Barium swallow is an examination of the upper GI tract using barium sulfate as a contrast agent under fluoroscopy. It has several advantages over other exams as it allows visualization of the entire esophagus and proximal stomach. Some common indications for a barium swallow exam include dysphagia, gastroesophageal reflux disease, and assessment of hiatal hernias or fistulas. The procedure involves ingesting or injecting barium and taking x-ray images to detect any abnormalities. Findings may include hiatal hernias, ulcers, tumors, or other pathological conditions of the upper GI tract.

1. Barium swallow
Examination

2. Introduction:
Barium swallow is a special test of the pharynx,
oesophagus, and proximal stomach i.e. upper GI tract
using Contrast medium as Barium, and may be
performed as a single or double contrast study.
Barium migration into the bloodstream, known as
intravasation.
Barium sulfate forms the basis for a range of contrast
media used in fluoroscopic examinations of the
gastrointestinal tract.

3. Advantage
&Disadvantage

4. Anatomy:

5. Indications:
• High or low dysphagia.
• Gastro-oesophageal reflux disease (GORD/GORD).
• Assessment of a hiatus hernia.
• Generalised epigastric pain.
• Globus pharyngeus.
• Persistent vomiting.
• assessment of fistula.
• inability to pass the endoscope during UGIE.

6. Contradications:
Water soluble contrast agents should be used instead of
barium in the following cases:
• Suspected perforation.
• Post-operative assessment for leak.
• Anastomosis.
• Pregnancy.
• Lactating mother.
• Ulceration.

7. Patient Preparations:

8. Techniques:(Single
Contrast)

9. Single Contrast film

10. Single Contrast film

11. Single Contrast film

12. Techniques:(Double Contrast)
• Double-contrast barium swallow is the preferred mode of
examination patient swallows a packet of effervescent
agent and then rapidly gulps a packet of high-density
barium frontal and left posterior oblique views are taken
2 exposures are centred on the upper/mid oesophagus
and two on distal oesophagus.
• GE junction is then observed fluoroscopically as the
patient slowly turns to right, looking for elicited gastro-
oesophageal reflux.
• Additional views like mucosal relief views are useful in
suspected tumours, varices or oesophagitis.

13. Double Contrast film

14. Complication

15. Pathology: Hiatus hernia

16. Pathology:Double arch

17. Pathology: Carcinoma

18. Pathology: Fistula

19. Pathology: Barrett's
Esophagus

20. Pathology: Esophagitis

21. Pathology: Zenker's Diverticulum

22. Pathology: Stritcher

23. Pathology: Achlasia