Upper GI for high obstruction in premature infant done portably

  • Patient preparation: must already have feeding tube in place with tip in stomach placed by clinical service
  • Contrast used: iso osmolar water soluble
  • Technique:
    — With patient in supine position inject 5 cc of contrast through the feeding tube and then flush the feeding tube with 2 cc of sterile saline, turn patient to right lateral position for 5 minutes to empty stomach and then return to supine position and follow contrast through small bowel to level of obstruction
  • Images to obtain: AP scout image, AP image after injecting contrast, AP image after turning patient from right lateral to supine, AP image every 30 minutes as you follow contrast to level of obstruction
  • Looking for: duodenal atresia or duodenal stenosis or malrotation or midgut volvulus or jejunal atresia or jejunal stenosis, note you cannot document the position of the ligament of Treitz with this exam
  • Post procedure tasks: aspirate the stomach at the end of the exam