Esophageal barium meal examination

Esophageal barium meal radiography refers to barium meal radiography of the upper gastrointestinal tract. This is a relatively common examination method. It has a good examination effect on the health of the esophagus. When conducting an esophageal barium meal radiography, you must be fully prepared. For example, you must fast and abstain from water for eight hours the day before, and you must be examined on an empty stomach the next day. In addition, you should maintain a good attitude during the examination, etc. Let's take a look at this aspect.

Preparation for angiography

1. Do not eat or drink anything after 8pm the night before, and do the examination on an empty stomach the next day.

2. Under normal circumstances, take 3g of gas-producing powder orally before angiography. After swallowing it with 10ml of warm water, it will produce about 300ml of gas to inflate and expand the stomach.

3. For patients with pyloric obstruction, a gastric tube should be inserted to extract gastric juice before performing angiography.

4. The contrast agent commonly used is barium sulfate suspension, concentration: 200-250% (W/V), about 200ml, ask the patient to take a full mouthful (about 40-50ml) and stand upright in front of the examination bed.

Imaging steps

1. Perform chest and abdominal fluoroscopy first. Find out whether there are any lesions in the heart and lungs, metastatic tumors, or diseases such as lung cancer. Peritoneal fluoroscopy is performed to check for high-density shadows that are not X-ray transparent and for contraindications such as obstruction or perforation.

2. Look at the esophagus at a 45-degree right anterior angle.

3. Look at it again 45 degrees to the left front. Double oblique position is used to observe the passage of barium through the esophagus from different angles, and peristalsis can be observed in the supine position when necessary.

4. Lie down on the bed and turn 1-2 circles from right to left (quickly), then lie on your back and look at the stomach. Make sure the barium is evenly coated on the gastric mucosa as much as possible to prepare for mucosal observation.

5. Supine position, observe the posterior wall of the gastric body and antrum from the right anterior oblique

6. Supine left anterior oblique position] Observe the filling phase of the gastric fundus and gastric body and antrum and the filling phase of the duodenum

7. Look for lesions on the anterior wall of the stomach in the prone position.

8. Semi-recumbent right anterior oblique

9. Observe the filling phase and peristalsis of the gastric body and antrum in the semi-recumbent left anterior oblique position

10. Drink barium in a standing position to see the fullness of the stomach

11. Standing Compression Image

12. Finally, stand up and scan from the esophagus to the stomach again

Precautions

1. Through questioning, roughly determine whether the lesion is in the esophagus, stomach or duodenum and roughly determine the nature of the disease.

2. Position the patient during examination, with the patient's comfort as the priority.

3. Pay attention to the first one or two barium examinations. Because the upper gastrointestinal tract has good tension and less secretion at this time, patients are often more cooperative.

4. Check general parts systematically, don’t just go through the motions; check key parts repeatedly, don’t just go through the motions. The so-called systematic examination is to check all parts from the esophagus to the duodenum. The key areas refer to the sites where lesions are prone to occur, such as the middle esophagus, cardia, lesser curvature of stomach, gastric antrum, duodenal bulb and other parts. We must overcome difficulties and strive to identify difficult areas, such as the cardia.

5. To locate lesions, make full use of body position and multi-axis fluoroscopy. In addition to observation from all aspects, differential diagnosis also requires repeated observation in the same position (such as differentiation between antral gastritis and invasive antral carcinoma).

6. Palpation should be performed with both hands and eyes. Palpation should be used to observe mucosal folds and half-filling and full filling, especially the observation of mucosal folds.

7. When you find X-ray signs that are difficult to explain, think again and recheck if necessary.

8. The purpose of the reexamination is to see the emptying of the upper segment and the filling of the lower segment. In order to differentiate between functional and organic lesions, it is very important to conduct follow-up examinations (such as whether there is pyloric obstruction).