Page 30 - Radiology Book

esoPHagram
1. Begin with patient upright and (1) LPO.
2. Set exposure rate at 2 frames/sec.
3. Give crystals with minimal water, patient should take as a “shot”.
4. Have patient drink 3-4 swallows of high density (thick) barium.
5. Obtain images of esophagus and follow barium bolus down to GE
junction. Repeat if necessary for suspected pathology.
6. Do (2) AP and (3) right lateral cervical esophagus with multispot
exposure (ie, 2 fr/sec).
7. Have patient rotate counterclockwise (toward left) until ventral
surface is facing table. Lower table down. Patient should be in
prone position.
8. Put patient prone RAO.
9. Perform single swallows with low density (thin) barium to evaluate
peristalsis.
10. Continuous drinking to distend GE junction, obtain distended view
distal esophagus, GE junction with single exposure setting.
11. Re ux maneuvers: patient turned to left side and then onto back,
monitor GE junction as the patient is slowly turned to the right to elicit GE re ux. Have patient bear down with Valsalva.
Total upright projections: 3 as above in parenthesis
double contrast ugi
1. Patient should be NPO.
2. Begin with patient upright and LPO.
3. Give crystals with minimal water.
4. Have patient drink 3-4 swallows of high density (thick) barium. 5. Obtain (2-3) images of the lower esophagus; GE junction.
6. Have the patient rotate counterclockwise (leftward) until ventral
surface is facing table. Lower table down. Patient should be in the
prone position.
7. Turn patient toward the left until positioned on back (supine), to get
adequate coating.
8. In supine position (1), take images of body.
9. Turn patient LPO (2), take pictures of body and antrum.
10. Right lateral (3), take picture of fundus.
11. Semi-upright RPO (4), upper body and fundus.
12. Supine LPO (5), antrum duodenum with air contrast.
13. Put patient prone RAO (6); have patient drink. Obtain images of
GE junction.
14. Still in prone RAO, compression-single contrast antrum and
duodenum.
15. Re ux maneuvers as outlined above in esophagram protocol.
Total projections: Esophagus (2); UGI (6)
ugi witH esoPHagram
1. Patient should be NPO.
2. Begin as a routine Esophagram with thick barium. Perform steps
5-8 in Esophagram protocol.
3. Then do routine UGI, steps 6-14 in UGI protocol.
4. Single swallow RAO with low density barium to evaluate peristalsis. 5. Re ux maneuvers.
Southfield16
GI Protocol