How to perform barium meal (double contrast)

NBM since 10 pm

Consent explain

Put IV scalp vein.

Patient in supine position

Tell him to take 1 gulp of barium 98% w/v mixed with water.

Follow it on fluoroscopy to seen any obstruction /reflux.

Tell him to take 2more gulps of barium.

Fundus of stomach will start getting coated.

Roll him over to coat mucosa of stomach.

If he needs more tell him to take more gulps to coat entire stomach.

Put him in right lateral decubitus for barium to cross pylorus.

Once barium just crosses pylorus , give him IV buscopan now (to stop motility in 10 minutes).

Then immediately give him ENO 1 packet with barium.

Now tilt him left lateral decubitus for gas to rise into pylorus.

Once gas reaches duodenum, make him erect for gas to reach duodenal cap. Take first shoot (on half
plate)

Then make him lie down roll him and take C –loop double contrast. Take second shoot (on half plate)

Then mix barium 1:1 with water and tell him to take more gulps. Barium should reach small bowels. Put
him in right lateral decubitus so that barium reaches IC junction.

Take stomach and small bowel …3rd shoot. From nipples down on 10x10 or 11x14 cassette.

Then take IC junction shoot after compression paddles.

Then take OG junction after another gulp in supine postion. 4th shoot

Total films given are 3

1) C –loop + duodenal cap, half plate each

2) Stomach and bowel loops (additional IC junction maginified after compression paddles are given)

3) OG junction

Barium swallow (single or double contrast) …in double contrast just add ENO to the barium.

In 1st gulp

First take pharynx, AP and Lateral

Then coat mucosa of esophagus…take AP , lateral.

Done .

4 shoots