedure is performed, a pertinent history should be taken and the examination carefully explained to the patient.
The first part of an esophagram involves fluoroscopy with a positive-contrast medium. The examination room should be clean, tidy, and appropriately stocked before the patient is escorted to the room. The appropriate amount and type of contrast medium should be ready. Esophagrams generally use both thin and thick barium.

DETECTION OF RADIOLUCENT FOREIGN BODY IN ESOPHAGRAM:

 

Radiologic Technologist oftenly use the following:

 

  1. Cotton balls soaked in the thin barium
  2. Barium Pills or Gelatin capsules filled with Barium Sulfate
  3. Marshmallow.
After swallowing one of these three substances, the patient is asked to swallow an additional thin barium mixture.
Because the esophagram begins with the table in the vertical positio, the footboard should be in place and tested for security. Lead aprons, compression paddle, and lead gloves should be provided for the radiologist, as well as lead aprons for other personnel in the room. Proper radiation protection methods must be observed at all times during fluoroscopy.


GENERAL PROCEDURE OF ESOPHAGRAM:

 

Fluoroscopy with the room prepared and the patients ready, the patient and radiologist are introduced and the patient's history and the reason for the exam is discussed to the patient. The fluoroscopy examination usually begins with a general survey of the patient's chest, including the heart, lungs, and diaphragm, as well as the abdomen.
During fluoroscopy, the Radiologic Technologist duties, in general, are to follow the radiologist instructions, assist the patient as needed, and expedite the procedure in any manner posible. Because the examination is begun with the patient in an upright or errect position, a cup of thin barium is placed in the patient's left hand close to the left shoulder. The patients then is instructed to follow the radiologist instructions concerning how much to drink and when. The radiologist observes the flow of barium with the fluoroscope.

SWALLOWING ( DEGLUTION ) OF BARIUM:

 

Thin barium is observed with the patient in the various positions. Similar position may be used while the patient swallows thick barium. The used of thick barium allows better visualization of mucosal patterns and any lesion within the esophagus. The type of barium mixture to be used is determined by the radiologist.

PATIENT'S POSITION | ESOPHAGRAM


esophagram
Right Anterior Oblique
After the upright studies have been completed, horizontal and trendelenburg position with thick and thin barium may follow. A patient is shown in position for an Right Anterior Oblique (RAO) with a cup of barium. The pharynx and the cervical esophagus usually are studied fluoroscopically with spot images, whereas the main portion of the esophagus down to the stomach is studied both with flouroscopy and with postfluoroscopy ''overhead'' radiographs





PATHOLOGIC INDICATION FOR ESOPHAGOGRAM

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