GASTROINTESTINAL CONTRAST STUDIES
• Barium study
Types of Barium studies
• 1-Barium Swallow
• Oral cavity to fundus of stomach
• 2-Barium meal
• Esophagus,stomach,duodenum,proximal jejunum
• 3-Barium follow through
• Small bowel and ileocecal junction
• 4-Barium enema
• Large bowel
Barium swallow
Two types of contrasts
1-Barium
Used to see mucosal damage . It is thick so it sticks to
mucosa
It can cause barium peritonitis
2-Gastrografin
It is used in perforations where barium is contraindicated
It Is hyperosmolar fluid it can be therapeutic sometimes in
intussessption
It can cause pulmonary edema if aspirated
Barium swallow
• Barium swallow
fluoroscopy image
• It is double meal barium
swallow s it shows black
and white contrast
• It is thoracic esophagus
as it shows ribs
Barium swallow
• It shows circumferential
narrowing at the lower
end of esophagus
• It is gradual smoth
narrowing
• Esophagus show
dilatation with air fluid
levels
• Most probably Cardia
achlasia
Same as previous
Barium swallow
• It has circumferential,
abrupt , irregular
narrowing at the the
lower end of esophagus
• It has shouldering sign
• It has dilated esophagus
• Most probably it is a
malignant lesion
Barium swalow
• It has eccentric,smooth
narrowing at the middle
third of esophagus
Barium Swallow
• It has circumferential ,
abrupt , irregular
narrowing at the middle
third of esophagus
• It has shouldering sign
• It has apple core sign
• Most probably it is a
malignant lesion
• Barium meal showing
circumferential, abrupt
irregular narrowing
• Apple core appereance/
shouldering at the level
of body of stomach
• Most likely there is a
malignant mass in the
stomach
In single contrast only
barium sulphate is given
It can outline stricture and
lumen only
2nd one is double contrast
in which barium with
gas(ENO) is given it
identifies rugal folds,
strictures and diverticulum
Barium meal showing
ecentric irregular
mass at body
ofstomach near the
lesser curvature
Barium meal showing
circumferential
abrupt irregular
narrowing at pyloric
region of stomach /
apple core
appearance
Most likely malignant
mass
Same as previous
Barium follow through
showing normal small
intestine Upper part is
jejunum in which folds are
more closer to each other
appears like stocked coin
Lower part is ileum in
which folds are far apart
from each other
Barium enema showing
normal large intestine
Having haustrations and
large calliber as compared
to small intestione
Barium enema showing
circumferential abrupt
irregular narrowing at
ileocecal junction and
decrease caliber of
cecum most likely
diagnosis is abdominal
TB / cronhs disease
Abdominal TB mostly
occurs at ileocecal
junction
Barium enema showing
narrowing at ileocecal
junction alongwith
contracted irregular
ascending colon
Barium follow through
showing multiple skip
lesions in ileum,most
likely diagnosis is crohns
disease
Barium enema showing
loss of haustrations
decrease caliber of large
intestine and itregular
mucosa due to multiple
ulcers in large intestine
showing lead pipe
appearance most likelg it
is ulcerative colitis
Same as previous
Reverse image 0f
barium enema
showing abrupt
circumferential
irregulat narrowing
at rectosigmoid
junction
Barium enema showing
abrupt circumferential
irregular narrowing of
ascending colon
T tube
Having two limbs one is to be
inserted in common hepatic
duct and other is to be
inserted in common bile duct
Curved end is attached with
overlying skin
T tube cholangiogram
Omnipaque contrast is used
Used to check caliber of CBD
lumen,filling defect in CBD and
intrahepatic ducts structure
It should be done at 7 to 10 days
post operatively
Before 7 days mucosa is inflammed
and after 10 days there is risk pf
fistula formation
Normal t tube cholangiogram
Showing fluid / contrast in
duodenum If there is obstruction
fluid will leak out from the
curved portion
T tube cholangiogram
showing dilatation in CBD
Mosy likely there is
obstruction in duodenum
Same as peechy wala🥱
normal Loopogram
Gastrograpphin contrast is used
Used after colostomy to check
the patency of loop, any mass or
perforation of non used/ distal
loop of intestine
Contrast should be added in non
used/ feacal free loop
Sinogram showing blind
ended tract in perianal
region
Using omnipaque contrast
Sinus is the opening till
soft tissue and here we
have to check the
secondary tract too which
is present
Fistulogram using
omnipaque contrast
showing communication
between skin and gut
Enterocutaneous fistula
Sinogram and fistulogram
contrast is gievn by folleys
Same as peeechyy
walaaa🙏
