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Barium Swallow

(Esophagography, Esophagogram)
Procedure overview
What is a barium swallow?
A barium swallow is a radiographic (X-ray) examination of the upper gastrointestinal (GI) tract,
specifically the pharynx (back of mouth and throat) and the esophagus (a hollow tube of muscle
extending from below the tongue to the stomach). The pharynx and esophagus are made visible
on X-ray film by a liquid suspension called barium sulfate (barium). Barium highlights certain
areas in the body to create a clearer picture. A barium swallow may be performed separately or
as part of an upper gastrointestinal (UGI) series, which evaluates the esophagus, stomach, and
duodenum (first part of the small intestine).
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones,
and organs on film. X-rays are made by using external radiation to produce images of the body,
its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues
onto specially-treated plates (similar to camera film) and a "negative" type picture is made.
Fluoroscopy is often used during a barium swallow. Fluoroscopy is a study of moving body
structuressimilar to an X-ray "movie." A continuous X-ray beam is passed through the body
part being examined, and is transmitted to a TV-like monitor so that the body part and its motion
can be seen in detail. In barium X-rays, fluoroscopy allows the radiologist to see the movement
of the barium through the pharynx and esophagus as a person drinks.
Why is barium used with X-rays?
Barium is a dry, white, chalky, metallic powder that is mixed with water to make a thick,
milkshake-like drink. Barium is an X-ray absorber and appears white on X-ray film. When
swallowed, a barium drink coats the inside walls of the pharynx and esophagus so that the
swallowing motion, inside wall lining, and size and shape of these organs is visible on X-ray.
This process shows differences that might not be seen on standard X-rays. Barium is used only
for diagnostic studies of the GI tract.
The use of barium with X-rays contributes to the visibility of various characteristics of the
pharynx and esophagus. Some abnormalities of the pharynx and/or esophagus that may be
detected by a barium swallow include tumors, ulcers, hernias, diverticula (pouches), strictures
(narrowing), inflammation, and swallowing difficulties.
Another related procedure that may be used to diagnose upper GI problems is
esophagogastroduodenoscopy (EGD). Please see this procedure for additional information.
About the pharynx and esophagus

Click Image to Enlarge
Digestion is the process by which food and liquid are broken down into smaller parts so that the
body can use them to build and nourish cells, and to provide energy. Digestion begins in the
mouth, where food and liquids are taken in, and is completed in the large intestine.
One of the main functions of the pharynx is swallowing. The main function of the esophagus is
the forward propulsion of foods to the stomach.
Reasons for the procedure
A barium swallow may be performed to diagnose structural or functional abnormalities of the
pharynx and esophagus. These abnormalities may include, but are not limited to:
Cancers of the head, neck, pharynx, and esophagus
Tumors
Hiatal hernia. Upward movement of the stomach, either into or alongside the esophagus
Structural problems. Such as diverticula, strictures, or polyps (growths)
Esophageal varices (enlarged veins)
Muscle disorders (pharyngeal or esophageal). Such as dysphagia (difficulty
swallowing) or spasms (pharyngeal or esophageal)
Achalasia. A condition in which the lower esophageal sphincter muscle doesn't relax and
allow food to pass into the stomach
Gastroesophageal reflux disease (GERD) and ulcers
There may be other reasons for your physician to recommend a barium swallow.
Risks of the procedure
You may want to ask your physician about the amount of radiation used during the procedure
and the risks related to your particular situation. It's a good idea to keep a record of your past
history of radiation exposure, such as previous scans and other types of X-rays, so that you can
inform your physician. Risks associated with radiation exposure may be related to the cumulative
number of X-ray examinations and/or treatments over a long period of time.
If you're pregnant or suspect that you may be pregnant, you should notify your physician.
Radiation exposure during pregnancy may lead to birth defects.
Patients who are allergic to or sensitive to medications, contrast dyes, iodine, or latex should
notify their physician.
Constipation or fecal impaction may occur if the barium isn't completely eliminated from the
body.
Contraindications for a barium swallow may include, but are not limited to:
Esophageal or bowel perforation
Bowel obstruction or severe constipation
Pregnancy
Severe swallowing difficulty such that aspiration (entry of substances into the lungs) of
barium is likely
There may be other risks depending upon your specific medical condition. Be sure to discuss any
concerns with your physician prior to the procedure.
