PDF Radiology of the Stomach and Duodenum

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Radiology of the Stomach and Duodenum aims to “provide useful and informative reading for any radiologist with an interest in the stomach.
Table of contents

The patient will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken. When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained.

Radiology of Stomach (Barium Meal) - Prof. Dr. Mamdouh Mahfouz (In Arabic)

Occasionally, patients find the thick consistency of the barium unpleasant and difficult to swallow. The liquid barium has a chalky taste that may be masked somewhat by added flavors such as strawberry or chocolate.

ECR 2017 / C-0037

Being tilted on the examination table and having pressure applied to the abdomen can be uncomfortable for some patients. The examination may also make you feel bloated. If you receive gas-producing crystals, you may feel the need to belch. However, the radiologist or technologist will tell you to try to hold the gas in by swallowing your saliva if necessary to enhance the detail on the x-ray images. In some medical centers, the technologist can minimize patient movement by automatically tilting the examining table.

These actions ensure that the barium is coating all parts of the upper GI tract. As the procedure continues, the technologist or the radiologist may ask you to drink more barium. You may hear the mechanical noises of the radiographic apparatus moving into place during the exam. After the examination, you can resume a regular diet and take orally administered medications unless instructed otherwise by your doctor. The barium may color your stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation , which is usually treated by an over-the-counter laxative.

Drinking large quantities of fluids for several days following the test can also help.


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If you are unable to have a bowel movement or if your bowel habits undergo any significant changes following the exam, you should contact your physician. A radiologist , a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician , who will discuss the results with you. Follow-up exams may be needed. If so, your doctor will explain why. Sometimes a follow-up exam is done because a potential abnormality needs further evaluation with additional views or a special imaging technique.

A follow-up exam may also be done to see if there has been any change in an abnormality over time. Follow-up exams are sometimes the best way to see if treatment is working or if an abnormality is stable or has changed. Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection organizations continually review and update the technique standards used by radiology professionals.

Modern x-ray systems have very controlled x-ray beams and dose control methods to minimize stray scatter radiation. This ensures that those parts of a patient's body not being imaged receive minimal radiation exposure. The test will detect larger ulcers. It can also suggest the presence of underlying infection with the bacterium, Helicobacter pylori, the most common cause of ulcers; but additional noninvasive tests such as a blood test or breath test may be required to confirm this infection.

Finally, biopsies of any abnormal areas cannot be performed with this test. Please type your comment or suggestion into the text box below. Note: we are unable to answer specific questions or offer individual medical advice or opinions. Some imaging tests and treatments have special pediatric considerations.

Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region.

Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America RSNA and the American College of Radiology ACR , comprising physicians with expertise in several radiologic areas.


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    Upper Gastrointestinal Series

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    Differential diagnosis

    The parenchyma is normal and thereby has the same risks of hepatic pathology as the rest of the liver except theoretically in trauma, where it is more prone injury following trauma to the left upper quadrant or lower left chest. Gray's Anatomy 39th Edition, Elsevier 2. Schumacher U. Thieme Atlas of Anatomy. Thieme Georg Verlag. Read it at Google Books - Find it at Amazon 3. Applied Radiological Anatomy. Cambridge University Press.

    Differential diagnosis

    Read it at Google Books - Find it at Amazon 4. Yamada S, Okajima K.

    Upper gastrointestinal series - Wikipedia

    Study of lymph node metastasis around the left renal vein in gastric cancer, Surgical Gastroenterology. Clinopathological study about the paraortic lymphnode metastases of gastric cancer, Surgical Gastroenterology, Last's anatomy, regional and applied. Churchill Livingstone. Ultrasound assessment of gastric volume in severely obese individuals: a validation study. Point-of-care ultrasound defines gastric content and changes the anesthetic management of elective surgical patients who have not followed fasting instructions: a prospective case series.

    Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume. Endoscopic treatment for Bouveret syndrome. Bouveret syndrome. Laparoscopic treatment of a gastric outlet obstruction caused by a gallstone Bouveret's syndrome. Laparoscopic adjustable gastric banding: What radiologists need to know. A prospective randomized trial of different laparoscopic gastric banding techniques for morbid obesity.

    Management of trichobezoar: Case report and literature review. Pediatr Surg Int ; High incidence of gastric bezoars in cystic fibrosis patients after lung transplantation. Transplantation ; Gastrointestinal bezoars: Sonographic and CT characteristics. Ingested foreign bodies of the gastrointestinal tract: Retrospective analysis of cases. World J Surg.

    Emphysematous infections of the abdomen and pelvis: A pictorial review. Gas within the wall of the stomach report of a case and review of the literature. Dig Dis Sci ; Pathogenesis, diagnosis, and management of gastric ischemia. Clin Gastroenterol Hepatol ; The significance of gastric and duodenal histological ischemia reported on endoscopic biopsy. Endoscopy ; Coumarin-induced intramural hematoma of the duodenum: Case report and review of the literature.

    Arain J, Al-Dabbagh A. Gastric outlet obstruction secondary to spontaneous intramural haematoma as a complication of warfarin treatment. Multimodality imaging of adult gastric emergencies: A pictorial review. Indian J Radiol Imaging ; Gastric Anatomy. Figure 1 A and B : Normal gastric anatomy: Upper GI fluoroscopy image A showing the normal gastric anatomy including air filled fundus, body, incisura angularis arrow , antrum, and pyloric canal. Role of Imaging. Table 1: Imaging findings in adult gastric emergencies Click here to view.