Imaging Study of Fluoroscopy

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Lorain County Community College *

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Medicine

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Dec 6, 2023

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Imaging Study of Fluoroscopy Of the Esophagus, Stomach, and Small intestine. Fluoroscopy is an x-ray procedure that uses as small as possible dose of continuous or pulsed x-ray beam of ionizing radiation to watch internal organs movement or to create images generally at a rate of 25-30 complete images a second. That are used with a contrast material like Barium or an iodine contrast and sometimes baking soda crystals may be used to improve images. Barium consists of a chalky taste, flavored to make it more palatable. The barium coats the inside of the organs allowing the radiologist a better view of the organs. They may inject the organs in order to slow the movement of the organs and allow them to maintain better images of the organs. Generally, the procedure can be performed as an Outpatient or at a hospital, when examining the throat, stomach or intestines they may require not eating or drinking before the exam typically about eight hours before and normally begins at midnight although an exam for the smaller intestine may require changing your diet for a couple of days before the procedure. Typically any items worn or clothing in the area needing to be examined will be asked to remove and stored in a secure area, gowns will be provided to cover the patient for the esophagus procedure generally will be asked to sit upright in a chair/stool or to stand on a platform. The radiologist, technologist or a speech-language pathologist will generally guide the patient through the exam although sometimes the Physician or other staff may be attending during the exam. During the procedure the patient will be eating and drinking different thickness and textures in food mixed with barium contrast material while the doctor moves the x-ray camera near the throat, the radiologist/pathologist will be monitoring how the patient swallows in real time using the fluoroscope that will digitally be recorded after the fluoroscopy converts the x-
2 rays into video images and displays on a video monitor. Small intestine procedures can be performed alone or with an esophagus and stomach exam, Small intestine exams after drinking two or more large cups of contrast material, the patient will be asked to lay on the x-ray table in the supine position to position the x-ray machine above the abdominal area and lead shields may be used to protect other areas of the body. After the contrast reaches the small intestine which may take some time depending on the patient the radiologist will use the fluoroscopy to observe the flow and Spot x-rays will be taken for any abnormalities to the tissues. Patients will be asked to hold very still and possibly holding their breath for a few seconds to help prevent blurry images, generally the technologist will activate the machine behind a wall or in another room. Throughout the exam the patient will be asked to continue drinking contrast material so the radiologist may exam the entire intestine and may be asked to lie on their right side between x- rays to move the fluid from the stomach into the intestine. When contrast reaches the end of the intestines the radiologist may press on the lower right side of the abdomen with a hand or paddle to help enhance the view. Once it reaches the colon patients may be asked to use the bathroom before receiving one more additional x-ray to receive a general picture of how the contrast. Is distributed in the small/large intestines. Generally this procedure is a non-invasive and painless procedure that can provide a lot of information that may avoid any more procedures and the radiation leaves the body after the exam. However there is small risks due to the length of radiation exposure required for the procedures to both the patients and the staff involved. There is a risk of cancer, hair loss, reddened skin, radiation burns or allergic reactions and drinking Barium contrast can stimulate the bowels resulting in diarrhea or constipation and bloating which recommends drinking enough water or fiber to help flush the contrast from the body. Patients with Kidney problems and Patients that are Pregnant or possibly are pregnant are also encouraged to inform the staff
3 before these procedures. Common reasons for the procedure are generally for looking for digestive function, Cancers, abnormal masses and polyps, any complications relating to surgery, the thickness and diameter of the structures and diseases relating to the area being observed such as inflammatory bowel disease, Crohn’s disease, bowel obstructions. The esophagus they may evaluate any ulcers, tumors, inflammation of the esophagus and stomach, scaring, blockages, hiatal hernias and abnormalities, fluoroscopy can also be used to diagnose the cause of symptoms from difficulty swallowing to blood in the stood and indigestion. Fluoroscopes can also be used to guide treatments such as installing catheters, implants and injections in surgery. Exams may take anywhere from 15 minutes to several hours depending on the procedure, anatomical planes would run from axis (coronal) that would extend from side to side allowing frontal view of the esophagus, stomach and intestines. The long axis (sagittal) goes from front to back and would run up the bottom of the intestines through the stomach and up the esophagus. Short axis (transverse) would run from top to bottom perpendicular to the long axis and would include areas such as the stomach, small intestine (abdominal area) or the esophagus to minimize the area being observed and limiting radiation exposure.
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4 Works cited Centers for Disease Control and Prevention, Radiation in Healthcare: Fluoroscopy, October 20, 2021, https://www.cdc.gov/nceh/radiation/fluoroscopy.html US Food and Drug Administration, Fluoroscopy, 02/21/2023, https://www.fda.gov/radiation- emitting-products/medical-x-ray- imaging/fluoroscopy#:~:text=Fluoroscopy%20is%20a%20type%20of,is%20passed%20through %20the%20body . Radiologyinfo.org, Video Fluoroscopic swallowing Exam/Esophagram, 06/01/2022, https://www.radiologyinfo.org/en/info/modbariumswallow Hopkins medicine, Barium swallow, https://www.hopkinsmedicine.org/health/treatment-tests- and-therapies/barium-swallow Radiologyinfo.org, Upper GI X-ray, 04/15/2022, https://www.radiologyinfo.org/en/info/uppergi Phillips, M. Michael, MD, Professor of Medicine, Upper GI and small bowel series, 11/3/2022, https://medlineplus.gov/ency/article/003816.htm Radiologyinfo.org, Small bowel follow-through, 04/15/2022, https://www.radiologyinfo.org/en/info/small-bowel-follow-thru Gingold, Eric, PhD, Modern Fluoroscopy Imaging systems, https://www.imagewisely.org/Imaging- Modalities/Fluoroscopy/Modern-Imaging- Systems#:~:text=A%20schematic%20of%20an%20image,comp uter%20and%20a%20display%20device . Hopkins medicine, Fluoroscopy Procedure, https://www.hopkinsmedicine.org/health/treatment- tests-and-therapies/fluoroscopy-procedure
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