Before the procedure:
Your physician will explain the procedure to you and offer you the opportunity to ask any
questions that you might have about the procedure.
You may be asked to sign a consent form that gives your permission to do the procedure.
Read the form carefully and ask questions if something is not clear.
You'll be asked to not eat or drink liquids for eight hours before the procedure, generally
after midnight.
If you're pregnant or suspect that you may be pregnant, you should notify your physician.
Notify your physician if you're sensitive to or are allergic to any medications, latex, tape,
and anesthetic agents (local and general).
Notify your physician of all medications (prescribed and over the counter) and herbal
supplements that you're taking. Your physician may advise you to withhold certain
medications prior to the procedure.
Notify the radiologist if you've had a recent barium X-ray or cholangiography procedure,
as this may interfere with obtaining an optimal X-ray exposure of the upper GI area.
Based upon your medical condition, your physician may request other specific
preparation.
During the procedure
A barium swallow may be performed on an outpatient basis or as part of your stay in a hospital.
Procedures may vary, depending on your condition and your physician's practices.
Generally, a barium swallow follows this process:
1. You'll be asked to remove any clothing, jewelry, or other objects that may interfere with
the procedure.
2. If you're asked to remove clothing, you'll be given a gown to wear.
3. You'll be positioned on an X-ray table that can tilt you from a horizontal to an upright
position. You may also be asked to change positions (for example, lying on your side,
back, or stomach) at intervals during the procedure.
4. Standard X-rays of the heart, lung, and abdomen may be performed first.
5. The radiologist will ask you to take a swallow of a thickened barium drink. The barium is
usually flavored, although it may not be very pleasant tasting.
6. As you swallow the barium, the radiologist will take single pictures, a series of X-rays, or
a video (fluoroscopy) to observe the barium moving through the pharynx.
7. You may be asked to hold your breath at certain times during the procedure.
8. You will be given a thinner barium drink to swallow. X-rays and/or fluoroscopy will be
used to observe the barium's passage down the esophagus. You may also be asked to
swallow a barium tableta small, solid pill, which can help to visualize certain structural
problems of the esophagus.
9. If an additional procedure called a small bowel follow-through has been requested, it will
be performed after the barium swallow has been completed.
10. Once all required X-rays have been taken, you'll be assisted from the table.
After the procedure
You may resume your normal diet and activities after a barium swallow, unless your physician
advises you differently.
Barium may cause constipation or possible impaction after the procedure if it isn't completely
eliminated from your body. You may be advised to drink plenty of fluids and eat foods high in
fiber to expel the barium from the body. You may also be given a cathartic or laxative to help
expel the barium.
Since barium isn't absorbed into the body but passes through the entire intestinal tract, your
bowel movements may be lighter in color until all of the barium has been excreted.
Notify your physician to report any of the following:
Difficulty with bowel movements or inability to have a bowel movement
Pain and/or distention of the abdomen
Stools that are smaller in diameter than normal
Your physician may give you additional or alternate instructions after the procedure, depending
on your particular situation.
Online Resources
The content provided here is for informational purposes only, and wasn't designed to diagnose or
treat a health problem or disease, or replace the professional medical advice you receive from
your physician. Please consult your physician with any questions or concerns you may have
regarding your condition.
This page contains links to other websites with information about this procedure and related
health conditions. We hope you find these sites helpful. But please remember we don't control or
endorse the information presented on these websites, nor do these sites endorse the information
contained here.
American Cancer Society
American Gastroenterological Association
National Cancer Institute (NCI)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Institutes of Health (NIH)
National Library of Medicine















Barium Enema
(BE, Lower Gastrointestinal Series, Lower GI Series, Colon X-ray)
Procedure Overview
What is a barium enema?
A barium enema is a radiographic (X-ray) examination of the lower gastrointestinal (GI) tract.
The large intestine, including the rectum, is made visible on X-ray film by filling the colon with
a liquid suspension called barium sulfate (barium). Barium highlights certain areas in the body to
create a clearer picture.
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones,
and organs on film. X-rays are made by using external radiation to produce images of the body,
its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues
onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the
more solid a structure is, the whiter it appears on the film).
