Barium Meal
In a barium meal test, X-ray images are taken of the stomach and the beginning of duodenum (the beginning of small intestine, the passageway that takes food away from the stomach). A barium meal test is often performed straight after a barium swallow test
Methods
• Double contrast:The method of choice to demonstrate mucosal pattern.
• Single contrast – uses :Children – since it usually is not necessary to
demonstrate mucosal patternVery ill adults – to demonstrate gross pathology only.
Basic Anatomy
Barium Meal indications
• Dyspepsia.• Weight loss,• Upper abdominal mass.• Gastrointestinal haemorrhage, • Partial obstruction
Barium Meal Contraindications• Complete large bowel obstruction.
BARIUM MEALprocedure
• Contrast medium125ml Barium sulphate suspension 250% w/v
• Patient PreparationNil by mouth for 6 hr’s prior to examination. Smoking
should be avoided on the day of the examination since it increases gastric motility
• Preliminary filmsNone
Technique A gas producing agent is swallowed.
The patient then drinks the barium whilst lying on his left side, this prevents the barium from reaching the duodenum too quickly and so obscuring the greater curve.
The patient then lies supine and slightly on his right side and trendelenberg tilted to bring the barium up against the gastro oesophageal junction, this manoeuvre is ‘screened’ to check for reflux and the patient is asked to cough to encourage reflux,
Spot films are taken if reflux occurs.
An I.V. injection of a smooth muscle relaxant is given.
The patient is then asked to roll onto his right side then completely over to fully coat the stomach wall to finish in RAO position .
PositionDemonstrates
Supine RAOAntrum and greater curve
SupineAntrum and body
Supine LAOLesser curve
Supine Left Lateral, (head up 45 degree)
Fundus
ProneDuodenal loop
Prone, RAO, Supine, LAO
Duodenal Cap series
ErectFundus
Erect (RAO, LAO)Duodenal Cap series
Erect RAO SwallowOesophagus
PositionDemonstrates
Supine RAOAntrum and greater curve
SupineAntrum and body
Supine LAOLesser curve
Supine Left Lateral, (head up 45 degree)
Fundus
ProneDuodenal loop
Prone, RAO, Supine, LAO ,
Erect RAO, LAODuodenal Cap series
ErectFundus
• From prone position, the patient lies on the left side first the supine then to the right side to prevent barium flooding into the duodenum
Aftercare
• The patient should be warned his bowel motions will be white for a few days, some centres advise a mild laxative for 48 hr’s to encourage the passage of ‘barium’ and reduce the possibility of impaction.
Complications
• Leakage of ‘barium from unsuspected perforation,
• Aspiration,• Obstruction,• Barium appendicitis.• Side effects of any other drugs used.