Difference between revisions of "Barium swallow X-ray in bowel obstruction"

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;Distension:
 
;Distension:
 
On abdominal X-rays, the small intestine is considered to be abnormally dilated when the diameter exceeds 3&nbsp;cm.<ref name=medscape>{{cite web|url=http://emedicine.medscape.com/article/374962-overview|title=Small-Bowel Obstruction Imaging|website=[[Medscape]]|date=2016-09-22|author=Ali Nawaz Khan|accessdate=2017-02-07}}</ref><ref>{{cite web|url=http://www.radiologymasterclass.co.uk/tutorials/abdo/abdomen_x-ray_abnormalities/pathology_small_bowel_obstruction|title=Abdominal X-ray - Abnormal bowel gas pattern|website=radiologymasterclass.co.uk|accessdate=2017-02-07}}</ref> This number accounts for an expected geometric magnification in radiography, where the projection on the detector becomes larger than the actual organ.
 
On abdominal X-rays, the small intestine is considered to be abnormally dilated when the diameter exceeds 3&nbsp;cm.<ref name=medscape>{{cite web|url=http://emedicine.medscape.com/article/374962-overview|title=Small-Bowel Obstruction Imaging|website=[[Medscape]]|date=2016-09-22|author=Ali Nawaz Khan|accessdate=2017-02-07}}</ref><ref>{{cite web|url=http://www.radiologymasterclass.co.uk/tutorials/abdo/abdomen_x-ray_abnormalities/pathology_small_bowel_obstruction|title=Abdominal X-ray - Abnormal bowel gas pattern|website=radiologymasterclass.co.uk|accessdate=2017-02-07}}</ref> This number accounts for an expected geometric magnification in radiography, where the projection on the detector becomes larger than the actual organ.
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https://www.ncbi.nlm.nih.gov/pubmed/17331829
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https://www.hindawi.com/journals/bmri/2016/6569103/
  
 
==Report==
 
==Report==

Revision as of 14:00, 27 June 2018

Projectional radiography ("X-ray") with peroral intake of barium can determine whether a bowel obstruction is partial or incomplete, and may give clues to the cause.[1]

Planning

Indication

After a CT in abdominal pain indicates bowel obstruction, but otherwise inconclusive.[1]

Endpoint and chronology

Imaging is generally made until the contrast reaches the large colon (if small bowel obstruction is suspected). The first image may be taken at 2 hours after peroral contrast intake. If contrast hasn't reached the large intestine already, the frequency of further imaging depends on the progress, but the following repeat images are often made after 4-8 and then 6-10 hours.

Evaluation

Distension

On abdominal X-rays, the small intestine is considered to be abnormally dilated when the diameter exceeds 3 cm.[2][3] This number accounts for an expected geometric magnification in radiography, where the projection on the detector becomes larger than the actual organ.

Grading: https://www.ncbi.nlm.nih.gov/pubmed/17331829 https://www.hindawi.com/journals/bmri/2016/6569103/

Report

Should include:

  • Time since intake of contrast.
  • Any distension of the intestines.
  • The most distal part reached by the contrast.

There also needs to be a decision when any repeat image is taken.

References

  1. 1.0 1.1 Thompson JS (2002). "Contrast radiography and intestinal obstruction. ". Ann Surg 236 (1): 7-8. PMID 12131079. PMC: 1422542. Archived from the original. . 
  2. Ali Nawaz Khan (2016-09-22). Small-Bowel Obstruction Imaging. Medscape. Retrieved on 2017-02-07.
  3. . Abdominal X-ray - Abnormal bowel gas pattern. radiologymasterclass.co.uk. Retrieved on 2017-02-07.