A Pediatric Radiology textbook and Pediatric Radiology digital library
Upper GI double contrast
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