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SDK Barium swallow 0000
- 1. Click to edit Master title style 1 BARIUM SWALLOW S O U R A D I P K U N D U B s c M I T 2 n d Ye a r 1 8 111 2 11 6
- 2. Click to edit Master title style 2 2 Definition Barium swallow is the study which is done for examining oral cavity to the fundus of stomach by the use of barium sulphate as contrast media.
- 3. Click to edit Master title style 3 Anatomy 3
- 4. Click to edit Master title style 4 4 Anatomy
- 5. Click to edit Master title style 5 Patient ID 3396645 45yr , Male 5 Patient Information
- 6. Click to edit Master title style 6 Smoking 2packet daily for 24yr 6 Patient past History
- 7. Click to edit Master title style 7 Breathing Difficulty for 2 months Change Voice for 2 months Dysphagia Odynophagia R/O pyriform apex and post cricoid area 7 Present History
- 8. Click to edit Master title style 8 8 Diagnosis by physical examination in ENT department Laryngeal Crepitus (+ve) Stridor(+ve) Left neck level 3 two nodes (+ve) A proliferating growth involving the left AEF ,left PEF and laryngeal surface of the epiglottis
- 9. Click to edit Master title style 9 K/c /o c a la r yn x a n d a ma s s le s io n p r e s e n t in le ft s u p r a g lo ttic r e g io n in vo lve th e p yr ifo r m fo s s a is d ia g n o s e d b y C T s c a n Th e n tr a c h e o s to my w a s p e r fo r me d fo r r e lie f fr o m b r e a th in g p r o b le m o f p a tie n t 9
- 10. Click to edit Master title style 1010 Indications Dysphagia Odynophagia
- 11. Click to edit Master title style 11 Non in particular but advisable to be in NPO prior to the procedure Patient should restrain from smoking Procedure should explain to the patient before undergoing the procedure All radiopaque material should be taken out from the region of study and patient be dressed in appropriate hospital gown 11 Patient Preparations
- 12. Click to edit Master title style 12 Fluoroscopy guided Xray machine (SIEMENS AXIOM ICONOS R200) 12 Equipments Used:
- 13. Click to edit Master title style 1313 Paper cup for giving barium
- 14. Click to edit Master title style 14 95% W/V Barium Sulphate Suspension 14 Contrast Medium
- 15. Click to edit Master title style 1515 Barium Swallow Protocol Frame rate – 2FPS Exposure Factor – 98 kVp / 3mAs
- 16. Click to edit Master title style 16 Fluoroscopy table keep 90degree (Vertically) 16 Technique
- 17. Click to edit Master title style 17 Take scout film of neck and thorax region of Erect AP position 17 Technique
- 18. Click to edit Master title style 18 One mouthful contrast is given to the patient and ask for swallowing under fluoroscopy observation. The act of deglutition is observed Erect AP view form mouth to gastro oesophageal junction 18 Technique
- 19. Click to edit Master title style 1919
- 20. Click to edit Master title style 20 Again one mouthful contrast is given under fluoroscopy observation. The act of deglutition is observed Erect LPO view from mouth to gastro oesophageal junction and take lateral view of neck region 20 Technique
- 21. Click to edit Master title style 2121
- 22. Click to edit Master title style 2222
- 23. Click to edit Master title style 23 Then optimal mucosal coating film is taken lateral erect position of neck region, ask the patient to say eee…..eee…this view is called phonation view to show distended pyriform sinus and valecullae 23 Technique
- 24. Click to edit Master title style 2424
- 25. Click to edit Master title style 2525
- 26. Click to edit Master title style 26 Normal Barium Swallow 26 Impression
- 27. Click to edit Master title style 2727
Editor's Notes
- Good morning respected mam and my dear classmates today I present a case presentation about barium swallow Barium swallow is a commonest study in our hospital
- Definition Anybody tell me that why use barium sulphate contrast for oesophagus study (high atomic number 56/non absorbable/better radio opacity/and non toxic) And if patient have tracheoesophageal fistula or recent biopsy or bowel obstruction history this time should not use barium sulphate contrast it is contraindicated should use only water soluble contrast
- Pharynx is a fibro mascular tube its long about 12-14 cm it extended from base of the skull to lower border of cricoid cartilage, level of c6 It has three part Nasopharynx- it lies behind the nasal cavity and above and behind the soft palate Oropharynx – it lies behind the mouth and tongue Hypopharynx – lies behind the larynx. lower part of hypopharynx continues the oesophagus
- Oesophagus is 25cm mascular tube It passes food help by peristaltic contraction from pharynx to stomach It lies behind the trachea and start from lower border of cricoid cartilage level of c6 vertebrae to cardiac orifice of stomach level of t11 vertebrae and the esophagus pears the diaphragm at level of t10 vertebrae It has 3 part cervical(4cm) Thoracic(20) abdominal (2cm)
- Dysphagia is difficulty during swallowing Odynophagia pain during swallowing
- Physical examination have done by ent doctor and diagnose laryngeal crepitus is positive Laryngeal crepitus is felt by the examiner when the larynx is moved from side to side with a slight posterior pressure. When absent, it is a clinical sign of a mass in the retrolaryngeal space or hypopharynx ) Stridor is positive Stridor is a high-pitched, wheezing sound AEF – aryepiglottic fold PEF- pharyngo epiglottic fold There I show a diagram
- Then ent doctors suggest for ct san, k/c/o …………………………… There we can see a mass in neck region of this ct scan image. After the diagnosis ent doctor suggested for tracheostomy and remove the mass for relief from breathing problem. Tracheotomy is a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea. So after the operation they suggested for barium swallow study and checked if any swallowing dificultics is present.
- Smoking may interfere with optimum coating of mucossa
- I am showing a demo picture of patient positioning Scout film is taken to check any foreign body is present inside and to check exposure factor
- This is Erect ap view of contrast study of oesophagus
- Why we should take LPO view of barium swallow Oblique view helps to project oesophagus separately from the spine Why we should take lateral view Lateral view is taken for demonstrate fistula
- LPO view of contrast study of oesophagus
- Lateral view of contrast study of oesphagus
- This is phonation radiography
- This is the gross video of barium study