Fluoroscopy is often used during a barium enema. Fluoroscopy is a study of moving body
structuressimilar to an X-ray "movie." A continuous X-ray beam is passed through the body
part being examined, and is transmitted to a TV-like monitor so that the body part and its motion
can be seen in detail. In a barium enema, fluoroscopy allows the radiologist to see the movement
of the barium through the large intestine as it is instilled through the rectum.
Why is barium used with X-rays?
Barium is a dry, white, chalky, metallic powder that is mixed with water to make barium liquid.
Barium is an X-ray absorber and appears white on X-ray film. When instilled via the rectum,
barium coats the inside wall of the large intestine so that the inside wall lining, size, shape,
contour, and the colon's patency are visible on X-ray. This process shows differences that might
not be seen on standard X-rays. Barium is used only for diagnostic studies for the GI tract.
The use of barium with standard X-rays contributes to the visibility of various characteristics of
the large intestine. Some abnormalities of the large intestine that may be detected by a barium
enema include tumors, inflammation, polyps (growths), diverticula (pouches), obstructions, and
changes in the intestinal structure.
After the instillation of barium into the rectum, the radiologist may also fill the large intestine
with air. Air will appear black on X-ray film, contrasting with barium's white image. The use of
the two substances, barium and air, is called a double contrast study.
The purpose of using two contrast substances is to achieve an enhancement of the inside wall
lining of the large intestine. As the air expands the large intestine (like blowing up a balloon), a
barium coating is formed on the inner surface of the colon wall. This technique enhances
visualization by sharpening the outline of the inner surface layer of the large intestine. The
benefit of this technique is to show smaller surface abnormalities in the large intestine.
Other related procedures that may be used to diagnose lower GI problems include colonoscopy,
abdominal X-ray, CT (computed tomography) scan of the abdomen, and abdominal ultrasound.
Please see these procedures for additional information.
Anatomy of the colon

Click Image to Enlarge
The large intestine, or colon, has four sections:
Ascending colon. Extends upward on the right side of the abdomen
Transverse colon. Extends from the ascending colon across the body to the left side
Descending colon. Extends from the transverse colon downward on the left side
Sigmoid colon. Named because of its S-shape; extends from the descending colon to the
rectum
The rectum joins the anus, or the opening where waste matter passes out of the body.
Reasons for the procedure
A barium enema may be performed to diagnose structural or functional abnormalities of the large
intestine, including the rectum. These abnormalities may include, but are not limited to:
Ulcerative colitis. Ulcerations and inflammation of the large intestine
Crohn's disease. Ulcerations and inflammation occurring in any part of the GI tract
(mouth to anus)
Obstructions and polyps (growths)
Cancer
Unusual bloating or lower abdominal pain
Unexplained weight loss
Irritable bowel syndrome
Changes in bowel movements. Such as chronic diarrhea or constipation, or passing of
blood, mucus, and/or pus
There may be other reasons for your doctor to recommend a barium enema.
Risks of the procedure
You may want to ask your doctor about the amount of radiation used during the procedure and
the risks related to your particular situation. It's a good idea to keep a record of your past history
of radiation exposure, such as previous scans and other types of X-rays, so that you can inform
your health care provider. Risks associated with radiation exposure may be related to the
cumulative number of X-ray examinations and/or treatments over a long period of time.
If you're pregnant or suspect that you may be pregnant, you should notify your doctor. Radiation
exposure during pregnancy may lead to birth defects.
Patients who are allergic to or sensitive to medications, contrast dyes, iodine, or latex should
notify their health care provider.
Constipation or fecal impaction may occur if the barium isn't completely eliminated from the
body.
Risks of barium enema may include, but are not limited to:
Colon perforation
Water intoxication (excess intake of water) from cleansing enemas prior to the procedure
Constipation or fecal impaction
Contraindications for a barium enema include, but are not limited to:
Suspected bowel perforation
Severe ulcerative colitis
Pregnancy
Toxic megacolon
Acute abdominal pain
There may be other risks depending on your specific medical condition. Be sure to discuss any
concerns with your doctor prior to the procedure.
Certain factors or conditions may interfere with the accuracy of a barium enema procedure.
