Single Double (Single + Air)
Barium Studies For GIT
Radiographic Anatomy & Pathology By Dr Ma moon Al-omari AlInterventional & Diagnostic Radiologist JUST
Note: Added notes will be displayed in this Font
Barium Swallow, Single Contrast
Cricopharyngeus Muscle
At level of C5-C6, Part of upper esophageal sphincter (UES)
Esophagus
Barium Swallow, Single Contrast
ain Indi ation: Dys i
Barium Swallow, Double Contrast
D ubl C
tr st
t ti
f .
I t ti f L.m i br chus
Si gl C
tr st
Barium Swallow, Single Contrast
Doubl
ontr st
Heart
Barium Swallow, Double Contrast
Indentation of L.main bronchus
Double Contrast
Single Contrast
Barium Swallow, Single Contrast
Ampulla
Normal Varient
Fun us
Bo y
Barium Swallow, Single Contrast
Aortic Arch
Barium Swallow, Double Contrast
Narrowin :
Coul be erist lsis o ot er s ot is vised
Barium Meal, Double Contrast (Supine Position) Supine Position:
Note Barium Distribution in the Fundus due to gravity
Angular otch Incisura Angularis
Antrum
Bo y
Barium Meal + Follow-Through Follow(Erect Position)
DJJ:
Normal Position= Left side
Barium Meal Angular otch
Incisura Angularis
Duo enal Cap Pyloric Canal 2n Part of Duo enum 3rd Part of Duodenum
Body Antrum
Jejunum:
Plica Circularis on the outer border
Ileum Barium Follow-Through
Barium Follow-Through to Cecum Follow(Erect Position)
DJJ:
Normal Position= Left side
2nd Part of Duodenum 3rd Part of Duodenum
Small Bowel Enema
A Modified Follow-Through which is called Small Bowel Enema note that the bowel is more distended here
This procedure involves inserting a thin tube through the mouth, esophagus and past the stomach to inject barium, methylcellulose and water into the small bowel. This allows for better visualization of the small bowel than can be seen during a small bowel follow-through
Barium Follow-through Follow-
Barium Enema, Single Contrast
Ascending Colon Transverse Colon
Descending Colon Cecum
Terminal Ileum
Sigmoid
Barium Enema, Double Contrast (Right Lateral Decubitus) Decubitus)
Hepatic Flexure
Note t e effect of ra ity
Barium Enema, Double Contrast (Prone Position)
Note the
Haustrations
If lost UC (IBD)
Cecum
Barium Enema, Double Contrast (Supine Position)
Rectum
Barium Swallow, Single Contrast
Esophagus
Proximal Dilatations arrowing (Stricture)
Bird Peak Sign DDx: Achalasia
Barium Swallow, Single Contrast Lower Esophagus
Benign Stricture:
The transitional Zone looks smooth and free of filling defects
Proximal Dilatations
Distal arrowing
Barium Swallow, Single Contrast
Malignant Stricture:
-The transitional Zone looks Irregular & ill defined - Presence of many filling defects
DDx: Adeno CA Sq. Cell CA
Filling Defect
It shows an irregularity that almost looks like an apple core lesion in the esophagus. This is typical in carcinoma of the esophagus
Barium Swallow, Single Contrast (Oblique)
Filling Defect
Malignant Stricture
Long Irregular arrowing
It shows an irregularity that almost looks like an apple core lesion in the esophagus. This is typical in carcinoma of the esophagus
Barium Swallow, Single Contrast (Oblique)
Irregular Wall & ilatation:
Tertiary Contraction (Pathological non-propulsive Contraction)
Funnel Shape (Achalasia)
Barium swallow in this patient with achalasia reveals a smooth distal tapering caused by the hypertensive lower esophageal sphincter that straddles the diaphragm, and multiple non-Peristaltic contractions throughout the body of the esophagus. This radiographic appearance sometimes has been called "vigorous achalasia". This term has little value, however, because recent studies suggest that patients with socalled vigorous achalasia cannot be distinguished clinically from nonvigorous achalasia.
Barium Swallow, Single Contrast ell Defined (Oblique) Contrast Filled left
cervical level sac
Pharyngeal Pouch (Zenker's Diverticulum):
occurs in an area of anatomic weakness known as Killian's dehiscence
Barium Swallow, Single Contrast
Irregular ulti le illing efe ts
ifferential iagnosis ulti le Eso hageal illing efe ts: 1. Fungal Infx 2. Polyps 3. Esophageal Varices (irregular) 4. Food Particles
Varices Barium swallow examination: AP view: Numerous rounded and elongated smooth-contoured filling defects are present in the inferior two thirds of the esophagus. The contour of the esophagus is irregular and spiculated.
