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What does esophagography do?
evaluate structure and function of esophagus
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What structures does esophagography evaluate?
- megaesophagus
- foreign body
- stricture
- rupture
- mass inside
- mass outside
- fistula
- diverticulum
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What are the indications to do an esophagography?
- regurgitation
- dysphagia
- excessive salivation
- gagging or retching
- foreign body suspected
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What kind of contrast agents can we use for an esophagography?
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Do we need to fast the patient when doing an esophagography? If so for how long?
- yes
- off of food for 12 hours and off water for 3 hours
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Do we need to use tranquilizers when doing an esophagography?
we can, but we need to be careful because the patient still needs to be able to swallow
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How do we give the contrast agent when doing an esophagography?
calculate the total dose of contrast agent, give half per view
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What two views do we need to take for an esophagography?
lateral and oblique
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Where do we give the contrast agent for esophagography?
give contrast agen into buccal pouch - between the cheek and teeth
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When should we take the radiograph for a esophagography?
as the patient swallows
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What is the upper GI series used to study?
the stomach and the small intestines
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How can the contrast agent be given for an upper GI series?
orally or by stomach tube
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Why can't we study the large intestines during an upper GI series contrast study?
contrast agent does not fill the large intestines enough to be diagnostic
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When would we do an upper GI series contrast study?
- vomiting
- abdominal masses
- abnormal bowel movement
- suspect foreign body
- suspect blockage
- abdominal pain
- weight loss, anorexia
- diaphragmatic hernia
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How much barium do we give a cat, small dog, and large dog for an upper GI series?
- cat: 12 - 16 ml/kg
- small dog: 8 - 10 ml/kg
- large dog: 3 - 5 ml/kg
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How much iodine (Gastrografin) do we use for an upper GI series?
3 ml/kg
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Do we use idoine when doing an upper GI series contrast study in a cat?
we can but it is not recommended
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What is the maximum dose of iodine we can use for an upper GI series?
50 ml
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When would we use iodine instead of barium for an upper GI series?
when we suspect a rupture
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Can we mix barium and iodine together when doing an upper GI contrast study?
- yes
- add 5 - 15 ml iodine to barium
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What kind of effects do we get from mixing barium and iodine together?
- barium - good coating
- iodine - rapid transit
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How do we do a negative contrast study for the upper GI?
gas placed by stomach tube
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How do we do a double contrast study for the upper GI?
small amount of barium (1 - 3 ml/kg) followed by 30 - 60 ml of gas
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What is a double contrast study of the upper GI series good for evaluating?
radiolucent foreign body and intramural (in wall) lesions
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How much contrast agent to do need to make sure we add for an upper GI series? Do people have a tendency to underdose the patient?
- enough to adequately distend stomach and bowel
- yes
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How do we prep the patient for an upper GI contrast study?
- fast: 12 - 24 hours off food, 3 - 4 hours off water
- mild cathartic: milk of magnesia
- enemas: mild soapy water - 12 and 4 hours prior to study
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Why do we need to make sure we prep well in advance for a upper GI contrast study?
- no defecation during the study
- gas pattern in GI tract returns to normal
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Can we use a tranquilizer during an upper GI contrast study? Which one do we usually use? Which ones do we avoid and why?
- yes
- acepromazine
- atropine and other parasympatholytics because it delays gastric emptying
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What do we need to do first before doing a contrast study of the upper GI?
lateral and VD survey films
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How do we administer the contrast agent for an upper GI study?
- orally - give liquids in buccal pouch
- stomach tube
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What should be included in a survey film before doing a contrast study of the upper GI?
diaphragm to hip joints or further
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When do we take the images for a contrast study of the upper GI?
- dog: 0, 15, 30, 60 minutes, then hourly
- cat: 0, 5, 30, 60, then hourly
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When do we stop taking images for a contrast study of the upper GI?
when the stomach is empty and the contrast agent is in the colon
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What is another term for a lower GI study?
barium enema
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What does a lower GI study evaluate?
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Is a lower GI series done often in veterinary medicine?
no
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Why is a lower GI series rarely performed in veterinary medicine?
- difficult and messy
- anesthesia is required
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What is a better way to evaluate the lower GI?
endoscopy
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When is a lower GI study done?
- abnormal stool
- diarrhea
- painful or difficult defecation
- bowel obstruction, distention
- suspected pelvic or pre-pelvic masses
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When is a stool considered abnormal enough to do a lower GI contrast study?
- excess mucus
- bright red blood coating stool
- unusual shape of stool
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How much barium and Gastrografin (iodine) do we use for a lower GI contrast study?
- barium: 5 ml/kg
- Gastrografin: 3 - 5 ml/kg
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How do we prep a patient for a lower GI contrast study?
- diet: 24 hours of low residue diet (i/d) followed by 24 hours of fasting
- mild cathartics and enemas: saline enema only,
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What are the steps to doing a lower GI contrast series?
- survey radiograph
- anesthesia (to keep patient from straining)
- place Foley catheter in rectum
- infuse contrast agent slowly into rectum by gravity
- take radiographs
- remove as much contrast as possible
- take evacuation radiographs
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What is a Foley catheter?
- soft rubber retention catheter with inflatable bulb on the end, like a trach tube
- bulb just inside anus and keeps contrast material from leaking out
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What is the goal when putting in the contrast agent for a lower GI study?
fill rectum, colon, cecum, and have a small amount entering the ileum
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What radiograph views do we take for a lower GI study?
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Why do we need to remove as much contrast agent as possible when we are done with a lower GI contrast study?
causes constipation if left in
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How do we remove the contrast agent after a lower GI study?
- elevate cranial abdomen
- massage
- drain
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What are evacuation radiographs?
radiographs taken after material is drained
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How do we do a double contrast lower GI study?
- left contrast agent out
- infuse in same amount of air as contrast agent
- take radiographs
- evacuate
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