These factors include, but are not limited to:
Recent barium swallow or upper GI procedure that may interfere with the X-ray exposure
of the lower GI area
Colon spasm
Stool in the bowel
Before the procedure
Here are some things to expect before the barium enema procedure:
Your doctor will explain the procedure to you and offer you the opportunity to ask any
questions that you might have about the procedure.
You may be asked to sign a consent form that gives your permission to do the procedure.
Read the form carefully and ask questions if something is not clear.
You'll be asked to not eat or drink liquids for eight hours before the procedure, generally
after midnight. You'll be given a bowel prep kit to use on the day before the procedure.
This may consist of a laxative to drink, suppositories, or an enema. You'll most likely be
on a clear liquid diet the day before the study (clear broth, gelatin, tea, clear soft drinks).
If you're pregnant or suspect that you may be pregnant, you should notify your doctor.
Notify your health care provider if you're sensitive to or are allergic to any medications,
latex, tape, and anesthetic agents (local and general).
Notify your doctor of all medications (prescribed and over-the-counter) and herbal
supplements that you're taking. Your doctor may advise you to withhold certain
medications prior to the procedure.
Notify the radiologist if you've had a recent barium swallow or upper GI procedure, as
this may interfere with obtaining an optimal X-ray exposure of the lower GI area.
Based on your medical condition, your health care provider may request other specific
preparation.
During the procedure
A barium enema may be performed on an outpatient basis or as part of your stay in a hospital.
Procedures may vary depending on your condition and your doctor's practices.
Generally, a barium enema will follow this process:
1. You'll be asked to remove any clothing, jewelry, or other objects that may interfere with
the procedure.
2. If you're asked to remove clothing, you'll be given a gown to wear.
3. You will be positioned horizontally on the examination table in a side-lying position.
4. A rectal tube will be inserted into the rectum to allow the barium to flow into the
intestine.
5. The barium will be allowed to flow slowly into the intestine. You may experience
cramping in the lower abdominal area as the barium is instilled. To lessen the discomfort,
it may be helpful to take slow deep breaths.
6. You may feel the need to have a bowel movement. It will be important to resist the urge
to prevent the barium from leaking back out. At the appropriate time, you'll be given a
bedpan or assisted to the bathroom as needed.
7. During the procedure, the machine and examination table will move and you may be
asked to assume various positions as the X-rays are being taken.
8. The radiologist will take single pictures, a series of X-rays, or a video (fluoroscopy) as
the barium moves through the intestine.
9. If a double contrast study is ordered, you'll be asked to evacuate some of the barium. A
bedpan or access to a bathroom will be provided. Some barium will remain in your
intestine. Air is injected via the rectum in order to expand the large intestine, and more X-
rays will be taken.
10. Once all required X-rays have been taken, you'll be assisted from the table.
After the procedure
Following the examination, some barium will be expelled immediately. You'll be assisted to the
bathroom or given a bedpan.
You may resume your normal diet and activities after a barium enema, unless your doctor
advises you differently.
Barium may cause constipation or possible impaction after the procedure if it isn't completely
eliminated from your body. You may be advised to drink plenty of fluids and eat foods high in
fiber to expel the barium from the body. You may also be given a cathartic or laxative to help
expel the barium.
Since barium isn't absorbed into the body but passes through your entire gastrointestinal tract,
your bowel movements may be lighter in color until all the barium has been excreted.
The long and rigorous bowel preparation prior to the procedure may cause fatigue afterward.
You should rest as needed.
You may experience soreness of the anus and rectum due to the bowel preparation. Your doctor
may recommend the application of a soothing ointment to the area.
Notify your health care provider to report any of the following:
Difficulty with bowel movements or inability to have a bowel movement
Pain and/or distention of the abdomen
Stools that are smaller in diameter than normal
Your doctor may give you additional or alternate instructions after the procedure, depending on
your particular situation.
Online resources
The content provided here is for informational purposes only, and wasn't designed to diagnose or
treat a health problem or disease, or replace the professional medical advice you receive from
your doctor. Please consult your health care provider with any questions or concerns you may
have regarding your condition.
This page contains links to other websites with information about this procedure and related
health conditions. We hope you find these sites helpful. But please remember we do not control
or endorse the information presented on these websites, nor do these sites endorse the
information contained here.
