GI Radiology > Esophagus > Upper G.I.

Upper G.I. Tract Biphasic-Contrast Exam (cont.)

Method (cont.)

  1. Take the empty cup from the patient. Turn the x-ray table into a horizontal position. Give the patient a pillow on which to rest his head.

  2. Ask patient to roll toward you or rightward (counter-clockwise, as viewed from the foot end of table) through three 360 rotations, stopping in the steep LPO or left lateral position. (If patient cannot turn around, roll him back and forth three times from one lateral position to the other.) This is done to obtain good barium coating of the gastric mucosa while the CO2 is dissociating from the barium and distending the gastric lumen.

 

  1. Take four DC spots (4-on-1 film format) in the following sequence from the distal to the proximal end of the stomach (use magnification if using photospots or digital) (90 kVp):
  • Gastric antrum (patient LPO)

 

  • Gastric body, inferior portion (patient supine, AP)

 

  • Fundus (patient right lateral)

 

  • Gastric body, superior portion (patient RPO). (Elevate head of table 15 to keep barium from flowing back into gastric fundus as he rolls back into RPO position.)

 

  1. Have patient make another counter-clockwise rotation (as viewed from foot of table) to refresh the barium coating of the gastric mucosa. Stop in the steep LPO position.

 

  1. Take four (1-on-1, 10" x 12") DC spot films of the entire stomach in the following sequence:
  • LPO position

 

  • AP (supine)

 

  • RPO (First, turn patient into right lateral position and elevate head of table 15 to keep barium from flowing back into gastric fundus as he rolls back into RPO position.)

 

  • Right lateral (Wait until duodenal C-loop is sufficiently filled with barium; otherwise, take this film at end of study.)

 

© Copyright Rector and Visitors of the University of Virginia 2013