Wednesday, May 26, 2010
Friday, December 18, 2009
Ba Swallow
Procedure Overview
What is a barium swallow
A barium swallow is a radiographic (x-ray) examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of mouth and throat) and the esophagus (hollow tube of muscle extending from below the tongue to the stomach). The pharynx and esophagus are made visible on x-ray film by a liquid suspension called barium. A barium swallow may be performed separately or as part of an upper gastrointestinal (UGI) series, which evaluates the esophagus, stomach, and duodenum (first part of the small intestine).
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially-treated plates (similar to camera film) and a “negative” type picture is made (the more solid a structure is, the whiter it appears on the film).
Fluoroscopy is often used during a barium swallow. Fluoroscopy is a study of moving body structures - similar to an x-ray “movie.” A continuous x-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. In barium x-rays, fluoroscopy allows the radiologist to see the movement of the barium through the pharynx and esophagus as a person drinks it, hence the name barium swallow.
Indications for the Procedure
A barium swallow may be performed to diagnose structural or functional abnormalities of the pharynx and esophagus. These abnormalities may include, but are not limited to, the following:
• cancers of the head, neck, pharynx, and esophagus
• tumors
• hiatal hernia - upward movement of the stomach, either into or alongside the esophagus
• structural problems, such as diverticula, strictures, or polyps (growths)
• esophageal varices (enlarged veins)
• muscle disorders (pharyngeal or esophageal), such as dysphagia (difficulty swallowing) or spasms (pharyngeal or esophageal)
• achalasia - the lower esophageal sphincter muscle does not relax and allow food to pass into the stomach
• gastroesophageal reflux disease (GERD) and ulcers
What is a barium swallow
A barium swallow is a radiographic (x-ray) examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of mouth and throat) and the esophagus (hollow tube of muscle extending from below the tongue to the stomach). The pharynx and esophagus are made visible on x-ray film by a liquid suspension called barium. A barium swallow may be performed separately or as part of an upper gastrointestinal (UGI) series, which evaluates the esophagus, stomach, and duodenum (first part of the small intestine).
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially-treated plates (similar to camera film) and a “negative” type picture is made (the more solid a structure is, the whiter it appears on the film).
Fluoroscopy is often used during a barium swallow. Fluoroscopy is a study of moving body structures - similar to an x-ray “movie.” A continuous x-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. In barium x-rays, fluoroscopy allows the radiologist to see the movement of the barium through the pharynx and esophagus as a person drinks it, hence the name barium swallow.
Indications for the Procedure
A barium swallow may be performed to diagnose structural or functional abnormalities of the pharynx and esophagus. These abnormalities may include, but are not limited to, the following:
• cancers of the head, neck, pharynx, and esophagus
• tumors
• hiatal hernia - upward movement of the stomach, either into or alongside the esophagus
• structural problems, such as diverticula, strictures, or polyps (growths)
• esophageal varices (enlarged veins)
• muscle disorders (pharyngeal or esophageal), such as dysphagia (difficulty swallowing) or spasms (pharyngeal or esophageal)
• achalasia - the lower esophageal sphincter muscle does not relax and allow food to pass into the stomach
• gastroesophageal reflux disease (GERD) and ulcers
Barium Enema Preparation
To conduct the most accurate barium enema test, the patient must follow a prescribed diet and bowel preparation instructions prior to the test. This preparation commonly includes restricted intake of diary products and a liquid diet for 24 hours prior to the test, in addition to drinking large amounts of water or clear liquids 12–24 hours before the test. Patients may also be given laxatives, and asked to give themselves a cleansing enema.
In addition to the prescribed diet and bowel preparation prior to the test, the patient can expect the following during a barium enema:
They will be well draped with a gown as they are placed on a tilting x-ray table.
As the barium or air is injected into the intestine, they may experience cramping pains or the urge to defecate.
The patient will be instructed to take slow, deep breaths through the mouth to ease any discomfort.
