BARIUM MEAL

Normal vs Abnormal
 DEFINTION

ID\ It is a type of x-ray fluoroscopy study of

gastroesophageal junction, stomach and
duodenum abnormalities.

AIMS\ To look for problems in the stomach and duodenum by

drinking barium sulfate suspension, then X-ray series of images are
taken. It is often performed straight after a barium swallow test.
 Indications
Dyspepsia Upper abdominal mass Reflux diseases

Unexplained weight loss

Partial gastric or duodenal obstruction

Gastrointestinal hemorrhage Suspected hiatus hernia

 CONTRAINDICATIONS

Complete bowel obstruction

Suspected perforation

Pregnancy
 ADVANTAGES vs DISADVANTAGES

Extremely safe
Slight chance of cancer
Noninvasive
In GENERAL from excessive exposure
to radiation
The results of the upper
GI series usually lead to
Occasionally allergy to
accurate evaluation
the flavoring added to
some brands of barium
Allergic reactions are
extremely rare
Slight chance that some
barium could be retained,
No radiation remains in a
and block the digestive
patient's body
system.
Rare side effects
 TYPES

SINGLE contrast\ Using HIGH density and BIG amount

of BARIUM suspension alone to fill the stomach and
duodenum

DOUBLE contrast\ Using with LOW density and

SMALL amount of BARIUM suspension with AIR to coat the
wall of stomach and duodenum

BI-PHASIC contrast\ It combines Both types in one

procedure
PATIENT PREPARATION
 NORMAL BARIUM MEAL

SINGLE contrast DOUBLE contrast

 ABNORMAL
BARIUM MEAL
INFILTRATIVA CARCINOMA

EROSIVE GASTRITIS
 HIATUS HERNIA

MALIGNANT GASTRIC ULCER

GASTRITIS VALVULUS

GASTRITIS DIVERTICULUM
PYLORIC STENOSIS

DEUDENAL ULCER
 SUMMARY
-BARIUM MEAL a type of x-ray fluoroscopy study of
gastroesophageal junction, stomach and duodenum

-It is INDICATED in case of upper GI abnormalities like tumor,

ulcer and partial obstruction

-CONTRAINDICATED in case of complete obstruction of

perforation

-Extremely SAFE

3 TYPES are used (single, double and biphasic)

 Atresia duodenum

Suatu kondisi dimana

duodenum tidak berkembang dengan baik,
sehingga tidak memungkinkan
perjalanan makanan dari lambung ke usus.
 ETIOLOGI
• Kelainan bawaan yang penyebabnya belum
diketahui secara jelas

• Kelainan pengembangan embrionik saat

masih dalam kehamilan.
 Tanda dan Gejala
• Pembengkakan abdomen Pada bagian atas
• Muntah terus-menerus
• Tidak memproduksi urine setelah beberapa kali
buang air kecil
• Muntah banyak segera setelah lahir & berwarna hijau
karena empedu
• Hilangnya bising usus setelah beberapa kali buang air
besar
 PEMERIKSAAN RADIOLOGI
Radiografi
The Double Bubble Sign
Supine frontal radiograph of the abdomen demonstrates the double
bubble sign: an enlarged stomach (S) and proximal duodenum (D) in
a neonate with duodenal atresia. Note the absence of distal gas.
Sonography of the fetal abdomen (see pictures above), show 2
anechoic lesions (double bubble sign). The first bubble is formed by
the fluid filled fetal stomach, the second being formed by the
distended fetal duodenum. The obstruction is likely to be at the 2nd
part of the duodenum. These ultrasound images (double bubble sign)
suggest the likelihood of duodenal atresia.
CT Scan
 PENATALAKSANAAN
• Pemasangan tuba orogastrik
• Memberikan cairan elektrolit intravena
• Mengatasi sindrom down
• Pembedahan
 STENOSIS DUODENUM
• penyempitan pada duodenum yang menyebabkan obstruksi
pada duodenum akibat kegagalan dalam proses
pembentukan embriologi struktur bilier dan pankreas
selama masa fetus.
 TANDA DAN GEJALA
• Gejala klinis yang paling sering muncul adalah muntah
bilious dan intoleransi makanan. Dari pemeriksaan fisis,
tdak ada temuan yang spesifik untuk menegakkan
diagnosis, namun mungkin kita akan menemukan distensi
pada perut bagian atas.
 PEMERIKSAAN RADIOLOGI
Pada foto polos abdomen akan didapatkan gambaran udara
double bubble yang merupakan patognomonis gambaran pada
obstruksi duodenum.
Prenatal sonogram in a sagittal
oblique plane to the fetus Axial ultrasound, shows
demonstrates the double polyhydramnios and the
bubble sign in a fetus with stomach and duodenal bulb
duodenal stenosis. In utero,
the stomach (S) and
duodenum (D) are filled with
fluid.
 PENATALAKSANAAN
Prinsip penatalaksanaan ileus obstruktif parsial et causa
suspek stenosis duodenum pada dasarnya berupa :
• Balance cairan dan elektrolit
• Dekompresi
• mengatasi syok dan keadaan emergensi (jika ada)
• hilangkan obstruksi

Dapat dipertimbangkan untuk pemberian antibiotik spektrum

luas. Duodenuduodenostomy atau duodenotomy dengan
reseksi membran merupakan pilihan tindakan operatif pilihan.