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AP 2 Book

Lecture 8 exam study - SBFT

QuestionAnswer
A radiographic and fluoroscopic procedure that demonstrates the form and function of the Small Intestine Small Bowel Follow Through (SBFT)
Exam that investigates how fast it takes the contrast medium to travel through the entire small intestine A motility or timed exam - a functional study
An inflammation of the Small Intestine - may be caused by bacterial or viral infections Enteritis
A form of inflammatory bowel disease of unknown origin - often referred to as Crohn's Disease Regional Enteritis
Radiographic signs of Crohn's Disease or Regional Enteritis Cobblestone appearance of the intestine from scar tissue or string sign where segments of the intestine become narrowed
A common infection of the lumen of the small intestine that is caused by a flagellate protozoan - often spread by contaminated food and water - often affects the Duodenum and Jejunum Giardiasis
malignant tumors found in the small intestine - radiographically produce short "napkin ring" defects within the lumen of the bowel Adenocarcinomas
An obstruction of the Small Intestine - radiographically appearance of dilated loops of small bowel that look like stacks of coins on their side Ileus
Two types of Bowel Obstructions (Ileus): Adynamic and Mechanical
Examples of Mechanical Bowel Obstructions: Volvulus (twisting of intestine), adhesions (scar tissue), Intussusception (telescoping of bowel)
Examples of Adynamic Bowel Obstructions: loss of voluntary movement or lack of peristalsis caused by medications, surgery, anesthesia, or disease process
A general term used to describe a variety of malabsorption syndromes in which the gastrointestinal tract is unable to process and absorb certain nutrients Sprue
An autoimmune response to eating gluten, a protein found in wheat, barley, and rye Celiac Disease
Procedure performed to investigate the Stomach along with the Small Intestine (after UGI Overheads, patient drinks an additional cup of barium - images are taken of specific time intervals until contrast passes Large Intestine) UGI with SBFT
Procedure of the Small Intestine (patient drinks 2 c. barium, Overhead imaging at specific time intervals, 15-30 m/first hour, after every 30 m until barium reaches Large Intestine) SBFT
A radiographic and fluoroscopic procedure of the Small Intestine though an NG or feeding tube Enteroclysis
A radiographic and fluoroscopic procedure of the Small Intestine through a specialized NG Tube called Bilboa or Sellink tube (placed in Jejunum through nose, WSICM or thin barium admin. by syringe attached to NG tube, contrast injected) THERAPEUTIC Intubation SBFT
What procedure can be therapeutic if the patient has a known Small Bowel Obstruction An Intubation SBFT
Once tube placement has occurred with an Intubation SBFT procedure, what is done with the tube? it is connected to a suction machine to remove gas and fluid to relieve distention of the bowel caused by SBO
With thin barium administered during a SBFT, if the patient exhibits Hypomotility of the Small Intestine, what may be provided to promote the transition time of the Barium? Ice water
What travels faster through the GI tract than barium sulfate? Water-soluble Iodinated Contrast Media
What may be added to Barium to increase peristalsis and transit time of contrast media through the Small Intestine? Water-soluble Iodinated Contrast Media
When is Water-soluble contrast media used in a SBFT exam? When Barium Sulfate is contraindicated
What projection is commonly performed if a Small Bowel Follow Through examination is ordered without performing the UGI first? An AP SCOUT Projection
When is the Fluoroscopic procedure performed in a SBFT and why? At the end of the procedure to demonstrate the Ileocecal Valve and to document that the entire length of the Small Intestine has been investigated
What should you tell the patient to prepare them for the examination? Make sure that the patient understands this could be a long procedure and that it depends on motility of their digestive system
Imaging sequence for a SBFT: 15 minute (if performed with UGI) 30 minute (If SBFT only) 45 minute 60 minute 90 minute 2 hour
SBFT procedure images: 1 2 1. AP SCOUT Projection 2. AP/PA Overheads after ingestion of Barium Sulfate
AP SCOUT Projection - SBFT: CR: kV: Symphysis Pubis: CR: Perpendicular 2-3 inches above Iliac Crest (to include upper abdomen kV: 70-80 kV is used because there is no contrast in abdomen Symphysis Pubis: does not have to be included - this is an upper abdomen image
AP/PA Overheads after ingestion of Barium Sulfate - SBFT - depends upon the? Preference of Radiologist and Patient condition
The PA Projection (prone recumbent) Overhead after ingestion of Barium Sulfate, is preferred if tolerated by patient because: 1. 2. 1. It places the Small Intestine closer to the Image Receptor 2. It utilizes natural compression to separate the loops of the bowel, making each segment more visible
Each image for a SBFT must be marked or annotated with what? The time taken
1st Projection after ingestion of barium Sulfate: CR: kV: CR: Perpendicular 2-3 inches above Iliac Crest kV: 100-125
Additional Projections after ingestion of barium sulfate: CR: CR: level of Iliac Crest Symphysis Pubis is included
One or more of the following structures will be demonstrated on the last overhead image: 1. The terminal Ileum or Ileocecal valve on last timed image 2. Cecum or Ascending Colon visualized - visible differences in diameter and location of barium 3. Large Intestine located around the periphery of the abdomen - haustral markings 4. Appendix
kV for a SBFT? high kV 90-125
A very thin barium, contains a 0.1% barium sulfate suspension Volumen
When a patient is intubated, where is imaging done for the fluoroscopic procedure? CT department for imaging
Procedure of the Small Intestine that requires luminal distension, by Oral or Jejunal administration of contrast medium MR Enteroclysis
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