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Chapter: Ultrasound after kidney transplantations. Chapter: Functional ultrasound of the gastrointestinal tract.

Giovanni Maconi, Milan Evaluation of deep remission in IBD using ultrasound – EFSUMB

Chapter: Echoscopy — a new concept in mobile ultrasound. Chapter: Ultrasound of the gastrointestinal tract. Chapter: Ultrasound of liver transplantation. Chapter: Ultrasound of the gallbladder and hepatobiliary system. Chapter: Ultrasound evaluation of cerebrovascular steno-occlusive disease.

Information is also provided on recent technical developments and ultrasound applications that are likely to become of increasing importance, such as functional and 3D ultrasound, contrast agents and intraoperative ultrasound, elastography, and transperineal ultrasound. The authors are all distinguished experts in the topics they address.

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Ultrasound of the Gastrointestinal Tract will be a helpful guide in daily practice not only for radiologists but also for gastroenterologists, abdominal surgeons, pediatricians, and oncologists. Product details Format Hardback pages Dimensions x x Other books in this series.

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Radiology and Imaging of the Colon Anthony H. Imaging in Pediatric Skeletal Trauma A. In this case the gas is referred to as the negative contrast medium. Traditionally the images produced with barium contrast are made with plain-film radiography, but computed tomography is also used in combination with barium contrast, in which case the procedure is called CT enterography. Various types of barium X-ray examinations are used to examine different parts of the gastrointestinal tract. These include barium swallow, barium meal, barium follow-through, and barium enema. Barium X-ray examinations are useful tools for the study of appearance and function of the parts of the gastrointestinal tract.

They are used to diagnose and monitor esophageal reflux , dysphagia , hiatus hernia , strictures , diverticula , pyloric stenosis , gastritis , enteritis , volvulus , varices , ulcers , tumors , and gastrointestinal dysmotility, as well as to detect foreign bodies. Barium sulfate is swallowed, which because it is a radio opaque substance does not allow the passage of X-rays.

As a result, areas coated by barium sulfate will appear white on an X-ray film. The passage of barium through the gastrointestinal tract is observed by a radiologist using a fluoroscope attached to a TV monitor. The radiologist takes a series of individual X-ray images at timed intervals depending on the areas to be studied. Sometimes medication which produces gas in the gastrointestinal tract is administered together with the Barium sulfate. This gas distends the gastrointestinal lumen, providing better imaging conditions and in this case the procedure is called double-contrast imaging.

Clinical status and relevant medical history are reviewed prior to the studies. Little or no preparations are required for the study of the larynx, pharynx, and esophagus when studied alone. Then several swallows of a thin barium mixture are taken and the passage is recorded by fluoroscopy and standard radiographs.

The procedure is repeated several times with the examination table tilted at various angles. For barium meal or barium follow-through examinations, a 6-hour period of fasting is observed prior to the studies. Metoclopramide is sometimes also added to the mixture to enhance gastric emptying.

X-ray images are then taken in a supine position at intervals of 20—30 minutes. Real-time fluoroscopy is used to assess bowel motility. The radiologist may press or palpate the abdomen during images to separate intestinal loops. The total time necessary for the test depends on the speed of bowel motility or transit time and may vary between 1 and 3 hours.

Description

For small bowel examinations, in addition to fasting for 8 hours prior to examination, a laxative may also be necessary for bowel preparation and cleansing. Then methylcellulose is instilled through the tube. Barium and methylcellulose fill the intestinal loops which can be viewed continuously using fluoroscopy , or viewed as standard radiographs taken at frequent intervals. The technique is a double-contrast procedure that allows detailed imaging of the entire small intestine. However, the procedure may take 6 hours or longer to complete and is quite uncomfortable to undergo.

Radiographic examinations involve radiation exposure in the form of X-rays.

Ultrasound of the Gastrointestinal Tract

Leakage of barium sulfate into the abdominal cavity may occur in people with duodenal ulcers or other perforations and may lead to peritonitis , adhesion , and granulomas ; it is associated with a high mortality rate. Barium sulfate as a contrast medium was evolved from the prior use of bismuth preparations which were too toxic. The use of bismuth preparations had been described as early as Barium sulfate as a contrast medium in medical practice was introduced largely as a result of the works of Krause a director of the Bonn Polyclinic, now the medical faculty of the University of Bonn and his colleagues Bachem and Gunther.