barium meal

Barium Meal

In a barium meal test, X-ray images are taken of the stomach and the beginning of duodenum (the beginning of small intestine, the passageway that takes food away from the stomach). A barium meal test is often performed straight after a barium swallow test

Methods

• Double contrast:The method of choice to demonstrate mucosal pattern.

• Single contrast – uses :Children – since it usually is not necessary to

demonstrate mucosal patternVery ill adults – to demonstrate gross pathology only.

Basic Anatomy

Barium Meal indications

• Dyspepsia.• Weight loss,• Upper abdominal mass.• Gastrointestinal haemorrhage, • Partial obstruction

Barium Meal Contraindications• Complete large bowel obstruction.

BARIUM MEALprocedure

• Contrast medium125ml Barium sulphate suspension 250% w/v

• Patient PreparationNil by mouth for 6 hr’s prior to examination. Smoking

should be avoided on the day of the examination since it increases gastric motility

• Preliminary filmsNone

Technique A gas producing agent is swallowed.

The patient then drinks the barium whilst lying on his left side, this prevents the barium from reaching the duodenum too quickly and so obscuring the greater curve.

The patient then lies supine and slightly on his right side and trendelenberg tilted to bring the barium up against the gastro oesophageal junction, this manoeuvre is ‘screened’ to check for reflux and the patient is asked to cough to encourage reflux,

Spot films are taken if reflux occurs.

An I.V. injection of a smooth muscle relaxant is given.

The patient is then asked to roll onto his right side then completely over to fully coat the stomach wall to finish in RAO position .

PositionDemonstrates

Supine RAOAntrum and greater curve

SupineAntrum and body

Supine LAOLesser curve

Supine Left Lateral, (head up 45 degree)

Fundus

ProneDuodenal loop

Prone, RAO, Supine, LAO

Duodenal Cap series

ErectFundus

Erect (RAO, LAO)Duodenal Cap series

Erect RAO SwallowOesophagus

PositionDemonstrates

Supine RAOAntrum and greater curve

SupineAntrum and body

Supine LAOLesser curve

Supine Left Lateral, (head up 45 degree)

Fundus

ProneDuodenal loop

Prone, RAO, Supine, LAO ,

Erect RAO, LAODuodenal Cap series

ErectFundus

• From prone position, the patient lies on the left side first the supine then to the right side to prevent barium flooding into the duodenum

Aftercare

• The patient should be warned his bowel motions will be white for a few days, some centres advise a mild laxative for 48 hr’s to encourage the passage of ‘barium’ and reduce the possibility of impaction.

Complications

• Leakage of ‘barium from unsuspected perforation,

• Aspiration,• Obstruction,• Barium appendicitis.• Side effects of any other drugs used.