Barium Swallow, Single Contrast
Irregular Multiple Filling Defects (Esophageal Varices)
Barium Meal, Double Contrast
Contrast Filled Speculated Lesion (Gastric Ulcer)
Barium Meal, Double Contrast
Rugae
Contrast illed Out ou ing at t e Greater Curviture ( li nant astric lcer)
Barium Meal + Follow-Through Follow-
1st Part of duodenum
Contrast Filled Speculated Lesion (Duodenal Ulcer)
2nd Part of duodenum 4th Part of duodenum 3rd Part of duodenum
Barium Meal, Double Contrast
Speculated Mass Ulcer
Pylorus
Stomach
Barium Meal, Double Contrast
Distended Stomach Single Bubble Sign DDx: astric utput bstruction ( ) (Pyloric Stenosis)
as in Descending Colon (partial obstruction)
Barium Meal, Double Contrast (Erect Position)
DDx: Pyloric Stenosis Mushroom s Sign (or apple core Sign) String s Sign
Shoulder s Sign
For further information refer to Pediatric Abdomen Radiology Slides (37-46)
Barium Enema, Double Contrast ormal Segments (Prone Position)
Skip Lesions lesions in Small intestines DDx: Crohns Disease Strictures in Small intestines
There is a short segment of abnormal descending colon with asymmetrical puckering of the mucosal surface, without stricturing. Note also however that contrast has refluxed into the terminal ileum and small bowel, and there are several strictures present within it. One of these lies adjacent to the large bowel abnormality.
Cecum
Differential Diagnosis of Terminal Ileum arrowing: 1. Tumor Lymphoma 2. Iatrogenic Adhesion 3. Inflammatory (IBD)
There is smooth narrowing of the terminal ileum and an adjacent loop of more proximal ileum as it crosses to the right side of the pelvis. There is no visible mucosal fold thickening or ulceration.
Barium Enema
Multiple Filling Defects Cobble Stone appearance DDx: Crohn s Disease
Cecu m
There is abnormal wall thickening, luminal narrowing, and cobblestoning involving a long segment of the distal ileum including the terminal ileum.
Barium Enema
Ascending colon DDx: IBD Pseudopolyps
Pseudodiverticulum
Barium Enema
Contrast Filled Sacs (outside the Lumen)
Diverticulosis in Descending
Sigmoid Colon
Barium Enema
Diverticulosis
Barium Enema, Double Contrast
Barium Enema, Double Contrast
Multiple Small Round Filling Defects DDx: Multiple Polyps
Barium Enema, Double Contrast
Loss of Haustrations LEAD PIPE SI
DDx: Ulcerative Colitis (Pancolitis)
Cecum
Terminal Ilium
Barium Enema, Double Contrast
Loss of Haustrations Splenic Flexure ranular Mucosa
Multiple Filling Defects
DDx: Ulcerative Colitis
Granular mucosa and complete absence of haustra which confirm total colitis. 2 short strictures are present in the descending colon, but there were no malignant features radiologically
Barium Enema, Double Contrast
Ask the Doctor About these
Multiple Apple Core Sign
DDx: Colon CA
Barium Enema
Stricture
Apple Core Sign
DDx: Sigmoid Colon CA
Barium Enema
Apple Core Sign
DDx: Colon CA
Barium Enema
A Sigmoid Stricture is always considered malignant until proven otherwise
Barium Enema, Double Contrast
A huge right indirect hernia in the scrotum
Barium Enema, Double Contrast
A huge mass that has displaced the intestines (Spleen)
Barium Enema
Meconium Filling defects dilated Descending Sigmoid Colon Transition Zone
is the ter applied to the region in which a arked change in caliber occurs, with the dilated, nor al colon above and the narrowed, aganglionic colon below
ccording to t e Transition Zone: ectum ltra S ort ectosigmoid S ort Transverse Colon ong Beginning of t e Colon Total ( icrocolon) DDx: Hirschsprung disease (HD) which is
ore definitively diagnosed by eans of contrast ene a exa ination, which can show the presence of a transition zone, irregular contractions, ucosal irregularity, and delayed evacuation of contrast aterial, a ong other findings Although the hall ark of the diagnosis is the presence of transition zone but it s absence exclude the disease
For ore info visit: http://e edicine. edscape.com/article/409150-imaging
le se if yo fin ny ist es or e tr i notes cont ct: ro @ ot il.co ns ll t ey ill te it
Done By:
