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Barium Swallow

Barium Swallow. Jason Carnes September 27, 2007. Overview. Introduction Technique Indications Limitations Cases. Introduction. Barium Swallow = Esophagram or Upper GI series Used to diagnose pathology in the esophagus, stomach, and duodenum

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Barium Swallow

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  1. Barium Swallow Jason Carnes September 27, 2007

  2. Overview • Introduction • Technique • Indications • Limitations • Cases

  3. Introduction • Barium Swallow = Esophagram or Upper GI series • Used to diagnose pathology in the esophagus, stomach, and duodenum • Use barium to coat the lining so these organs are visible on x-ray

  4. Technique • Patient will need to be NPO after midnight before the exam • The patient will have to swallow a contrast agent: Barium or Gastrograffin • May also swallow sodium bicarbonate for double contrast barium swallow • X-ray tech will have the patient perform various maneuvers so that the barium can coat the GI tract

  5. Technique • Tech takes a series of plain films or uses fluoroscope to identify any pathology • Films are then read by radiologist • The patient should drink plenty of fluids and may need a laxative after the test because the barium can be constipating

  6. Indications • Odynaphagia • Dysphagia • Hematemesis • Abdominal pain • Unexplained weight loss

  7. Achalasia

  8. Diffuse Esophageal Spasm

  9. Strictures

  10. Squamous Cell Carcinoma

  11. Adenocarcinoma

  12. Crohn’s Disease

  13. Limitations • Not good for evaluating small ulcers • Cannot test for H. pylori or take biopsies of ulcers • Not specific for diagnosis of esophagitis • Not possible to provide interventions for any lesions

  14. Case • 63 year old male comes in with complaints of chronic bad breath and regurgitation of undigested food when laying down at night. • You order a barium swallow.

  15. Case • Zenker’s Diverticulum

  16. Case • 29 year old female with a past medical history significant for HIV/AIDS comes in with complaint of 8 pound weight loss over the past 2 weeks and pain on swallowing. Also feels like food is getting stuck in her throat. • Takes HAART therapy and Septra but is noncompliant with meds. • You order a barium swallow.

  17. Case • Candida Esophagitis

  18. Case • 33 year old female presents with complaints of dysphagia of both solids and liquids. She also complains that her hands turn white when they are cold and that she feels like the skin on her face has been getting very tight over the past few years. • You order a barium swallow.

  19. Case • Scleroderma Esophagus

  20. Case • 49 year old male presents with complaint of progressive dysphagia. Also complains of weakness and double vision that are worse at the end of the day and improve upon awakening in the morning. Denies any pain with swallowing. Nonsmoker and nonalcoholic. No PHM. • You order a barium swallow.

  21. Case • Thymoma causing compression of esophagus

  22. Conclusion • Barium Swallow is a safe and easy initial test for several upper GI complaints • Has certain limitations that need to be considered when ordering and interpreting

  23. Questions?

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