Exam 2 - GI Contrast

Question 1

what is the example given of negative contrast for gi studies?

Answer 1

gas/air

Question 2

what are the 3 examples given for positive contrast medias used for gi studies?

Answer 2

ionic-iodinated

barium sulfate

non-ionic iodinated

Question 3

what kind of contrast media is ionic iodinated?

Answer 3

early water soluble iodinated (iodine-based) contrast media

Question 4

why is ionic iodinated contrast media not commonly used?

Answer 4

it has a high osmolality & has a higher degree of adverse reactions

Question 5

what studies may use barium sulfate?

Answer 5

esophagrams, upper gis, gastrograms, & colonograms

Question 6

what are the cons of using barium sulfate?

Answer 6

it’s not absorbed by the gi tract, so leakage into the pleural/peritoneal cavities can cause pleuritis/peritonitis with severe adhesions & granulomas

Question 7

why is aspirating barium sulfate so bad?

Answer 7

small amount is relatively inert, but a large amount can cause inflammation leading to lung lobectomies & death

Question 8

what kind of contrast media is non-ionic iodinated?

Answer 8

lower osmolar compound than ionic, so it has fewer adverse reactions

Question 9

how can non-ionic iodinated media be given safely?

Answer 9

IV, intrathecally, orally

safe in pleural & peritoneal cavities

Question 10

what are the cons of using non-ionic iodinated media?

Answer 10

aspiration will cause pulmonary edema

acute & late adverse reactions are possible

Question 11

why should you put your patient in left lateral recumbency if using negative contrast media?

Answer 11

helps decrease the risk of fatal embolism

Question 12

what gases lower the risk of an air embolism associated with using negative contrast media?

Answer 12

CO2 & NO2 - more soluble gases

Question 13

what is this study? when may you use it?

Answer 13

pneumocolonogram

• determine location of the colon
• small intestinal dilation vs. colon
• location of foreign bodies

Question 14

how would you perform this study?

Answer 14

insert air into the rectum using a red rubber catheter & radiograph the patient immediately (VD & opposite laterals as needed)

Question 15

what is this study? when may you use it?

Answer 15

barium enema/colonogram

• determine location of colon
• small intestinal dilation vs. colon
• location of foreign bodies
• colonic torsion/stricture

Question 16

how would you perform this study?

Answer 16

insert barium into the colon using a red rubber

radiograph immediately

Question 17

what must be done to do a gastrogram/pneumogastrogram?

Answer 17

fast the patient for 12-24 hours

Question 18

how would you perform this study?

Answer 18

administer barium/air via an orogastric tube & radiograph immediately

Question 19

what is this study? when may you use it?

Answer 19

gastrogram/pneumogastrogram

• foreign body, mass
• identify the location of the stomach

Question 20

when is an upper gi study indicated?

Answer 20

vomiting without evidence of obstruction on survey rads, motility disorder, evaluate mass identified on rads/palpation, & concern for ulceration

Question 21

what are contraindications of an upper gi study?

Answer 21

PERFORATION - no barium!!!!

intractable vomiting, evidence of surgical lesions, fractious animal, or planning to do an abdominal ultrasound

Question 22

what is the purpose of an upper gi study?

Answer 22

using a positive contrast medium to evaluate the stomach & small intestines

Question 23

what two mediums are typically used for upper gi studies?

Answer 23

barium sulfate & non-ionic iodinated

Question 24

how is an upper gi study performed?

Answer 24

give medium via syringe or orogastric tube

Question 25

what is the time that the contrast media should reach the colon in dogs?

Answer 25

1-4 hours

Question 26

what is the time that the contrast media should reach the colon in cats?

Answer 26

1 hour

Question 27

at what times should radiographs be taken if doing an upper gi study on a dog?

Answer 27

0 minutes, 30 minutes, 60 minutes, 120 minutes, & 240 minutes

Question 28

when should the stomach be empty in an upper gi study on a dog?

Answer 28

2 hours - begins to empty ~15 minutes in normal animals

Question 29

when should the stomach be empty in an upper gi study on a cat?

Answer 29

30 minutes

Question 30

at what times should radiographs be taken if doing an upper gi study on a cat?

Answer 30

0 minutes, 30 minutes, 60 minutes

Question 31

when does your upper gi study end?

Answer 31

mechanical obstruction is identified or the contrast is in the colon & the stomach is empty

Question 32

what are the pitfalls of upper gi studies?

Answer 32

insufficient contrast medium given failure to complete study failure to note times on images

Question 33

what must be noted on radiographic images of upper gi studies?

Answer 33

the time!!!!

Question 34

what obstructional pattern is seen here?

Answer 34

intraluminal pattern - foreign body or intraluminal mass

Question 35

what obstructional pattern is seen here?

Answer 35

mass in wall & stricture

Question 36

what obstructional pattern is seen here?

Answer 36

extramural - mass outside the wall causing compression/displacement

Question 37

should you do a contrast procedure before an ultrasound?

Answer 37

no