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BARIUM SULPHATE
Non absorbable.
Insoluble in water / Lipid.
Inert to tissues.
Can be used for double contrast studies.
APPLICATION
GOOD
BAD
ADVANTAGES OF BaSO4
PREPARATION
NON-ABSORBABLE. Therefore barium does
not get degraded throughout the bowel
SUITABLE FOR DOUBLE CONTRAST
STUDIES As it coats the mucosa in a thin
layer, thus allows introduction of negative
contrast agents without significant degradation
ADV over water soluble contrast agent
Results in better coating --- better mucosal
detail
Low cost.
DISADVANTAGE
SUBSEQUENT ABDOMINAL CT is
rendered difficult to interpret
(May need to wait upto 2 weeks)
HIGH MORBIDITY associated with
barium in the peritoneal cavity
BARIUM MEASURING
SYSTEMS
W/W Suspension
W/V Suspension
BARIUM REQUIREMENTS
BARIUM
SWALLOW
250 % W/V
100 ml
BARIUM MEAL
250 % W/V
135 ml
BARIUM MEAL
FOLLOW
THROUGH
SMALL BOWEL
ENEMA
60-100% W/V
300 ml
60-100% W/V
1500 ml
BARIUM ENEMA
115% W/V
500 ml
PREPARATIONS
MICROBAR
PASTE
MICROBAR
SUSPENSION
MICROBAR
HD
MICROBAR
for enema
ADDITIVES
CARBOXYL METHYL CELLULOSETo prevent settling. Rate of settling
should be less than 1/10 at the end
of 3 hours.
ANTACIDS- To prevent flocculations
ADDITIVES
SODIUM META BI SULPHATE,
METHYL PARABEN Preservatives.
SIMETHICONE /
METHYLPOLYSILOXONE Antifoaming
agents
ERYTHROCIN Coloring agent
SACCHARINE, FRUIT ESSENCES
Sweetening agent
COMPLICATIONS
PERFORATION Into the peritoneal
cavity / mediastinum.
ASPIRATION Into bronchial tree.
INTRAVASATION embolism.
BARIUM INSPISSATION Colonic
obstruction to form hard stones.
Very rarely Barium encephalopathy
INDICATIONS:
ANATOMY
DUODENUM (25cm)
5
cm
LI
L2
7.5
cm
L3
10 cm
2.5
BARIUM MEAL
INDICATIONS
Malignancies of gastro esophageal junction, stomach,
duodenum
Upper abdominal mass
Motility disorders
Gastric or duodenal obstruction
Systemic diseases like Tb (Affecting upper GIT)
GIT hemorrhage
SYMPTOMS WHICH PROMPTS BARIUM MEAL STUDY:
Epigastric pain suggestive of peptic ulceration/ Anorexia /
Weight loss / Vomiting / Anemia / Heart burn / Dyspepsia
IN CHILDREN
TO IDENTIFY A CAUSE FOR
VOMITING:
Gastro-oesophageal reflux
Pyloric obstruction
Malrotation
CONTRAINDICATIONS
SUSPECTED CASES OF GASTRODUODENAL PERFORATION
H/O OR SUSPICION OF ASPIRATION
LARGE BOWEL OBSTRUCTION
RECENT BIOPSY FROM GIT
PREPARATION
NPO for atleast 6 hours before
examination.
Abstain from-smoking
SINGLE
DOUBLE
LOW
CONTRAST
CONTRAST
BARIUM SUSPENSION
HIGHDENSITY
DENSITY(250%W/V),
LOW VISCOS
STANDARD VIEWS
SINGLE CONTRAST
DOUBLE CONTRAST
FUNDUS
SUPINE
BODY
ERECT or PRONE
ANTRUM AND
PYLORUS
D1 AND C Loop OF
DUODENUM
D4 OF DUODENUM
SUPINE
SINGLE CONTRAST
EXAMINATION
SINGLE CONTRAST :
100 to 250 ml
Prone , RAO, LPO, R LATERAL
Wall rigidity, contour abnormalities
Lesions/Filling defects
ADVANTAGE
Optimal for patients
who are immobile
Filling defects due to
large masses in
pyloric and duodenal
region are more easily
identifiable
DISADVANTAGE
Lack of sensitivity in
detecting small
erosion, linear ulcer,
superficial gastric
carcinoma
ADVANTAGE
Highly accurate
detecting
abnormalities
following gastric
surgery, bile reflex
gastritis, marginal
ulceration, recurrent
carcinomas
DISADVANTAGE
BIPHASIC STUDY
To have both mucosal delineation
in double contrast phase and full
column distension in single
contrast phase.
CONTRAST MEDIUM:
60 -100 % low viscosity , 200 250 ml of barium
is given orally with gas forming powder in the last
few mouthfuls.
FILMING
PRONE OBLIQUE, RT SIDE
DOWN
DUODENUM
ERECT
GASTRC FUNDUS
SUPINE
AFTERCARE
The patient should be warned that his
bowel motions will be white for a few
days after the examination.
The patient should be advised to eat
and drink normally to avoid barium
impaction.
The patient must not leave the
department until any blurring of vision
produced by the Buscopan has resolved
Double-contrast spot
image of gastric fundus with
patient in right-side-down
position shows normal gastric
cardia with smooth folds
radiating to central point
(white arrow) at closed
gastroesophageal junction,
also known as cardiac rosette.
Long, straight fold
(arrowheads) extends
inferiorly from cardia along
lesser curvature. Black arrows
denote normal extrinsic
impression by adjacent spleen
OBLIQUE
VIEW
BARIUM MEAL
PROCEDURE OF CHOICE
DIAGNOSTIC ACCURACY IS VERY
HIGH (100%)
SUMMARY
KNOW WHY BARIUM IS USED
LOW/HIGH DENSITY BARIUM
BARIUM MEASUREMENT SYSTEMS
BARIUM MEAL
INDICATIONS, CONTRA
INDICATIONS, PREPARATION,
AFTERCARE,FILMING
RADIOLOGICAL ANATOMY
ATOMIC NUMBER OF
BARIUM???
45
56
58
54