Introduction of Barium Swallow for Radiographer Srinivas Rao. Radiology Technologist

1. SRINIVAS RAO
Unison - Radiology Department
Khorfakkan Hospital

2. BARIUM SWALLOW
• It is a Medical Imaging Procedure used to examine the
Upper
• Gastro intestinal Tract, which include the Oesophagus and to
• Lesser extent the Stomach.
The Contrast used is Barium Sulphate.

3. Anatomy
The Oesophagus begins at the upper Oesophageal sphincter at
the level of C6 and ends at lower Oesophageal sphincter at
thoracic eleven and is approx. 25 cm in length.

4. Constrictions
• Superiorly : Level of Cricoid Cartilage, Junction with
Pharynx
• Middle : Crossed by Aorta and left main Bronchi
• Inferiorly : Diaphragmatic Sphincter

5. ANATOMY

6. Anatomy

7. SPHINCTERS
• Two high pressure zones prevent the backflow of food
• Upper Esophageal Sphincter
• Lower Esophageal Sphincter
• It is located at the upper and lower end of Oesophagus.

8. SPHINCTERS

9. Anatomy

10. Anatomy

11. Esophagus

12. Anatomy

13. CONTRAST
• TYPES OF CONTRAST STUDY
• 1. Single Contrast study
• 2. Double contrast study

14. CONTRAST USED
• 100% Barium Sulphate paste
• 80% Barium Sulphate suspension
• 30% Barium Sulphate suspension for High K.V Technique
• 200 – 250 % High Density, low viscosity for Double contrast
studies.

15. INDICATIONS
• Dysphagia
• Heart burn , Retrosternal pain, regurgitation
• Hiatus Hernia
• Reflux Esophagitis
• Stricture formation
• Esophageal carcinoma
• Motility disorder like
• Achalasia
• Diffuse esophageal spasms
• And other abnormalities like Zenkers diverticulum cricoid webs
etc.

16. CONTRA- INDICATIONS
• Suspected leakage from esophagus into the mediastinum or
• pleura and peritoneal cavities.
• Trachea- esophageal fistula.

17. Contra- Indications

18. PATIENT PREPARATION
• NPO prior to the procedure.
• Ensure that no contra indication to the contrast agent.
• Check pregnancy status for female of child bearing age.
• Procedure should be explained to the patient before under
• Going the procedure and the duration the exam may take.
• Any other medical history needed.

19. Radiographic Views
• VIEWS OR PROJECTIONS
• A.P Scout
• Lateral
• Right Anterior Oblique (RAO)
• Soft Tissue Neck – A.P & LAT
• Neck – AP & Lateral
• Thorax –( RAO)

20. Radiographic Projections -
Frontal

21. Radiographic Projection -
Lateral

22. Radiographic Projection oblique:-
RAO

23. Barium Swallow

24. Critique -Criteria

25. Critique criteria:
Right Anterior Oblique, Lateral Oblique's
The RAO should demonstrate the entire barium filled
Esophagus.
Like the RAO stomach , which is the single best projection, the
Right anterior oblique is also best for the esophagus.
The heart provides a homogeneous back ground to contrast it
Against and the distal esophagus traversing the esophageal
Hiatus is laid out in profile.

26. RAO- LPO

27. Critique criteria

28. A.P Projection
• Erect
• Barium filled
• cup

29. LATERAL

30. R-Anterior
Oblique

31. Trendelenburg
position

32. Barium swallow

33. Barium swallow

34. Barium Swallow

35. Achalasia

36. Barium Swallow

37. Hiatus Hernia

38. Achalasia

39. Double contrast

40. Fluoroscopy Room

41. Contrast Media

42. THANK YOU