Barium enema Flashcards
When do you not do a barium enema?
Pregnancy - as always
Suspected colonic perforation
Possible upcoming abdominal surgery
Patients at risk of intraperitoneal leakage (e.g. severe colitis, toxic megacolon)
Appendicitis
When can you not used water soluble iodine CM?
dehydrated patients
What are some complications that arise with barium enemas?
most complications arise from insertion of enema tube & inflation of the retention balloon at the enema tip. Very rarely patients may be allergic to the latex balloon
barium suspension could leak through an undetected perforation in the lower GI tract
Poor insertion technique or over inflation of balloon can result in
tearing of rectal wall
What are two variations of barium enema?
Barium absorbs x-rays, leaving an image of shape of the hollow inside of colon.
Double contrast enemas leave a barium coating on the internal colon wall
where is barium introduced?
rectally
Why do you use IV buscopan?
reduce & prevent acute spasm abdominal muscles
What bowel issues contraindicate the use of buscopan?
myasthenia gravis, megacolon,
narrow angle glaucoma, tachycardia,
prostatic enlargement with urinary retention, mechanical stenoses in the GI tract
paralytic ileus
When can’t you give buscopan ampouled via intramuscular injection?
pts treated with anticoagulant drugs because intramuscular bleeding may occur.
What are the routine barium enema overcouch radiographs for lower GI
Supine abdomen Prone abdomen prone rectum Lateral ventral decub Prone angled rectum (CR 30o CP:PSIS) Left & Right Lateral Decubitus
What position can you see the splenic flexure?
LAO/RPO: demonstrates splenic flexure & descending colon
What position can you see the hepatic flexure?
RAO/LPO – demonstrates primarily ascending colon, hepatic flexure & sigmoid colon
Right lateral decubitus shows the
Lateral side of descending colon
Medial side of ascending colon
Left lateral decubitus
lateral side of ascending colon
Medial side of descending colon
What can’t diabetic patient be given prior or during procedures unless ordered by physicians?
glucagon
