Page 34 - Radiology Book

“don’t” in gi radiology
DON’T use a rectal balloon in a patient with known or suspected proctitis or rectal carcinoma. In our patient population, proctitis is usually secondary to radiation therapy (cervical and prostate carcinoma) or in ammatory bowel disease. Radiographically, the rectum may or may not be nondistensible with loss of the normal rectal values of Houston and a granular mucosa.
DON’T in ate a rectal balloon except under uoroscopic vision, after the rectum has been distended with barium.
DON’T do a barium enema examination in a patient with fulminant colitis or toxic megacolon. Radiographically, the latter appears as a dilated colon, particularly the transverse colon, with loss of the normal haustra and fold thickening (ie, thumb printing).
DON’T do a barium enema examination if a polypectomy has been performed in the last 7 days.
DON’T do a barium enema if free colonic perforation is suspected. Diluted water-soluble contrast material is indicated (ie, Gastrogra n).
DON’T perform a rectal exam or use standard adult rectal tube in patients after J-pouch Surgery. Use pediatric tubes instead
(esp for Dr. Drelichman’s patients).
DON’T give barium by mouth if a free perforation of the GI tract is suspected. Again, a water-soluble agent is a better choice (ie, Gastrogra n).
DON’T begin a GI procedure in a woman of childbearing age without inquiring about the possibility of pregnancy.
DON’T leave an obtunded patient unattended or let them leave the radiology dept with contrast material in their stomach. Aspiration of gastric contrast material is the most frequent cause of death caused by uoroscopic GI examinations. SUCTION RESIDUAL CONTRAST FROM STOMACH.
DON’T give orally more than 120 ml or 4 oz of undiluted Gastrogra n.
DON’T give oral preparations of iodinated water-soluble contrast material (ie, Gastrogra n) to patients with known or suspected aspiration or TE stula. If a water-soluble contrast agent is desired, low-osmolar intravenous contrast (e.g., Omnipaque) can be substituted.
DON’T give barium by mouth to a patient who has or may have a colonic obstruction.
DON’T vigorously insert or in ate the compression paddle under elderly patients or others with fragile bones.
DON’T use bicarbonate in patients after recent GI surgery.
DON’T do a stula or sinus tract study or a post-surgical study without a preliminary digital scout lm of the area to be studied. This should be obtained digitally.
Southfield16
GI Protocol