barium follow-through tbl
TRANSCRIPT
-
7/31/2019 Barium Follow-through TBL
1/16
Barium follow-through
Used to evaluate the small intestine
Contrast medium appears white on x-
rays,showing internal lining of the bowel
X-ray images taken as the contrast moves
through the intestine, commonly at 0 minutes,
20 minutes, 40 minutes and 90 minutes
Test completed when barium is visualized in
the terminal ileum and Caecum
-
7/31/2019 Barium Follow-through TBL
2/16
-
7/31/2019 Barium Follow-through TBL
3/16
Clinical Application
Long segment narrowing of the jejunal loops with loss of mucosal pattern
and bowel wall thickening.Diagnosis:Crohns disease
-
7/31/2019 Barium Follow-through TBL
4/16
Overhead image from a small bowel follow through in a
patient with history of Crohn's disease demonstrates
evidence of terminal ileal wall thickening, causing
narrowing of the lumen.
Frontal spot image from SBFT showssmooth elongated mass (black arrows) in
distal ileum with telescoping of small bowel
(intussusceptum, white arrow) into
adjacent lumen (intussuscipiens), producing
coil spring appearance (arrowheads). This
patient had inverted Meckel diverticulumactin as lead oint for intussusce tion.
-
7/31/2019 Barium Follow-through TBL
5/16
49-year-old woman with Crohn's disease involving small bowel. Five years
before these imaging studies were obtained, patient had undergone
segmental resection of ileum because of protein-losing enteropathy. Spot
compression image of small-bowel follow-through study obtained 1 day
afterA shows linear ulcer (arrows) in mesenteric border and
pseudosacculation (arrowheads) along antimesenteric border.
-
7/31/2019 Barium Follow-through TBL
6/16
Frontal spot image from SBFT shows primary adenocarcinoma
of small bowel as annular lesion in jejunum, with
circumferential narrowing, shelflike margins (black arrows),
and small central ulcer (white arrow).
-
7/31/2019 Barium Follow-through TBL
7/16
Contraindications
- known or suspected obstruction of the colon
- suspected tracheoesophageal fistula,
- known obstructing lesions of the small intestine,
- pyloric stenosis
- known hypersensitivity to barium sulfate formulations.- Imminent surgery and or suspected perforation; require water soluble
contrast media.
Adverse effects
aspiration pneumonitis
barium sulfate impaction
granuloma formation
intravasation, embolization and peritonitis following intestinal perforation
vasovagal and syncopal episodes
allergic reactions in atopic patients
-
7/31/2019 Barium Follow-through TBL
8/16
Small bowel enema(Enteroclysis)
Alternative for small bowel examination
A thin tube/catheter is passed down the
oesophagus, through the stomach, and into
the first part of the small intestine.
Barium liquid is then poured down the tube
Demonstrates strictures or adhesions whenthere is suspicion of intermittent obstruction
-
7/31/2019 Barium Follow-through TBL
9/16
Frontal spot image from enteroclysis shows normal
folds in distal jejunum as thin (12-mm-thick)
delicate structures perpendicular to longitudinal axis
of bowel. There are normally four to seven folds per
inch of jejunum.
-
7/31/2019 Barium Follow-through TBL
10/16
Frontal spot image from enteroclysis shows multiple smooth-
surfaced hemispheric submucosal masses (white arrows) in small
bowel; other lesions have bull's-eye appearance (black arrows)
due to central ulceration. This patient had malignant melanoma
with hematogenous metastases to small bowel
-
7/31/2019 Barium Follow-through TBL
11/16
Left posterior oblique spot image from enteroclysis shows
partially obstructing adhesive band as vertically oriented,
extrinsic, bandlike impression (arrows) traversing lumen of
jejunum, with proximal dilatation.
-
7/31/2019 Barium Follow-through TBL
12/16
Barium Enema
To examine and diagnose problems with thecolon(large intestine)
Patient lies on the X-ray table and a preliminary X-ray istaken
A well lubricated enema tube is inserted intothe rectum
Barium sulfate and air/Co2 is then allowed to flow intothe colon
A small balloon at the tip of the enema tube may beinflated to help keep the barium sulfate inside
flow of the barium sulfate is monitored by the healthcare provider on an X-ray fluoroscope screen
-
7/31/2019 Barium Follow-through TBL
13/16
Frontal spot image from double-contrast barium
enema examination (with reflux into terminal
ileum) shows carcinoid tumor as smooth, sessile,
1.5-cm-diameter polyp (black arrows) in terminal
ileum. Also note multiple ileal diverticula (whitearrows).
18-year-old woman with Crohn's
disease involving colon. Image
from double-contrast bariumenema reveals longitudinal and
perpendicular ulcerations
(arrows) in right colon.
-
7/31/2019 Barium Follow-through TBL
14/16
Peripheral T-cell lymphoma of the colon with diffuse
involvement in a 42-year-old woman.Double-contrast barium
enema image shows multiple shallow (arrows) and aphthous(arrowheads) ulcerations in the entire colon.
Small ulcerations with a
diffuse distribution
(arrows) and geographic
ulceration (arrowhead)
-
7/31/2019 Barium Follow-through TBL
15/16
Contraindication
Adverse effects
-
7/31/2019 Barium Follow-through TBL
16/16
Barium Swallow Barium Meal Barium Follow-
Through
Barium Enema
Indications Dysphagia,Heartburn,
Chest pain,Motility
disorder
Dyspepsia,Epigastric
pain,Anaemia,Vomiting
,Perforation(non-ionic
contrast)
Diarrhoea& abdominal
pain of small bowel
origin,possible
obstruction by
strictures
Altered bowel
habit,rectal
bleeding,Anaemia
Major Uses Strictures,Hiatus
hernia,GERD,motility
disorders(e.g:achalasia)
Gastric/duodenal
ulcer,gastric ca/outlet
obstruction,gastric
emptying disorders
Malabsoprtion,Crohns
disease
Neoplasia,Diverticulosi
s,strictures(e.g:ischaem
ic),megacolon
Limitations Risk of aspiration,poor
mucosal detail,unable
to biopsy
Low sensitivity for early
ca,Unable to biopsy or
assess
Helicobacter pylori
Time-
consuming,radiation
exposure
Difficult in frail elderly
or incontinent
patients,uncomfortable
,sigmoidoscopy
necessary to evaluaterectum,Misses
polyps