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    Anatomi Radiologi Barium Studies For GIT

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    Rio Arbiansyah
    This document provides an overview of barium studies used to examine the gastrointestinal tract, including barium swallows, meals, and enemas. It describes the normal radiographic anatomy and various pathological findings that can be seen. Some of the abnormalities addressed include esophageal strictures, achalasia, diverticula, ulcers, masses, strictures, varices, inflammatory bowel disease, diverticulosis, polyps, and cancer. Positioning is important for visualizing different regions. The purpose of these studies and differential diagnoses for certain findings are also noted.

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    Anatomi Radiologi Barium Studies For GIT

    Uploaded by

    Rio Arbiansyah
    124 views52 pages
    This document provides an overview of barium studies used to examine the gastrointestinal tract, including barium swallows, meals, and enemas. It describes the normal radiographic anatomy and various pathological findings that can be seen. Some of the abnormalities addressed include esophageal strictures, achalasia, diverticula, ulcers, masses, strictures, varices, inflammatory bowel disease, diverticulosis, polyps, and cancer. Positioning is important for visualizing different regions. The purpose of these studies and differential diagnoses for certain findings are also noted.

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    Anatomi Radiologi Barium Studies for GIT (1)

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    This document provides an overview of barium studies used to examine the gastrointestinal tract, including barium swallows, meals, and enemas. It describes the normal radiographic anatomy and various pathological findings that can be seen. Some of the abnormalities addressed include esophageal strictures, achalasia, diverticula, ulcers, masses, strictures, varices, inflammatory bowel disease, diverticulosis, polyps, and cancer. Positioning is important for visualizing different regions. The purpose of these studies and differential diagnoses for certain findings are also noted.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    124 views52 pages

    Anatomi Radiologi Barium Studies For GIT

    Uploaded by

    Rio Arbiansyah
    This document provides an overview of barium studies used to examine the gastrointestinal tract, including barium swallows, meals, and enemas. It describes the normal radiographic anatomy and various pathological findings that can be seen. Some of the abnormalities addressed include esophageal strictures, achalasia, diverticula, ulcers, masses, strictures, varices, inflammatory bowel disease, diverticulosis, polyps, and cancer. Positioning is important for visualizing different regions. The purpose of these studies and differential diagnoses for certain findings are also noted.

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    You are on page 1of 52

    Single

    Double (Single +
    Air)

    Pemeriksaan Barium Pada


    Saluran Cerna / GIT
    Radiographic Anatomy & Pathology

    Barium Swallow, Contrast Tunggal

    Cricopharyngeu
    s Muscle
    At level of C5-C6,
    Part of upper
    esophageal
    sphincter (UES)

    Esophagu
    s

    Barium Swallow, Contrast Tunggal


    Indikasi
    Utama:
    Dyshagia

    Double
    Contrast

    Identation of
    A.A

    Indentation of
    L.main
    bronchus

    Single Contrast

    Barium Swallow, Contrast Tunggal

    L.
    A
    .

    Heart

    L.
    V.

    Barium Swallow, Contrast Ganda

    Indentation of
    L.main
    bronchus

    Double Contrast

    Single Contrast

    Barium Swallow, Contrast Tunggal

    Ampulla
    Normal Varient

    Fundus

    Body

    Barium Swallow, Contrast Tunggal

    Aortic
    Arch

    Barium Swallow, Contrast Ganda

    Menyempit:
    Bisa karena
    peristaltik,
    diperlukan
    pengambilan
    gambar posisi lain

    Barium Meal, Double Contrast


    (Supine Position)
    Posisi
    Supine :
    Tampak Barium
    mengumpul di
    fundus akibat
    gravitasi

    Angular Notch
    Incisura
    Angularis

    Antrum

    Bod
    y

    Barium Meal + Follow-Through


    (Posisi Tegak)
    DJJ:

    Barium
    Meal

    Normal Position= Left


    side

    Angular Notch
    Incisura Angularis

    Duodenal
    Cap
    Pyloric
    Canal
    2nd Part of
    Duodenum
    3rd Part of
    Duodenum

    Ileu
    m

    Body
    Antru
    m

    Jejunum:
    Plica Circularis on the
    outer border

    Barium
    Follow-Through

    Barium Follow-Through to Cecum


    (Posisi Berdiri)

    DJJ:
    2nd Part of
    Duodenum
    3rd Part of
    Duodenum

    Normal Position= Left


    side

    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

    Barium Swallow, Single Contrast

    Esophag
    us

    Dilatasi
    sisi
    Proximal

    Menyemp
    it(Stricture
    )
    Bird Peak Sign (tanda paruh
    burung)

