2 Special (stomach)+ SMALL INTESTINE

Hamptons LPO

Demonstrate leaf like pattern of the pylorus and the bulb

Poppel’s Method Right lateral recumbent

demonstrate retrogastric and evaluate pancreatic mass

WOLF AND GUGLIELMO METHOD (PA OBLIQUE PROJECTION)

adequate contrast filling and max distension of entire esophagus

WOLF AND GUGLIELMO METHOD REFERENCE POINT

T6-T7 – result to 10–20-degree caudad

WOLF AND GUGLIELMO METHOD Useful for

demonstrates the relationship of the stomach to the diaphragm and is useful in diagnosing a hiatal hernia

SMALL INTESTINE EXAMINATION Oral Method

Ingestion of barium through mouth

SMALL INTESTINE EXAMINATION Preliminary Radiograph

usually preceded by a preliminary radiograph of the abdomen

SMALL INTESTINE EXAMINATION Radiograph Identification

Each radiograph of the small intestine is identified with a time marker indicating the interval between its exposure and the ingestion of barium

SMALL INTESTINE EXAMINATION Supine Position Use

• to take advantage of the superior and lateral shift of the barium-filled stomach for visualization of the retrogastric portions of the duodenum and jejunum

• to prevent possible compression overlapping of loops of the intestine.

• to compress the abdominal contents, which increases radiographic quality

SMALL INTESTINE EXAMINATION Trendelenburg Position Use

For the final radiographs in thin patients, it may be necessary to angle the table into the Trendelenburg position to "unfold" low-lying and superimposed loops of the ileum.

SMALL INTESTINE EXAMINATION First Radiograph Time

usually taken 15 minutes after the patient drinks the barium.

SMALL INTESTINE EXAMINATION Next Exposure Interval

varies from 15 to 30 minutes depending on the average transit time of the barium sulfate preparation used

SMALL INTESTINE EXAMINATION Hypomotility Stimulant

• a glass of ice water (or other routinely used food stimulant) may be given to the patient after 3 or 4 hours of administering barium sulfate to accelerate peristalsis

• watersoluble gastrointestinal contrast medium, tea, or coffee to stimulate peristalsis.

• peristaltic stimulants every 15 minutes through the transit time

SMALL INTESTINE EXAMINATION Fluoroscopy Time (Stimulant Method)

medium transit demonstrated fluoroscopically, examination usually completed in 30 to 60 minutes

PA or AP PROJECTION Purpose

Demonstrates small intestine progressively filling until the barium reaches the ileocecal valve

PA or AP PROJECTION Final Step (1)

When the barium has reached the ileocecal region, fluoroscopy may be performed, and compression radiographs may be obtained

PA or AP PROJECTION Final Step (2)

The examination is usually completed when the barium is visualized in the cecum, typically in about 2 hours for a patient with normal intestinal motility.

Examination Completion

completed when the barium is visualized in the cecum