In addition to the prescribed diet and bowel preparation prior to the test, the patient can expect the following during a barium enema:
They will be well draped with a gown as they are placed on a tilting x-ray table.
As the barium or air is injected into the intestine, they may experience cramping pains or the urge to defecate.
The patient will be instructed to take slow, deep breaths through the mouth to ease any discomfort.
Gastrointestinal Barium Enema Preparation
Day Before Exam
8:00 a.m. Eat light meal.
9:00 a.m. Drink 8 oz. clear liquid.
10:00 a.m. Drink 8 oz. clear liquid.
11:00 a.m. Drink 8 oz. clear liquid.
12:30 p.m. Take magnesium citrate effervescent laxative. To 6 oz. of cold water, slowly add contents of packet while gently stirring. After effervescence stops, stir again and drink. Or, drink 10 fluid oz. of magnesium citrate oral solution.
Eat a light liquid meal (bouillon, fruit juice, and plain gelatin). No solid foods. No dairy products (milk, cream, or cheese).
2:00 p.m. Drink 8 oz. clear liquid.
3:00 p.m. Drink 8 oz. clear liquid.
4:00 p.m. Drink 8 oz. clear liquid.
6:00 p.m. Eat a light liquid meal (bouillon, fruit juice, and plain gelatin). No solid foods. No dairy products (milk, cream, or cheese).
After eating, take four yellow bisacodyl tablets. Swallow tablets whole with a full glass of water. Do not chew or dissolve tablets.
Day of Exam
Eat no breakfast.
If you are being treated for a renal failure, consult your renal physician for special preparation.
8:00 a.m. Eat light meal.
9:00 a.m. Drink 8 oz. clear liquid.
10:00 a.m. Drink 8 oz. clear liquid.
11:00 a.m. Drink 8 oz. clear liquid.
12:30 p.m. Take magnesium citrate effervescent laxative. To 6 oz. of cold water, slowly add contents of packet while gently stirring. After effervescence stops, stir again and drink. Or, drink 10 fluid oz. of magnesium citrate oral solution.
Eat a light liquid meal (bouillon, fruit juice, and plain gelatin). No solid foods. No dairy products (milk, cream, or cheese).
2:00 p.m. Drink 8 oz. clear liquid.
3:00 p.m. Drink 8 oz. clear liquid.
4:00 p.m. Drink 8 oz. clear liquid.
6:00 p.m. Eat a light liquid meal (bouillon, fruit juice, and plain gelatin). No solid foods. No dairy products (milk, cream, or cheese).
After eating, take four yellow bisacodyl tablets. Swallow tablets whole with a full glass of water. Do not chew or dissolve tablets.
Day of Exam
Eat no breakfast.
If you are being treated for a renal failure, consult your renal physician for special preparation.
Monday, December 14, 2009
Implementing PACS in a Hospital Setting
Over the past two decades, groups of computer scientists, electronic design engineers, and physicians from universities and industry have achieved an electronic environment for the practice of radiography, with PACS comprising the radiography component of this revolution. It has become evident recently that the efficiencies and cost savings of PACS are more fully realized when they are part of an enterprise-wide electronic medical record. The installation of PACS requires careful planning by all the various stakeholders over many months prior to installation. All of the users must be aware of the initial disruption that will occur as they become familiar with system processes and procedures.
Modern fourth-generation PACS is linked to radiology and hospital information systems. PACS consists of electronic acquisition sites-a robust network intelligently managed by a server as well as multiple viewing sites and an archive. The details of how these components are linked and their workflow analysis determines the success of PACS. As PACS evolves over time, components are frequently replaced, and the users must continually learn about new and improved functionalities. The digital medical revolution is rapidly being adopted in many medical centers, improving patient care.
