barium swallow

Barium contests are superior quality unless given a specific contraception (contraindication).

Indication-

                  - Dysphagia loss of appetite.
                  - Anemia
                  - pain
                  - Assessment of tracheo-oesophageal fistulae (Determination of tracheo oesophageal fistulae)
                  - Assessment of the site of perforation (Determination of place of perfusion).

Contraindication- 

                             None

Contrast Media -

                            Barium 250% 100ml (or more as required)

                           - Gastrografin
                           - LOCM (350mg I / ml)
Note -

• Gastrografin contrast media should not be used if the patient has tracheo oesophageal fistulae or there is a possibility of contrast aspiration.
•  Barium should not be used if there is perforation in the GIT of the patient.

Equipment - 

Rapid serial radiography (2 frames per second) or video recording is required for the assessment of upper oesophagus during laryngopharynx and deglutition (ingestion).

Patient preparation - 

                                 None

Preliminary film-

                             If the perforation of the patient is suspended, then control film is taken with water soluble contrast media.

Technique- 

                  RAO (right anterior oblique) film is taken to separate the oesophagus from the spine. For this, taking a little barium in the mouth, the patient is asked to swallow it and a spot film of upper oesophagus and lower oesophagus is taken.
Apart from this, radiographs are taken in the right lateral, RAO and PA positions if needed.

Aftercare - 

                   none.

Complications -

                        - Barium lekage from an unlikely perforation.
                        - Aspiration.