    ABNORMALITY

    Barium Swallow, Contrast Tunggal


    Esophagus bagian bawah

    Stricture
    Jinak:
    Dilatasi
    Proximal

    Bagian
    Distal
    menyempi
    t

    Zona
    peralihan/
    transitional
    tampak halus
    dan tidak
    tampak filling
    defects

    Barium Swallow, Single Contrast


    Stricture
    Ganas:

    DDx:
    Adeno CA
    Sq. Cell
    CA

    -Zona
    transitional
    tampak Irregular
    & batas kabur
    - tampak filling
    defects

    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, Contrast Tunggal


    (Oblique)

    Filling
    Defect
    Malignant
    Stricture

    Long Irregular
    Narrowing

    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 & Dilatation:
    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
    so-called vigorous achalasia cannot be distinguished clinically

    Barium Swallow, Single Contrast


    Well 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
    Multiple Filling
    Defects

    Differential Diagnosis
    Multiple Esophageal Filling
    Defects:
    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

    Barium Swallow, Single Contrast

    Irregular
    Multiple Filling
    Defects
    (Esophageal
    Varices)

    Barium Meal, Double Contrast

    Contrast Filled
    Speculated
    Lesion
    (Gastric Ulcer)

    Barium Meal, Double Contrast

    Ruga
    e

    Contrast Filled
    Outpouching at
    the Greater
    Curviture
    (Malignant Gastric
    Ulcer)

    Barium Meal + Follow-Through

    1st Part of
    duodenum

    Contrast Filled
    Speculated
    Lesion
    (Duodenal Ulcer)

    2nd Part of
    duodenum
    4th Part of
    duodenu
    m
    3rd Part of
    duodenum

    Barium Meal, Double Contrast

    Speculate
    d Mass
    Ulcer

    Pylorus

    Stomac
    h

    Barium Meal, Double Contrast

    Distended
    Stomach
    Single Bubble
    Sign
    DDx: Gastric
    Output
    Obstruction (GOO)
    (Pyloric Stenosis)

    Gas in Descending
    Colon
    (partial
    obstruction)

    Barium Meal, Double Contrast


    (Erect Position)

    DDx:
    Pyloric Stenosis
    Mushrooms Sign
    (or apple core
    Sign)
    Strings
    Sign
    Shoulders
    Sign

    For further information refer to Pediatric Abdomen Radiology Slides

    Barium Enema, Contrast Tunggal


    Colon
    asende
    n

    Colon
    transversu
    m

    Colon
    Desenden
    Cecum

    Termina
    l Ileum

    Sigmoid

    Barium Enema, Double Contrast


    (Right Lateral Decubitus)
    Flexura
    Hepatica

    Perhatikan
    Akibat dari
    gravitasi

    Barium Enema, Double Contrast


    (Prone Position)

    Cecum

    Barium Enema, Contrast Ganda


    (Posisi Supine)

    Rectum

    ABNORMALITY

    Barium Enema, Double Contrast


    Normal
    (Prone Position)
    Segments
    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

    Cecum

    Differential Diagnosis of
    Terminal Ileum Narrowing:
    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: Crohns 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
    Pseudopoly
    ps
    Pseudodiverticulu
    m

    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 SIGN

    DDx:
    Ulcerative Colitis
    (Pancolitis)

    Cecum

    Terminal
    Ilium

    Barium Enema, Double Contrast


    Loss of
    Haustrations
    Splenic Flexure
    Granular
    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

    Strictur
    e

    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
    Meconiu
    m
    Filling defects & dilated
    Descending & Sigmoid
    Colon
    Transition
    Zone
    is the term applied to the region in which a marked change in
    caliber occurs, with the dilated, normal colon above and the
    narrowed, aganglionic colon below

    According to the Transition Zone:


    Rectum Ultra Short
    Rectosigmoid Short
    Transverse Colon Long
    Beginning of the Colon Total
    (microcolon)
    DDx:
    Hirschsprung disease (HD) which is more definitively
    diagnosed by means of contrast enema examination, which can
    show the presence of a transition zone, irregular contractions,
    mucosal irregularity, and delayed evacuation of contrast
    material, among other findings
    Although the hallmark of the diagnosis is the presence of
    transition zone but its absence exclude the disease

    For more info visit:


    http://emedicine.medscape.com/article/409150-

    TERIMA KASIH ATAS PERHATIANNYA


    SEMOGA BERMANFAAT

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