The PACS workflow itself must be described before we elaborate on its role in network systems. Image acquisition by cassettes using films is replaced by specially designed filmless cassettes, which can be used several times. The basic components of any PACS system include an image acquisition device (such as film cassettes, video frame grabbers, and digital imaging modalities like CT or MRI), an image display station, and database management and image storage devices. Patient images are acquired from the radiography or digital imaging modalities and sent to the PACS workstation. The images are viewed and interpreted there, and the interpretation results are made available to the physicians within the hospital network. An image storage backup system stores images on optical disks and MODs. Images are stored for a time period specified in each hospital's state and local rules.
The images from a hospital without a radiologist can be sent to other hospitals. Modalities including CT, MRI, ultrasound, computed radiography, and nuclear medicine send images to PACS servers in other hospitals directly or via a network gateway. Images can be transmitted on a regional hospital local area network (LAN), then onto high-speed phone circuits to reach the hospital with PACS. They then go onto the network core and PACS servers.
References
1. E.L. Siegel and B.I. Reiner, "Filmless Radiology at the Baltimore VA Medical Center: A 9 Year Retrospective," Comput Med Imaging Graph, 27 (2–3) 101–109 (2003).
2. P. Mildenberger, M. Eichelberg, E. Martin. Introduction to the DICOM standard," Eur Radiol., 12 (4) 920–927 (2002). Epub 2001 Sept. 15.
3. B.L.T. Guthrie, C. Price, J. Zaleski, E. Backensto, "Digital Imaging and Communications in Medicine (DICOM) Archive is a Dynamic Component of a Clinician Image-related Workflow Solution," J Digit Imaging, 14 (2 Suppl 1)190–193 (2001).
4. J. Eng, J.P. Leal, W. Shu, G. Yang Liang, "Collaboration System for Radiology Workstations," Radiographics, 22 (5) e5 (2002).
Modern fourth-generation PACS is linked to radiology and hospital information systems. PACS consists of electronic acquisition sites-a robust network intelligently managed by a server as well as multiple viewing sites and an archive. The details of how these components are linked and their workflow analysis determines the success of PACS. As PACS evolves over time, components are frequently replaced, and the users must continually learn about new and improved functionalities. The digital medical revolution is rapidly being adopted in many medical centers, improving patient care.
The PACS workflow itself must be described before we elaborate on its role in network systems. Image acquisition by cassettes using films is replaced by specially designed filmless cassettes, which can be used several times. The basic components of any PACS system include an image acquisition device (such as film cassettes, video frame grabbers, and digital imaging modalities like CT or MRI), an image display station, and database management and image storage devices. Patient images are acquired from the radiography or digital imaging modalities and sent to the PACS workstation. The images are viewed and interpreted there, and the interpretation results are made available to the physicians within the hospital network. An image storage backup system stores images on optical disks and MODs. Images are stored for a time period specified in each hospital's state and local rules.
The images from a hospital without a radiologist can be sent to other hospitals. Modalities including CT, MRI, ultrasound, computed radiography, and nuclear medicine send images to PACS servers in other hospitals directly or via a network gateway. Images can be transmitted on a regional hospital local area network (LAN), then onto high-speed phone circuits to reach the hospital with PACS. They then go onto the network core and PACS servers.
References
1. E.L. Siegel and B.I. Reiner, "Filmless Radiology at the Baltimore VA Medical Center: A 9 Year Retrospective," Comput Med Imaging Graph, 27 (2–3) 101–109 (2003).
2. P. Mildenberger, M. Eichelberg, E. Martin. Introduction to the DICOM standard," Eur Radiol., 12 (4) 920–927 (2002). Epub 2001 Sept. 15.
3. B.L.T. Guthrie, C. Price, J. Zaleski, E. Backensto, "Digital Imaging and Communications in Medicine (DICOM) Archive is a Dynamic Component of a Clinician Image-related Workflow Solution," J Digit Imaging, 14 (2 Suppl 1)190–193 (2001).
4. J. Eng, J.P. Leal, W. Shu, G. Yang Liang, "Collaboration System for Radiology Workstations," Radiographics, 22 (5) e5 (2002).
Subscribe to:
Posts (Atom)