American Cancer Society
American Gastroenterological Association
National Cancer Institute (NCI)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Institutes of Health (NIH)
National Library of Medicine



















SMALL BOWEL FOLLOW THROUGH
An upper gastrointestinal (UGI) series looks at the upper and middle sections of the
gastrointestinal tract . The test uses barium contrast material, fluoroscopy, and X-ray.
Before the test, you drink a mix of barium (barium contrast material) and water. The barium is
often combined with gas-making crystals. Your doctor watches the movement of the barium
through your esophagus, stomach, and the first part of the small intestine (duodenum ) on a
video screen. Several X-ray pictures are taken at different times and from different views.
A small bowel follow-through may be done immediately after a UGI to look at the rest of the
small intestine. If just the throat and esophagus are looked at, it is called an esophagram (or
barium swallow). See barium swallow images .
Upper endoscopy is done instead of a UGI in certain cases. Endoscopy uses a thin, flexible tube
(endoscope) to look at the lining of the esophagus, stomach, and upper small intestine
(duodenum).
Why It Is Done
An upper gastrointestinal (UGI) series is done to:
Find the cause of gastrointestinal symptoms, such as difficulty swallowing, vomiting,
burping up food, belly pain (including a burning or gnawing pain in the center of the
stomach), or indigestion. These may be caused by conditions such as hiatal hernia.
Find narrow spots (strictures) in the upper intestinal tract, ulcers, tumors, polyps, or
pyloric stenosis.
Find inflamed areas of the intestine, malabsorption syndrome, or problems with the
squeezing motion that moves food through the intestines (motility disorders).
Find swallowed objects.
Generally, a UGI series is not used if you do not have symptoms of a gastrointestinal problem. A
UGI series is done most often for people who have:
A hard time swallowing.
A history of Crohn's disease.
A possible blocked intestine (obstruction).
Belly pain that is relieved or gets worse while eating.
Severe heartburn or heartburn that occurs often
How To Prepare
Tell your doctor if you:
Are taking any medicine.
Are allergic to any medicines, barium, or any other X-ray contrast material.
Are or might be pregnant. This test is not done during pregnancy because of the risk of
radiation to the developing baby (fetus).
You may be asked to eat a low-fiber diet for 2 or 3 days before the test. You may also be asked
to stop eating for 12 hours before the test. Your doctor will tell you if you need to stop taking
certain medicines before the test.
The evening before the test, you may be asked to take a laxative to help clean out your intestines.
If your stomach cannot empty well on its own, you may have a special tube put through your
nose and down into your stomach just before the test begins. A gentle suction on the tube will
drain the stomach contents.
If you are having the small bowel follow-through after the UGI series, you will need to wait
between X-rays. The entire small bowel follow-through exam takes up to 6 hours, so bring along
a book to read or some other quiet activity.
You may be asked to sign a consent form. Talk to your doctor about any concerns you have
regarding the need for the test, its risks, how it will be done, or what the results will mean. To
help you understand the importance of this test, fill out the medical test information form.
How It Is Done
A UGI series is usually done in a clinic or the X-ray department of a hospital. You do not need to
stay overnight in the hospital. The test is done by a radiologist and a radiology technologist.
You will need to take off your clothes and put on a hospital gown. You will need to take out any
dentures and take off any jewelry. You may not smoke or chew gum during the test, since the
stomach will respond by making more gastric juices and this will slow the movement of the
barium through the intestines.
You will lie on your back on an X-ray table. The table is tilted to bring you to an upright position
with the X-ray machine in front of you. Straps may be used to keep you safely on the table. The
technologist will make sure you are comfortable during changes in table position.
You will have one X-ray taken before you drink the barium mix. Then you will take small
swallows repeatedly during the series of X-rays that follow. The radiologist will tell you when
and how much to drink. By the end of the test, you may have swallowed 1 cup (237 mL) to 2.5
cup (592 mL) of the barium mixture. See a picture of a barium swallow tes
The radiologist watches the barium pass through your gastrointestinal tract using fluoroscopy
and X-ray pictures. The table is tilted at different positions and you may change positions to help
spread the barium. Some gentle pressure is put on your belly with a belt or by the technologist's
gloved hand. You may be asked to cough so that the radiologist can see how that changes the
barium flow. See an image of a barium swallow .
