Upper GI for esophageal atresia post operative

  • Patient preparation: none
  • Contrast used: first use low osmolar water soluble or iso osmolar water soluble and then barium, never use high osmolar water soluble because if aspirated it can cause severe pulmonary edema
  • Technique: do not over distend the stomach, start with right side down to facilitate gastric emptying, give 5-10 cc of contrast, focus on the area of the surgical anastomosis which is the most likely site for a stricture and subsequent food impaction, observe motility of entire esophagus, when contrast is seen to enter 3rd/4th part of duodenum, turn patient supine and document the position of the duodenal-jejunal junction
  • Images to obtain: AP and lateral images of the esophagus focusing on the area of the surgical anastomosis, AP image of the duodenal-jejunal junction
  • Looking for: post operative leak which may be only subtly visualized as contrast draining out of a chest tube, recurrence of fistula, stricture, impacted foreign bodies above anastomosis (food), decreased distal esophageal motility, gastroesophageal reflux
  • Post procedure tasks: none