Radiography of stomach and duodenum
X-ray examination remains an important method not only in the study of bone structures that absorb x rays and produce clear images. The gastrointestinal tract is no exception. Moreover, despite the fact that the digestive tract is not radiopaque. Fluoroscopy of the stomach and intestines is carried out today in almost any hospital.
For informative studies of the lumen of the digestive tract only need to fill out a substance that is radiopaque. This applies to the barium. This substance, falling into the gastric cavity, and then into the intestine, coats the wall, fills the lumen, making visible all its internal bends and defects. A barium swallow test is safe. The drug is tasteless, it is absolutely not absorbed in the intestine and excreted whole without loss. Allergies to it are rare.
The day before the study, it is recommended to refuse to accept dense, poorly digestible or gas-forming foods. From the night before eliminates the meal at all. You are only permitted to drink water.
On the recommendation of the attending physician, if you have an x-ray of the stomach may be prescribed a cleansing enema.
If you plan a study of the rectum or large intestine, the diet changes still for 2-3 days. In addition, it is recommended to perform a cleansing of the intestine with the help of special preparations: Fortrans, Lavacolla. Also prescribed a cleansing enema. Need to get after all the training and enemas clean rinse water. The quality of the research depends on the quality of preparation for it. If the intestines are left in the stool, then the information content of the research may suffer. If the patient is prone to chronic constipation, he recommended more extensive training. This can be the additional intake of laxatives, enemas.
In the morning, at the beginning of the study is the review radiography abdominal cavity. Then the patient drinks a barium mixture. The radiologist watches on the fluoroscope screen during its progress through the digestive tract. Barium should fill the stomach and labeling, thus, its internal topography. If necessary, for better visualization, the radiologist may ask the patient to turn around, to lie on the other side, can put pressure on your stomach so the barium filled and outlined every curve of the stomach. X-rays of the stomach is about a quarter of an hour. Then the barium begins to flow into the duodenum, then thin, and then into the large intestine.
If you only need an x-ray study of the colon, barium can be administered directly to the intestine through the anus, entered the tube. The gut check will take about an hour.
The barium mixture has a slight chalky aftertaste. Mostly patients do not experience difficulties with its use, but in rare cases nausea, vomiting. No soreness while advancing through the intestines of a suspension of barium does not occur.
While under an x-ray of the stomach and remaining digestive tract, the radiologist makes a number of shots.
The advantages of the method
Fluoroscopy of the gastrointestinal tract has a number of advantages, which explains its widespread use today:
- accessibility (рентгеновскийаппаратибарийестьпрактическивлюбойбольницеиширокоприменяются);
- ease of implementation;
- affordable price;
- safety (risk of allergic reactions is small).
Interpretation of results
During the examination a radiologist first evaluated the quality of images, the degree of preparation of the gastrointestinal tract to the survey. Then determined by the dimensions of the digestive tract, internal relief (folding of the intestines, flattening the folds), the time advance of barium, the presence of obstacles. Upon detection of the defect is evaluated for its size, clarity of outline, form. Also appreciated the peristalsis, that is, the time during which the barium must leave consistently every organ. After a certain time, snapshots. So, after 3 hours, the barium is no longer in the stomach, after 6 hours in the intestine.
There are a number of specific radiological signs of gastrointestinal diseases, which describes the radiologist:
- A change in the lumen. Narrowing it may be due to education, growing inside, for example cancer tumor, polyps. Can reduce the lumen compression of the outside of the stomach or intestine. Widening of the lumen is also possible. Has been uneven, the expansion in the diverticula.
- The displacement of the body. X-ray of the stomach may show him the omission, or gastropod, in severe cases it can lead to the fact that it will be located in the pelvis.
- Violation of the integrity of the authority.
- The symptom of «niche». A defect in the wall of the stomach filled with contrast gives the picture shows the intense degree of darkening is probably somewhat beyond the perimeter of the body. This manifestation may indicate peptic ulcer disease. Often he is revealed, when is radiography of the stomach and duodenum.
- Filling defect. It shows the contrast bypassed and has not penetrated. It may be a polyp growing inside the lumen, tumor, foreign body.
- Violation of the orientation of the folds. If you rendered the folds are brought together, and directed this towards «niche», we can assume the ulcerative defect.
- Flattening the folds. Such a symptom is determined by the inflammatory phenomena. When inflammation and, as a result, swelling of the intestinal wall, its folding becomes less pronounced.
- Fluid levels (bowl kloybera). This symptom is characteristic of intestinal obstruction when the intestine retained fluid in place of the bends of the intestine, forming a «bowl» with liquid contents of the intestine.
- For intestinal obstruction and indicates the following symptom: bowel loops to the point of violation of patency of the intestine are stretched and inflated with gas, and after the stenosis collapsed.
The radiologist describes all identified radiographic signs. All the pictures, their description is sent to the attending physician and kept in the subsequent history of the patient.
Contraindicated x-ray examination with the barium in the following cases:
- the acute phase of the inflammatory process;
- perforation of a hollow organ of the gastrointestinal tract.
Thus, x-ray examination remains today one of the leading methods of diagnosis of diseases of the digestive tract. It will allow to reliably determine the presence of ulcers, polyps, diverticulitis, intestinal obstruction, to assume the tumors of the digestive tract.