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Barium Enema and Double Contrast Study

Barium Enema and Double Contrast Study

http://info.med.yale.edu/surgery/anatomy/radiology/barium_enema_1_content.php

Yale school of medicine

SLIDES 1
Goals
1. GI tract is often injected with contrast medium to visualize abnormal anatomy and the contrast is frequently followed up with air for a “double contrast” study
2. The position of the patient is adjusted to visualize specific regions of the bowel
3. You should be able to relate the images to the surface anatomy of the patient and appreciate the changes in the position of the patient to achieve the various views.

SLIDE 2
Barium Study
- This is a double contrast BE (barium enema). For this test we put a small amount of contrast in the colon to coat the surface and then distend the colon with air.

SLIDE 3
Question: What is the main reason we perform a double contrast barium enema?
- to look for colon cancer
Question: This is an oblique view. The patient is lying on his left side. Do you see all of the contrast on the dependent side of the colon?
Qustion: What do you have to do to make sure that there is no polyps or cancers hiding in the dense contrast?
- flip the patient on to his right side

SLIDE 4
Question: Can you find the splenic and hepatic flexures on this image?
- hepatic flexure
- splenic flexure
Question: You could see how a lesion would be difficult to see in one of these flexures due to overlap of the colon. How could we clear this up?
- If we did more films with some obliquity we could eliminate this overlap

SLIDE 5
This is a single contrast barium enema (no air only contrast). Can you see the narrowing in the transverse colon?

Question: Do you know what this is?
- This is an adenocarcinoma. This is what is classically described as an apple core lesion.
Question: [...]

SLIDE 5
SUMMARY
1. In double contrast studies the patient often lies on one side and then the other to obtain films revealing the right and left walls of the large bowel.
2. Oblique views may be required to visualize the splenic and hepatic flexures

Tagged with: Barium Enema and Double Contrast Study

Categorised as: Colon Barium Enema, Colorectal Cancer, Hepatic Flexure, Splenic Flexure