If you are having an air-contrast study, you will sip the barium liquid through a straw with a hole
in it or take pills that make gas in your stomach. The air or gas that you take in helps show the
lining of the stomach and intestines in greater detail.
If you are also having a small bowel study, the radiologist watches as the barium passes through
your small intestine into your large intestine. X-ray pictures are taken every 30 minutes.
The UGI series takes 30 to 40 minutes. The UGI series with a small bowel study takes 2 to 6
hours. In some cases, you may be asked to return after 24 hours to have more X-ray pictures
taken.
When the UGI series is done, you may eat and drink whatever you like, unless your doctor tells
you not to.
You may be given a laxative or enema to flush the barium out of your intestines after the test to
prevent constipation. Drink a lot of fluids for a few days to flush out the barium.
How It Feels
The barium liquid is thick and chalky, and some people find it hard to swallow. A sweet flavor,
like chocolate or strawberry, is used to make it easier to drink. Some people do not like it when
the X-ray table tilts. You may find that pressure on your belly is uncomfortable. After the test,
many people feel bloated and a little nauseated.
For 1 to 3 days after the test, your stool (feces) will look white from the barium. Call your doctor
if you are not able to have a bowel movement in 2 to 3 days after the test. If the barium stays in
your intestine, it can harden and cause a blockage. If you become constipated, you may need to
use a laxative to pass a stool.
Risks
Barium does not move into the blood, so allergic reactions are very rare.
Some people gag while drinking the barium fluid. In rare cases, a person may choke and inhale
(aspirate) some of the liquid into the lungs.
There is a small chance that the barium will block the intestine or leak into the belly through a
perforated ulcer. A special type of contrast material (Gastrografin) can be used if you have a
blockage or an ulcer.
There is always a small chance of damage to cells or tissue from being exposed to any radiation,
even the low level of radiation used for this test
Results
An upper gastrointestinal (UGI) series looks at the upper and middle sections of the
gastrointestinal tract . Results are usually ready in 1 to 3 days.
Upper gastrointestinal (UGI) series
Normal: The esophagus, stomach, and small intestine all look normal.
Abnormal: A narrowing (stricture), inflammation, a mass, a hiatal hernia, or enlarged veins
(varices) may be seen. Spasms of the esophagus or a backward flow (reflux) of
barium from the stomach may occur.
The UGI series may show a stomach (gastric) or intestinal (duodenal) ulcer, a
tumor, or something pushing on the intestines from outside the gastrointestinal
tract. Narrowing of the opening between the stomach and the small intestine
(pyloric stenosis) may be seen.
The small bowel follow-through may show inflammation or changes in the lining
that may explain poor absorption of food. This may be caused by Crohn's disease
or celiac disease.
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
Eating before or during the test.
Too much air in the small intestine.
What To Think About
A gastrointestinal (GI) motility study may be done if the squeezing motions of the small
intestine are not normal during the UGI series and small bowel follow-through. The
movement of the barium through the lower intestinal tract is recorded every few hours for
up to 24 hours. A barium enema or colonoscopy may be needed to confirm the diagnosis.
Upper endoscopy is done instead of a UGI test in certain cases. Endoscopy uses a thin,
flexible tube (endoscope) to look at the lining of the esophagus, stomach, and upper small
intestine (duodenum). For more information, see the medical test Upper Gastrointestinal
Endoscopy.
The UGI series test:
o Cannot show irritation of the stomach lining (gastritis) or esophagus (esophagitis)
or ulcers that are smaller than about 0.25 in. (6 mm) in diameter.
o Cannot show an infection with the bacteria Helicobacter pylori, which may be a
cause of stomach ulcers.
A biopsy cannot be done during the UGI if a problem is found.
Other Works Consulted
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures,
5th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and
Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby?s Manual of Diagnostic and Laboratory
Tests, 4th ed. St. Louis: Mosby Elsevier.
By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD, MD - Family Medicine
Specialist Medical Reviewer Adam Husney, MD, MD - Family Medicine
Last Revised October 29, 2010