Manal

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2016-05-09 28K 28 0 0

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AlOsaimi. Small Bowel procedures. Small Bowel Procedures. 1. 2. 3. 4. Anatomy. Anatomy . Parts of S.I:. Duodenum: 1. st. ,shortest,widest and most fixed.. Jejunum: 2/5 and feathery appearance.. Ileum: 3/5, longest, smooth no feathery appearance, and joins large intestine at . ID: 311916 Download Presentation

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Manal




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Slide1

Manal AlOsaimi

Small Bowel procedures

Slide2

Small Bowel Procedures

1

2

3

4

Slide3

Anatomy

Slide4

Anatomy

Parts of S.I:

Duodenum: 1

st

,shortest,widest and most fixed.

Jejunum: 2/5 and feathery appearance.

Ileum: 3/5, longest, smooth no feathery appearance, and joins large intestine at

ileocecal valve

.

Slide5

Slide6

Small Bowel Gas Pattern

Centrally located

Soft tissue

across

entire lumen

Colon Gas Pattern

Peripheral Located

Mostly not overlapping

Haustra

markings

Slide7

A: duodenum

C: jejunumD:ileumE: area of ileocecal valve

PA 30

mins

Slide8

To Prepare:

1

NPO

For 8 hrs

.

2

Low residue diet

2 days before the procedure.

3

No smoking or chewing gum during the NPO

period

.

4

Void before the procedure

To avoid displacement of the ileum due to distended bladder

5

Enhance the rate of gastric emptying

Metoclopramide

20 mg orally, 20 min before examination

Slide9

1. Ba Meal Follow through

Routine UGI first

Patient ingests a cup of

Ba

when UGI series is completed (note the time)

30 min PA radiograph (30 min after 1

st

Ba

ingestion, usually 15 min after UGI series is completed)

Half-hour interval radiographs until

Ba

reaches large bowel (usually 2 hours)

If more time is needed(

<

2hrs) 1-hour interval radiographs are obtained.

Optional: spot films of ileocecal valve using compression cone??

To separate the bowel loops that may obscure the terminal ileum

Slide10

PA 30 min 1 hr

Slide11

2 hr

Slide12

Spot film with compression cone?To separate the bowel loops that may obscure the terminal ileum

Ileocecal valve

Slide13

Plain radiograph(scout).2 cups of Ba ingested (note the time.)15 or 30 min radiograph (center to the iliac crest “high” to include the stomach, because most of the Ba is in the stomach and proximal S.B.)Half-hour interval radiographs until Ba reaches large bowel (usually 2 hours)If more time is needed(< 2hrs) 1-hour interval radiographs are obtained.

2.

Ba

Follow through (S.B only)

Slide14

Injection of c/m into the S.B. It is a Double contrast method used to evaluate the S.B. the pt is intubated under flouroscopic control with a special catheter. Stomach → duodenum → duodenojujinal junction.CMThin BaSO4. ( Coats the mucosa).Air or Methylcellulose

3.

Enteroclysis

Slide15

Double Contrast

3. Enteroclysis

Slide16

It is a single contrast method where a nasogastric tube is passed through: pt’s nose→esophagus→stomach→duodenum and into the jejunum. (RAO position is preferred ? )To help pass the tube from stomach →duodenum by gastric peristalsis.C.M: thin BaSO4 or water soluble iodinated c.m

4. Intubation ( S.B enema)

Slide17

Single Contrast

4. Intubation

Slide18

Thank you

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