Barium swallow examination

Full description with pathology-
Audio expalnation-https://youtu.be/dH74K-_9_ag

1. Barium swallow E x a m i n ation

2. Introduction : Barium swallow is a s p e c i a l test of the pharynx, oesophagus, and proximal stomach i . e . up p e r G I t r a c t u s i n g C o n t r a s t m e d i u m a s B a r i u m , and may be performed as a single or double contrast study . Barium migration into the bloodstream, known as intravasation . Barium sulfate forms the basis for a range of contrast media used in fluoroscopic examinations of the gastrointestinal tract.

3. A d v a n t a ge & Disad vantage

4. Anatomy :

5. I n d i c a t i o n s : H i g h or low dysphagia . G a s tro-oesophageal reflux disease (GORD/GORD) . A s sessment of a hiatus hernia . G e neralised epigastric pain . G l o bus pharyngeus . P e r sistent vomiting . assessment of fistula . inability to pass the endoscope during UGIE .

6. C o n t r a d i c a t i o n s : W a t e r soluble contrast agents should be used instead of barium in the following cases: S u spected perforation . P o st-operative assessment for leak . A n a s t o m o s i s . Pregnancy . Lactating m o t h e r . U l c e r a t i o n .

7. P a t i e n t P r e p a r a t i o n s :

8. T e c h n i q ues : ( Single Contrast ) S c o ut films are obtained to rule out any foreign body, abscess or fistula . T h e examination is performed in the E r e c t lateral position after swallowing high-density barium . R ight lateral views should be obtained initially to rule out aspiration or penetration, then frontal views are obtained . D y namic videofluoroscopic examination should be simultaneously acquired for optimal evaluation . S p ots are obtained quickly during suspended respiration and under phonation (patient instructed to say "Eeeee....") to distend the hypopharynx .

9. S i n g l e Contrast f i l m

10. S i n g l e Contrast f i l m

11. S i n g l e Contrast f i l m

12. T e c h n i q ues : ( D o u b l e Contrast ) D o u ble-contrast barium swallow is the preferred mode of examination patient swallows a packet of effervescent agent and then rapidly gulps a packet of high-density barium f r o n t a l and left posterior oblique views are taken 2 e xposures are centred on the upper/mid oesophagus and two on distal oesophagus . GE junction is then observed fluoroscopically as the patient slowly turns to right, looking for elicited gastro-oesophageal reflux . A d ditional views like mucosal relief views are useful in suspected tumours, varices or oesophagitis .

13. D o u b l e Contrast f i l m

14. C o m p l i c a t i o n

15. Pathology : Hiatus hernia

16. Pathology : D o u b l e a r c h

17. Pathology : C a r c i n o m a

18. Pathology : F i s t u l a

19. P a t h o l o g y : Bar r e tt ' s E s o p h a gus

20. P a t h o l o g y : E s o p h a g i t i s

21. P a t h o l o g y : Z e n k e r ' s D i v e r t i c u l u m

22. P a t h o l o g y : S t r i t c h e r

23. P a t h o l o g y : A c h l a s i a

24. T h a n k y o u - - - - - -