BARIUM SWALLOW /

ESOPHAGRAM

DEFINITION

• Radiographic examination of pharynx & esophagus

• Utilizing radiopaque contrast media (barium sulfate)

• With guidance of fluoroscopic unit

INDICATIONS

• Dysphagia

• Assessment of TOF (tracheo-oesophageal fistulae)

• Assessment of perforated region

• Barrett’s esophagus

• Carcinoma of esophagus

• FB

• Esophageal reflux

• Zenker’s diverticulum

CONTRAINDICATIONS

• No major contraindications• Sensitivity to BaSO4 /

water soluble CM

CONTRAST MEDIA

• Barium sulfate

• Amount: 100ml

OR

• Gastrografin

• Amount: 20 ml (gastrografin) added with 80 ml saline = 100ml

EQUIPMENT

• Fluoroscopy unit

• 24 X 30 cm cassette

• Small cup, straw

• Positive contrast media :barium sulfate / gastrografin

PATIENT PREPARATIONS

• Fasting a day before examination / at least 6hrs before examination

• No smoking on the examination’s day (smoking can increase gastric motality)

• No allergic reaction to any pharmacolgical esp. Buscopan

• Check for LMP (female)

• Ensure pt is not pregnant

FILMS

PRELIMINARY FILM

• AP/PA ROI (oesophagus)

DURING PROCEDURE

FILM

• R lateral• RAO• PA

• LAO (special)

TECHNIQUE• Pt is positioned in erect, RAO

(project esophagus away from spine)

• Pt is advised to follow the instruction/order given by radiologist

• Pt is ask to drink a small cup of barium sulfate & keep the barium inside his/her mouth

• Then, radiologist ordered pt to swallow the barium & pt followed the order

• Spot films are taken

COMPLICATIONS

• Leakage of barium sulfate in cases of suspected perforated

• Aspiration of barium sulfate