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    Upper Gastrointestinal Series

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    Upper Gastrointestinal Series

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    8 views9 pages

    Upper Gastrointestinal Series

    Uploaded by

    santosrichjanemanuel

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    © All Rights Reserved
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    of 9

    UGIS

    Upper Gastro - Intestinal Series/Barium meal

    Anatomic Consideration:
    The stomach is a sac-like organ below the left costal margin and the liver. Its shape is variable and differs in
    different times and it is somewhat that of a letter J in shape. It has 2 borders called curvatures, a lesser curvature on
    the right and a greater curvature on the left. It is subdivided into three parts, a centrally placed body, a ballooned-out
    portion projecting to the left called the fundus, and a constricted portion leading to the small intestine, the pylorus.
    The opening of the stomach into the esophagus is called the cardiac orifice since it lies under the heart, and the
    opening into the intestine is called the pyloric orifice.

    UPPER GASTROINTESTINAL SERIES


    • The radiographic examination of the distal esophagus, stomach, and duodenum after administering contrast
    media.
    • It requires 8 oz. of BaSO4.

    PURPOSE
    • To study radiographically the form and function of the distal esophagus, stomach, and duodenum, and to
    detect abnormal anatomic and functional conditions.

    CONTRAST MEDIA
    • Thin barium sulfate mixture
    • A thick mixture of BaSO4.
    • Water-soluble iodinated contrast media- is a form of water-soluble intravenous agent containing iodine, it
    enhances the visibility of vascular structure and organs
    during radiographic procedures.
    TYPES OF EXAMINATION

    1. SINGLE CONTRAST EXAMINATION.


    • The barium sulfate suspension is administered during the initial fluoroscopic examination for the
    type of examination.
    • The patient is given a glass of barium and instructed to drink it as directed by

    2. DOUBLE CONTRAST EXAMINATION.


    • The technologist gives the patient a gas-producing substance as powder crystals, a pill, or a
    carbonated beverage.
    • The patient is then given a small amount of high-density barium suspension, then instructed to turn
    from side to side or roll over a few times.

    3. BIPHASIC OR DUAL CONTRAST OR WELIN TECHNIQUE EXAMINATION


    • The patient is first examined by performing a double contrast examination of the upper
    gastrointestinal tract.
    • On completion, a single contrast examination was given.
    Pepsin- stomach enzyme that serves to digest protein found in ingested food.
    Peptic ulcer- it’s a break in the inner lining of the stomach

    ¢ To demonstrate gastric varices and colics.

    ¢ To demonstrate hiatal hernia


    ¢ To demonstrate any obstruction such as BEZOAR (a mass of
    undigested material that becomes trapped in the stomach).

    TRICHOTILLOMANIA- Compulsive urge to pull out one’s own hair.


    • may be triggered by depression or stress.
    • people with trichotillomania also ingest the hair that they pull

    ¢ to demonstrate tumor and carcinoma

    ¢ to demonstrate gastritis

    CONTRA-INDICATIONS
    • Sensitivity to the contrast media.
    • Patient with a history of bowel perforation laceration, and viscous rupture (an oral water-soluble iodinated
    contrast media may be used in place of barium sulfate).
    • Viscous rupture also called intestinal or bowel perforation- (gastrointestinal rupture, hole in the wall of GIT.
    • This is a life-threatening condition that occurs when the wall of the GIT ruptures and the enteric contents
    leak into the peritoneal cavity

    Patient Preparation
    1. Light evening meal.
    2. NPO at midnight. 6-8 hrs. before the schedule of exam to ensure complete gastric emptying
    3. No drinks or even smoking.
    • Smoking will cause salivation and tends to lower the BaSO4 concentration, when mixed with saliva,
    increases gastric juice secretion.
    • Laxatives such as castor oil if not contraindicated, to rid the intestines of fecaloid materials
    • Administered before bedtime.
    • The stomach can be emptied in a short period.
    4. Breakfast once the examination is finished.
    5. Patient is told to report to the x-ray department on time, first come first serve, no mental reservation
    whatsoever.
    Note:
    • The chief objective of the patient’s preparation is for the stomach to be free of any solid foodstuffs,
    or fluid materials, which may cause or lead to misinterpretation of the radiograph.
    • Attend to the patient right away when arrived at the hospital
    • Remove the jewelry that may obstruct the procedure
    • Wear gown properly
    • While the patient is undressing prepare all the necessary things needed

    AIR/GAS DISTRIBUTION IN THE STOMACH


    • Suppose an individual swallows a BaSO4 and H2O mixture along with gas-producing crystals. In that case,
    the position of the person’s body determines the distribution of Barium and air/carbon dioxide gas within the
    stomach.
    • Supine Position - The fundus of the stomach is the most posterior portion and therefore is where the heavy
    barium settles. Note the collection of gas in the body and the pylorus of the stomach.
    • Right Anterior Oblique (RAO) recumbent position -The fundus is in the highest position, causing the gas to
    fill this part of the stomach. The barium settles in the more anterior body and pylorus portions of the
    stomach.

    2 Methods Applied in the Study of UGIS


    1. Overhead or Conventional Method.
    • frequently employed because less hazardous to patient and RT
    2. Fluoroscopy-
    • More hazardous
    • Employed when taking spot filming or serial radiograph for accuracy

    PROJECTIONS
    Modifications employed in UGIS

    1. GORDON’S modification
    • The best projection to demonstrate the pylorus, the valve, the greater and lesser curvatures, and the antral
    portion of the stomach for hypersthenic patients. In this case, the filling of the distal half of the stomach is
    achieved
    • Patient in the prone position
    • CR 35-45 degrees cephalad, directed to the midpoint of the image receptor
    • Suspended respiration at the end of expiration

    2. Gugliantni modification
    • Designed for infants to demonstrate the pyloric canal and duodenal bulb
    • Patient in the prone position
    • CR 20-25 degrees cephalad

    3. Hampton’s modification
    • The best modification to demonstrate a leaflike pattern of the pylorus and the valve
    • Patient in supine
    • Rotate the body approximately 45degrees toward the side of interest is perpendicularly directed
    • Suspended respiration at the end of expiration
    UGIS for Infants

    • MOST FREQUENT INDICATION IS OBSTRUCTION


    • No feeding before the examination, starve the patient
    • A catheter is inserted down to the stomach through the nose. This is done by the attending Physician or the
    radiologist
    • Barium preparation- milk barium mixture (4 parts of barium milk and 1 part of water)
    • The barium mixture may be introduced via the pressure (syringe) or the gravity method via a catheter.
    • Take several projections in different positions, you must wrap the patient in a bedsheet like a mummy.
    • Used fast exposure technique

    Instructions that might be given to patients after GI examination

    1. Drink plenty of fluids


    2. Take a mild laxative

    estiratolintallorinradiographiccontrasteaxamination2024

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