Single
Double (Single +
Air)
Pemeriksaan Barium Pada
Saluran Cerna / GIT
Radiographic Anatomy & Pathology
Barium Swallow, Contrast Tunggal
Cricopharyngeu
s Muscle
At level of C5-C6,
Part of upper
esophageal
sphincter (UES)
Esophagu
s
Barium Swallow, Contrast Tunggal
Indikasi
Utama:
Dyshagia
Double
Contrast
Identation of
A.A
Indentation of
L.main
bronchus
Single Contrast
Barium Swallow, Contrast Tunggal
L.
A
.
Heart
L.
V.
Barium Swallow, Contrast Ganda
Indentation of
L.main
bronchus
Double Contrast
Single Contrast
Barium Swallow, Contrast Tunggal
Ampulla
Normal Varient
Fundus
Body
Barium Swallow, Contrast Tunggal
Aortic
Arch
Barium Swallow, Contrast Ganda
Menyempit:
Bisa karena
peristaltik,
diperlukan
pengambilan
gambar posisi lain
Barium Meal, Double Contrast
(Supine Position)
Posisi
Supine :
Tampak Barium
mengumpul di
fundus akibat
gravitasi
Angular Notch
Incisura
Angularis
Antrum
Bod
y
Barium Meal + Follow-Through
(Posisi Tegak)
DJJ:
Barium
Meal
Normal Position= Left
side
Angular Notch
Incisura Angularis
Duodenal
Cap
Pyloric
Canal
2nd Part of
Duodenum
3rd Part of
Duodenum
Ileu
m
Body
Antru
m
Jejunum:
Plica Circularis on the
outer border
Barium
Follow-Through
Barium Follow-Through to Cecum
(Posisi Berdiri)
DJJ:
2nd Part of
Duodenum
3rd Part of
Duodenum
Normal Position= Left
side
Small Bowel Enema
A Modified Follow-Through which is called Small Bowel Enema note that the
bowel is more distended here
This procedure involves inserting a thin tube through the mouth, esophagus and past the stomach to inject
barium, methylcellulose and water into the small bowel. This allows for better visualization of the small bowel
than can be seen during a small bowel follow-through
Barium Follow-through
Barium Swallow, Single Contrast
Esophag
us
Dilatasi
sisi
Proximal
Menyemp
it(Stricture
)
Bird Peak Sign (tanda paruh
burung)
ABNORMALITY
Barium Swallow, Contrast Tunggal
Esophagus bagian bawah
Stricture
Jinak:
Dilatasi
Proximal
Bagian
Distal
menyempi
t
Zona
peralihan/
transitional
tampak halus
dan tidak
tampak filling
defects
Barium Swallow, Single Contrast
Stricture
Ganas:
DDx:
Adeno CA
Sq. Cell
CA
-Zona
transitional
tampak Irregular
& batas kabur
- tampak filling
defects
Filling
Defect
It shows an irregularity that almost looks like an apple core lesion in the esophagus. This is typical
in carcinoma of the esophagus
Barium Swallow, Contrast Tunggal
(Oblique)
Filling
Defect
Malignant
Stricture
Long Irregular
Narrowing
It shows an irregularity that almost looks like an apple core lesion in the esophagus. This is typical
in carcinoma of the esophagus
Barium Swallow, Single Contrast
(Oblique)
Irregular Wall & Dilatation:
Tertiary Contraction (Pathological non-propulsive
Contraction)
Funnel
Shape
(Achalasia)
Barium swallow in this patient with achalasia reveals a
smooth distal tapering caused by the hypertensive lower
esophageal sphincter that straddles the diaphragm, and
multiple non-Peristaltic contractions throughout the body of
the esophagus. This radiographic appearance sometimes has
been called "vigorous achalasia". This term has little value,
however, because recent studies suggest that patients with
so-called vigorous achalasia cannot be distinguished clinically
Barium Swallow, Single Contrast
Well Defined
(Oblique)
Contrast Filled
left cervical level
sac
Pharyngeal Pouch
(Zenker's
Diverticulum):
occurs in an area of anatomic
weakness known as Killian's
dehiscence
Barium Swallow, Single Contrast
Irregular
Multiple Filling
Defects
Differential Diagnosis
Multiple Esophageal Filling
Defects:
1.Fungal Infx
2.Polyps
3.Esophageal Varices
(irregular)
4.Food Particles
Varices Barium swallow examination: AP view: Numerous rounded and elongated smooth-contoured
filling defects are present in the inferior two thirds of the esophagus. The contour of the esophagus
Barium Swallow, Single Contrast
Irregular
Multiple Filling
Defects
(Esophageal
Varices)
Barium Meal, Double Contrast
Contrast Filled
Speculated
Lesion
(Gastric Ulcer)
Barium Meal, Double Contrast
Ruga
e
Contrast Filled
Outpouching at
the Greater
Curviture
