What Is Barium Swallow ?
The Barium Swallow is the radiological examination to help the study of upper gastrointestinal tract from oral cavity to fundus of stomach. The barium swallow done by injection of barium Sulphate contrast media through orally.
Indication of Barium Swallow.
— Dysphagia
— Obstruction
— Pain during swallowing
— Mass region
— Diverticulum
— Gastro esophageal reflux disease
— Esophageal ulcer
— Esophageal polyps
— Esophageal stricture
— Esophageal carcinoma
— To rule out esophageal Perforation
— Weight loss
— Blood in vomiting
— Achalasia
— Diffuse esophageal spasm
— Zenker’s diverticulum
— Tracheo-oesophageal fistula
— Hiatus hernia
— Cricoid Webs
Contraindications Of Barium Swallow.
— Perforation
— Recent gastric or esophageal
— surgery
— Completely obstruction
— Tracheo- oesophageal fistula
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Equipment .
— Fluoroscopy unit / X-ray unit
— Barium pot
Contrast Media.
Single contrast study.
– 100% Barium Sulphate past.
– 80% Barium Sulphate suspension.
For Double Contrast Study.
— Barium solution of high density and low viscosity around 200 – 250% W/V for mucosal coating.
— 40 – 70 ml or more as required
— Thin Ba is used in case of suspected perforation .
Patient preparation.
— Mostly patient preparation not required but some time patient kept in NPO for 5-6 hrs.
— Ensure that no contraindication to the contrast agent used.
— Procedure should be explained to patient before undergoing the procedure.
Control Film.
— Advice prior to a water soluble contrast study, if perforation is suspected.
— AP and Lateral views are taken as control film.
Procedure /Technique.
— When the patient in radiology department to ask the patient remove the clothes and wear a hospital gown.
— During procedure time explain about the procedure.
— This procedure done by two methods.
A) Single contrast method.
B) Double contrast method.
A) Single contrast method:-
— The patient in the upright or erect position.
— The barium sulfate solution is taken into patient mouth and ask to swallow under a observation Fluoroscopy machine.
— Then the patient is ask to take a several swallow of barium sulphate solution .Than Tak film in different positions.
B) Double contrast method.
— The patient in the upright or erect position.
— Barium contrast (200 to 250%) used in double contrast method. This method help to study of mucosal details.
— The Buscopan (2ml iv)or glucagon injected into patient body.
— Than the barium Sulphate is given to the patient mouth and asked to patient to swallow under the observation of Fluoroscopy.
— Then effervescent power is given with mouthful Barium Sulphate to patient.
— Than take filming in different positions.
Filming.
— Ap view
— Lateral view
— RAO
— LAO
Aftercare
— Ask the patient to take a maximum fluid.
— To inform the patient about feces will be white for some days.
— Gave the Dulcolax to remove the barium sulfate solution through the feces.
Complications.
— Leakage of barium from unsuspecting perforation.
— Aspiration.
Advantage Of Single Contrast Study.
— Demonstrate caliber of esophagus very well.
Disadvantage of single contrast.
— Not able to visualize clearly.
— Small lesion
— Small polyps
— Small tumors
— Oesophageal varices
–Oesophageal ulsers
ALSO READ :- HSG
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Chapman & Nakielny’s Guide to Radiological Procedures: Expert Consult
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Very nicely description of all procedures