Barium Tests Overview

Study Notes

Barium Tests

Barium sulfate is a white liquid used to outline the upper parts of the gut (esophagus, stomach, and small intestines) for clear visibility on X-ray pictures.
Barium Swallow:
- Used to detect problems in the esophagus, such as narrowing (stricture), hiatus hernias, tumors, reflux from the stomach, and swallowing disorders.
- Involves drinking barium liquid and standing in front of an X-ray machine while pictures are taken during swallowing.
- Takes approximately 10 minutes to complete.
Barium Meal:
- Similar to a barium swallow but focuses on the stomach and the first part of the small intestine (duodenum).
- Aims to identify issues like ulcers, polyps, and tumors.
- The patient drinks barium liquid and lies on a couch while X-rays are taken over the abdomen.
- May take longer than a barium swallow.
Barium Follow Through:
- Similar to a barium meal but targets the small intestine.
- Barium liquid is ingested, and X-rays are taken every 30 minutes or so to track the barium's progress through the small intestine and into the large intestine (colon).
- The duration of the test depends on the speed of the patient's gut movement.
Barium Enema:
- Used for X-ray imaging of the colon.
- Barium liquid is inserted into the colon through the anus.
- The patient may be asked to change positions on the couch to ensure the barium coats the entire colon lining.
- A drug may be injected to relax the muscles in the colon walls, and air may be passed into the colon to enhance image clarity.
- X-rays are taken once the barium has spread throughout the colon.
- The test takes about 15-20 minutes.

Jejunum vs. Ileum

Jejunum:
- Larger diameter
- More densely packed and higher plica (folds)
- Feathery appearance on X-ray
- More vascular supply (pink color)
- Simple vascular supply with one arcade from which vasa recta emerge
- Less encroaching mesenteric fat
Ileum:
- Smaller diameter
- Fewer and shorter plica
- Sausage-like appearance on X-ray
- Less vascular supply (brown color)
- More complex vascular supply with multiple arcades, more encroaching mesenteric fat
- Presence of Peyer's patches and Meckel's diverticulum

CT Imaging of Abdomen

CT: Computed tomography, a powerful imaging technique that provides detailed cross-sectional views of the abdomen.
C: Caudate lobe: Represents a segment of the liver typically seen in the right superior side of the abdomen on CT scans.
D: Diaphragm: The dome-shaped, muscular structure that separates the chest cavity from the abdominal cavity.
Ad: Adrenal gland: Small, endocrine glands located near the kidneys, responsible for hormone production.

Hepatopancreatic Ducts

Hepatopancreatic ducts: The biliary and pancreatic ducts that merge and empty into the duodenum.
Endoscopic retrograde cholangiopancreatography (ERCP):
- A procedure that uses a fiberoptic endoscope passed through the mouth and into the duodenum.
- A cannula is inserted through the ampulla of Vater into the pancreatic duct.
- Contrast material is injected.
Celiac Trunk: The main artery supplying blood to the stomach, spleen, liver, and upper small intestine.
Translumbar needle injection: A technique used to inject contrast material directly into the organs or structures of interest.

Arteries of the Gastrointestinal Tract

Superior mesenteric artery (SMA): The major blood supply to the small intestine and part of the large intestine.
Inferior mesenteric artery (IMA): Supplies the descending colon, sigmoid colon, and rectum.
Ileocolic artery: Branch of the SMA that supplies the ileum and ascending colon.
Middle colic artery : Branch of the SMA that supplies the transverse colon.
An anastomosis: A connection or junction between two blood vessels, allowing blood flow to alternate routes.
Femoral artery catheterization: A common procedure to introduce a catheter into the femoral artery, providing access for angiographic studies.

Renal Arteriography

Renal arteriogram: A diagnostic test that uses X-ray imaging after injecting contrast material into the renal arteries to visualize the blood vessels in the kidneys.
Arterial phase: The first phase of the renal arteriogram showing the main branches of the renal arteries.
Glomerular phase: Highlights the glomeruli, the filtering units of the kidneys.
Venous phase: Visualizes the renal veins and surrounding structures.

Urinary Collecting System

Excretory urogram: An X-ray test of the urinary tract that involves injecting contrast material into a vein. The contrast travels to the kidneys and fills the urinary collecting system, allowing visualization of structures like the kidneys and ureters.