Professional Documents
Culture Documents
Complete Abdomen
Supine
Looking for
n
n
n
Complete Abdomen
Erect
Looking for
n
Free air
Air-fluid levels
Complete Abdomen
LLD
Looking for
n
Free air
Air-fluid levels
Complete Abdomen
Erect Chest
Looking for
n
n
Free air
Pneumonia at
bases
Pleural effusions
Stomach
n
Small Bowel
n
Always
Two or three loops of non-distended
bowel
Normal diameter = 2.5 cm
Large Bowel
n
Gas in
stomach
Gas in a
few loops
of small
bowel
Gas in
rectum or
sigmoid
Stomach
n
Small Bowel
n
Large Bowel
n
None normally
Always
air/fluid
level in
stomach
A few
air/fluid
levels in
small
bowel
Erect Abdomen
Large Bowel
n
n
Peripheral
Haustral markings don't
extend from wall to wall
Small Bowel
n
n
Central
Valvulae extend across
lumen
Functional Ileus
n
Localized (Sentinel
Loops)
Generalized adynamic
ileus
Mechanical
Obstruction
n
SBO
LBO
SBO
OMD
INDIKASI
Kelainan mobilitias
Kelainan mukosa (ulkus, divertikel, inflamasi)
Keganasan
Degeneratif
Kelainan kongenital
Kelainana obstruktif
KONTRA INDIKASI
Perforasi
Alergi kontras
Obstruksi total upper GI
PROSEDUR
Anamnese pasien adanya obstruksi
Puasa selama 6 jam sebelum pemeriksaan
Persiapan kontras barium , esofagus 1: 1 dan
Cricopharyngeu
s Muscle
At level of C5-C6,
Part of upper
esophageal
sphincter (UES)
Esophagu
s
Double
Contrast
Identation of
A.A
Indentation of
L.main
bronchus
Single Contrast
Double Contrast
L.
A
.
Heart
L.
V.
Indentation of
L.main
bronchus
Double Contrast
Single Contrast
Ampulla
Normal Varient
Fundus
Body
Aortic
Arch
Narrowing:
Could be peristalsis
So other shot is
advised
Position:
Note Barium
Distribution in the
Fundus due to gravity
Angular Notch
Incisura
Angularis
Antrum
Bod
y
Barium
Meal
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
DJJ:
2nd Part of
Duodenum
3rd Part of
Duodenum
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
Colon in loop
Fluoroscopy
Persiapan Pasien
48 jam sebelum pemeriksaan pasien makan makanan
lunak rendah serat
18 jam sebelum pemeriksaan ( jam 3 sore ) minum tablet
dulcolax
4 jam sebelum pemeriksaan ( jam 5 pagi ) pasien diberi
dulkolak kapsul per anus selanjutnya dilavement
Seterusnya puasa sampai pemeriksaan
30 menit sebelum pemeriksaan pasien diberi sulfas atrofin
0,25 1 mg / oral untuk mengurangi pembentukan lendir
15 menit sebelum pemeriksaan pasien diberi suntikan
buscopan untuk mengurangi peristaltic usus.
Persiapan Bahan
Media kontras BaSO4 = 70 80 % W/V ( Weight
/ Volume ), banyaknya sesuai panjang
pendeknya kolon kurang lebih 600 800 ml
dengan perbandingan 1: 8
Air hangat
Vaselin atau jelly
Tahap pemotretan
Pemotretan dilakukan apabila yakin seluruh kolon
mengembang semua
Posisi pemotretan tergantung dari bentuk dan
kelainan serta lokasinya.
Proyeksi PA, PA oblig & lateral ( rectum )
Proyeksi AP, AP oblig ( kolon transversum termasuk
fleksura)
Proyeksi PA, PA oblig pasien berdiri ( fleksura lienalis
dan hepatica)
Radiography Of Colon
Barium Enema
Pneumo Colon
demonstrates
anatomy and
tonus (contraction)
of colon, along
with most
abnormalities
Feces
Double Contrast
Double allows
visualization of
lumen along
with any
polyps or
lesions
AP Projection - Barium
Enema
Supine
MSP centered to
cassette
CR at iliac crest
Entire colon must
be included
Two cassettes are
sometimes
necessary
PA Projection - Barium
Enema
Pt. prone
MSP centered to film
CR at iliac crest
Entire colon must be
visualized
Barium should be
sufficiently
penetrated with
surrounding
structures visible
PA Axial Projection - BE
Pt. prone
MSP centered to film
CR directed 30 - 40
degrees caudal to
ASIS
Demonstrates
rectosigmoid area of
colon
Area must be
centered to film
PA Axial Projection - BE
AP Oblique Projection BE
Pt. supine
Body rotated 35 -
45 degrees
CR 1 - 2 in. lateral
to midline at iliac
crest
AP Oblique Projection BE
THANK YOU,,,