- Patient preparation: do not perform on a child less than 12 years old, NPO 4 hours
- Contrast used: barium and crystals
- Technique and Images to obtain:
— Start with patient upright
— AP fluoroscopy of chest and diaphragm
— AP – image of esophagus while swallowing
— Left posterior oblique – image of esophagus while swallowing
— Patient finishes barium
— AP – image of upright filled stomach
— Give patient crystals and tell them to swallow, swallow, swallow to prevent belching
— Tilt table down
— Patient to turn away from you supine – left lateral – prone – right lateral – supine
— Supine – image of lower body / antrum
— Right lateral – image of cardia and fundus
— Check for gastroesophageal reflux
— Right posterior oblique – image of upper body
— Left posterior oblique – image of antrum / bulb / duodenal C-loop
— Turn towards you to right anterior oblique
— Right anterior oblique – image of filled antrum / bulb / duodenal C-loop
— Check for hiatal hernia and Schatzki ring
— Right anterior oblique with swallow – image of lower esophagus / gastroesophageal junction
— Tip upright
— Left posterior oblique – image of fundus
— Left posterior oblique – images of body / antrum / bulb
— Tip down
— Left posterior oblique – compression images of body / antrum / bulb / Ligament of Treitz
— Prone overhead image - Looking for: mucosal lesions
- Post procedure tasks: advise patient to drink plenty of liquids to wash barium out of system and that barium will lighten color of stools
Pediatric Imaging 