(Malignant Gastric
Ulcer)
Barium Meal + Follow-Through
1st Part of
duodenum
Contrast Filled
Speculated
Lesion
(Duodenal Ulcer)
2nd Part of
duodenum
4th Part of
duodenu
m
3rd Part of
duodenum
Barium Meal, Double Contrast
Speculate
d Mass
Ulcer
Pylorus
Stomac
h
Barium Meal, Double Contrast
Distended
Stomach
Single Bubble
Sign
DDx: Gastric
Output
Obstruction (GOO)
(Pyloric Stenosis)
Gas in Descending
Colon
(partial
obstruction)
Barium Meal, Double Contrast
(Erect Position)
DDx:
Pyloric Stenosis
Mushrooms Sign
(or apple core
Sign)
Strings
Sign
Shoulders
Sign
For further information refer to Pediatric Abdomen Radiology Slides
Barium Enema, Contrast Tunggal
Colon
asende
n
Colon
transversu
m
Colon
Desenden
Cecum
Termina
l Ileum
Sigmoid
Barium Enema, Double Contrast
(Right Lateral Decubitus)
Flexura
Hepatica
Perhatikan
Akibat dari
gravitasi
Barium Enema, Double Contrast
(Prone Position)
Cecum
Barium Enema, Contrast Ganda
(Posisi Supine)
Rectum
ABNORMALITY
Barium Enema, Double Contrast
Normal
(Prone Position)
Segments
Skip Lesions & lesions
in Small intestines
DDx: Crohns Disease
Strictures in Small
intestines
There is a short segment of abnormal
descending colon with asymmetrical puckering
of the mucosal surface, without stricturing.
Note also however that contrast has refluxed
into the terminal ileum and small bowel, and
there are several strictures present within it.
One of these lies adjacent to the large bowel
Cecum
Differential Diagnosis of
Terminal Ileum Narrowing:
1.Tumor Lymphoma
2.Iatrogenic Adhesion
3.Inflammatory (IBD)
There is smooth narrowing of the terminal ileum and an adjacent loop of more proximal ileum as it
crosses to the right side of the pelvis. There is no visible mucosal fold thickening or ulceration.
Barium Enema
Multiple Filling Defects
Cobble Stone appearance
DDx: Crohns Disease
Cecu
m
There is abnormal wall thickening, luminal narrowing, and cobblestoning involving a long segment
of the distal ileum including the terminal ileum.
Barium Enema
Ascending colon
DDx: IBD
Pseudopoly
ps
Pseudodiverticulu
m
Barium Enema
Contrast Filled Sacs
(outside the Lumen)
Diverticulosis in Descending & Sigmoid Colon
Barium Enema
Diverticulosis
Barium Enema, Double Contrast
Barium Enema, Double Contrast
Multiple Small & Round Filling Defects
DDx: Multiple Polyps
Barium Enema, Double Contrast
Loss of Haustrations
LEAD PIPE SIGN
DDx:
Ulcerative Colitis
(Pancolitis)
Cecum
Terminal
Ilium
Barium Enema, Double Contrast
Loss of
Haustrations
Splenic Flexure
Granular
Mucosa
Multiple Filling
Defects
DDx:
Ulcerative
Colitis
Granular mucosa and complete absence of haustra which confirm total colitis. 2 short strictures are
present in the descending colon, but there were no malignant features radiologically
Barium Enema, Double Contrast
Ask the Doctor About
these
Multiple
Apple Core
Sign
DDx:
Colon
CA
Barium Enema
Strictur
e
Apple Core Sign
DDx:
Sigmoid Colon
CA
Barium Enema
Apple Core
Sign
DDx:
Colon
CA
Barium Enema
A Sigmoid Stricture is
always considered
malignant until proven
otherwise
Barium Enema, Double Contrast
A huge right indirect
hernia in the scrotum
Barium Enema, Double Contrast
A huge mass that has
displaced the
intestines
(Spleen)
Barium Enema
Meconiu
m
Filling defects & dilated
Descending & Sigmoid
Colon
Transition
Zone
is the term applied to the region in which a marked change in
caliber occurs, with the dilated, normal colon above and the
narrowed, aganglionic colon below
According to the Transition Zone:
Rectum Ultra Short
Rectosigmoid Short
Transverse Colon Long
Beginning of the Colon Total
(microcolon)
DDx:
Hirschsprung disease (HD) which is more definitively
diagnosed by means of contrast enema examination, which can
show the presence of a transition zone, irregular contractions,
mucosal irregularity, and delayed evacuation of contrast
material, among other findings
Although the hallmark of the diagnosis is the presence of
transition zone but its absence exclude the disease
For more info visit:
http://emedicine.medscape.com/article/409150-
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