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RG2A BariumStudies2

Ba follow through, small bowel enema & Ba enema

QuestionAnswer
What is valvulae conniventes? mucosal folds that go right across bowel
What are the limitations of plain AXR? 1. cant evaluate mucosa 2. cant assess bowel motility 3. cant assess level of obstruction accurately 4. cant detect perforation/leaks
When the couch is in erect position, where do the patient stand? on the foot rest
What is 'screening' (fluorscopy) used for? Fluoroscopy used to view the passage of barium/contrast through the bowel. Done intermittently throughout the examination.
What are spot films? spot films are x-ray films taken at specific times and of a specific area of the bowel
When is usually the procedure Barium follow-through performed? At the end of either barium meal or swallow examination
Barium follow-through procedure checks for _______? Small intestine
Patient is to drink barium till barium reaches __________. the Colon.
X-rays are taken at every_________ minutes until barium is seen in the colon. 20-30
Patient preparation includes (2 answers) 1. Laxative on the evening before (to help flow of barium into colon) 2. Fast 6 hours before
Indications for Ba follow-through: GPAD (mcm Ipad) GIT bleeding partial obstruction abdominal pain diarrhoea
Contra-indications for Ba follow through: CSI Complete Obstruction Suspected perforation (have to use water-soluble CM) Inflammatory diseases (eg Chrohn's disease. inflammations on bowel walls)
For the condition Valvulae Conniventes, what is the appearance of the small bowels with CM? Feathery appearance
Indications for small bowel enema: GPAD (mcm Ipad) GIT bleeding partial obstruction abdominal pain diarrhoea
How is CM introduced? By inserting a tube into patient's nose/mouth through the stomach to reach the fourth part of duodenum. the dilute barium is then infused
Spot films are taken until the barium reaches the __________. colon
What is the CM used for small bowel enema? Barium sulphate
Why is the barium sulphate being diluted? 1. there will be reduced viscosit to achieve better mucosal coating 2. there will be reduced density to allow visualisation of bowel loops
Disadvantages of small bowel enema? -intubation process may be uncomfortable for patient, thus taking longer time -higher radiation dose (intermittent spot films to check if ba fill colon already or not)
Indications for Barium enema: CARASO (rmb korean arasso)
Indications for Ba enema (II): -Chronic diarrhoea/constipation -abdominal pain -rectal bleeding -alteration in bowel habit -suspected abdominal mass -obstruction
Definition of barium enema: a radiographic study of the large intestine using a contrast media to demonstrate its components
Patient preparation (Ba enema): -laxative and clear fluid one day before -colonic washout with tepid water on day of examination(to cleanse colon of any faecal material)
What are the two types of Ba enema? Single contrast and double contrast
What does SINGLE contrasted Ba enema show? -entire colon filled with barium -shows LARGE surface abnormality
What does DOUBLE contrasted Ba enema show? -thicker barium fluid first -followed by air (double contrast) -shows finer surface abnormalities
Why is SINGLE contrasted Ba enema done? -usually done in children in whom it is not essential to demonstrate the mucosal pattern -to show site and extent of mucosal lesion urgently
Why is DOUBLE contrasted Ba enema done? -to demonstrate mucosal abnormalities
Contra-indication of Ba enema (initials): SpORT
Contra-indication of Ba enema (II): -Suspected perforation -Obstruction (complete colonic) -rectal biopsy w/in 7 days -toxic megacolon -toxic megacolon
Like barium meal preocedure, patient is rolled ________ around to coat the walls. around
"Spot films" are made with patient in various ________ to image various parts of the _______. position; colon
When preparing the enema solution, the water should be at a temperature of about ________ degree Celsius (human body temperature) 37 to 40.5
Why is using water colder than 30 degrees not favourable? may cause cramping
Why is using water warmer than 45 degrees not favourable? may scald the rectal area
what is the minimum and maximum temperature of the water to be mixed with Ba solution? 30 and 45 degree Celsius
What is the 1st thing to do when administering the enema? let enough enema solution flow through the tubing to force air out of it. this will reduce cramping when enema is administered.
After forcing air out of the tubing, what should the radiographer do to the tubing nozzle? Coat the tubing nozzle with lubricant.
which area of the patient should be lubricated? exterior of anus and as far up the rectal area as possible
why must the anus and rectal area be lubricated? tp make the tubing insertion easier and to protect skin around rectal area
the most common position for patient to receive the enema is the ______ position. Sim's
Describe the Sim's position. Lie on left side, left leg straight, right leg bent at the knee. left arm behind your back. right hand under/above the pillow on your head
to make the tube insertion easier, the tube should be ___________. twisted back and forth
the tube should be inserted no more than _____ (inches) / ____ (cm) without ________. 3; 7.5; forcing
to make it easier for patient to take in the tube, patient should be instructed to take __________. deep breaths
After successful insertion of the enema tube into the rectal area, the enema solution should be ___________. let flowing into the colon slowly
while letting the enema solution flow, the enema bag should be suspended _______ cm above patient's anus. 60-100
Suspending the enema bag too high will increase __________, and thus cause patient discomfort incoming pressure
What will happen if the enema bag is suspended too low? the fluid will flow back into the enema bag, leaving little fluid to reach colon.
Once the enema is stopped, the tube should be ________. clamped. to prevent backflow
for elderly patients doing barium enema procedure, a ______ attack could occur. vasovagal (dizzy, lost of concious)
Complications of Ba Studies: -50% mortality if barium spills into peritoneal cavity -30% will develop peritoneal adhesion
for contra-indicated Ba enema procedures, _____ CM is used. water-soluble (Gastografin)
other modalities to evaluate the GIT further: -ultrasound -CT
In US/CT, _____ and _______ can be seen (conditions of the GIT) bowel wall thickening; free/loculated fluid
US/CT can be used to check for spread of ______ in bowel cancer to _______ (other parts of body). metastases; mesentry or lymph nodes
Created by: choconad1891