Contrast Radiography - Gastrointestinal
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What does esophagography do?
evaluate structure and function of esophagus
What structures does esophagography evaluate?
- foreign body
- mass inside
- mass outside
What are the indications to do an esophagography?
- excessive salivation
- gagging or retching
- foreign body suspected
What kind of contrast agents can we use for an esophagography?
Do we need to fast the patient when doing an esophagography? If so for how long?
- off of food for 12 hours and off water for 3 hours
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
How do we give the contrast agent when doing an esophagography?
calculate the total dose of contrast agent, give half per view
What two views do we need to take for an esophagography?
lateral and oblique
Where do we give the contrast agent for esophagography?
give contrast agen into buccal pouch - between the cheek and teeth
When should we take the radiograph for a esophagography?
as the patient swallows
What is the upper GI series used to study?
the stomach and the small intestines
How can the contrast agent be given for an upper GI series?
orally or by stomach tube
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
When would we do an upper GI series contrast study?
- abdominal masses
- abnormal bowel movement
- suspect foreign body
- suspect blockage
- abdominal pain
- weight loss, anorexia
- diaphragmatic hernia
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
How much iodine (Gastrografin) do we use for an upper GI series?
Do we use idoine when doing an upper GI series contrast study in a cat?
we can but it is not recommended
What is the maximum dose of iodine we can use for an upper GI series?
When would we use iodine instead of barium for an upper GI series?
when we suspect a rupture
Can we mix barium and iodine together when doing an upper GI contrast study?
- add 5 - 15 ml iodine to barium
What kind of effects do we get from mixing barium and iodine together?
- barium - good coating
- iodine - rapid transit
How do we do a negative contrast study for the upper GI?
gas placed by stomach tube
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
What is a double contrast study of the upper GI series good for evaluating?
radiolucent foreign body and intramural (in wall) lesions
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
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
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
Can we use a tranquilizer during an upper GI contrast study? Which one do we usually use? Which ones do we avoid and why?
- atropine and other parasympatholytics because it delays gastric emptying
What do we need to do first before doing a contrast study of the upper GI?
lateral and VD survey films
How do we administer the contrast agent for an upper GI study?
- orally - give liquids in buccal pouch
- stomach tube
What should be included in a survey film before doing a contrast study of the upper GI?
diaphragm to hip joints or further
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
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
What is another term for a lower GI study?
What does a lower GI study evaluate?
Is a lower GI series done often in veterinary medicine?
Why is a lower GI series rarely performed in veterinary medicine?
- difficult and messy
- anesthesia is required
What is a better way to evaluate the lower GI?
When is a lower GI study done?
- abnormal stool
- painful or difficult defecation
- bowel obstruction, distention
- suspected pelvic or pre-pelvic masses
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
How much barium and Gastrografin (iodine) do we use for a lower GI contrast study?
- barium: 5 ml/kg
- Gastrografin: 3 - 5 ml/kg
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,
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
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
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
What radiograph views do we take for a lower GI study?
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
How do we remove the contrast agent after a lower GI study?
- elevate cranial abdomen
What are evacuation radiographs?
radiographs taken after material is drained
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
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