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1 OMD, Indikasi, Dan Mekanisme Rujukan Panoramic
1 OMD, Indikasi, Dan Mekanisme Rujukan Panoramic
1 OMD, Indikasi, Dan Mekanisme Rujukan Panoramic
( OESOPHAGUS MAAG
DUODENI ) /BARIUM MEAL
Departemen Radiologi
FK UNDIP
Anatomy Of Digestive System
⦿ Alimentary Canal
› Mouth
› Pharynx
› Esophagus
› Stomach
› Small and Large
Intestine
Anatomy Of Digestive
System
⦿Accessory
glands
› Liver
› Gallbladder
› Salivary
glands
› Pancreas
Esophagus
⦿ Originates around
C-6
⦿ In thorax, it is
anterior to spine,
posterior to
trachea and heart
⦿ Passes through
diaphragm
through
esophageal hiatus
Esophagus
⦿ Inferior to diaphragm
curves sharply left
⦿ Increases in diameter
⦿ Joins stomach at
esophagogastric
junction
⦿ At level of xyphoid tip
⦿ 4 layers of the
esophagus
› Outermost - fibrous
› Muscular
› Submucosal
› Innermost -
Mucosal
Stomach
⦿ Dilated saclike
portion of
digestive tract
⦿ Composed of
same 4 layers as
esophagus
› Outermost - fibrous
› Muscular
› Submucosal
› Innermost - Mucosal
Stomach
⦿ Divided into 4 parts
› Cardia
› Fundus
› Body
› Pyloric portion
⦿ Entrance to
stomach is cardiac
orifice
› Controlled by cardiac
sphincter
⦿ Exit is the pyloric
orifice
› Controlled by pyloric
sphincter
Small Intestine
⦿ Contains same four
layers as stomach
and esophagus
⦿ Mucosa contains
projections called villi
to facilitate digestion
and absorption
⦿ Divided into 3 parts:
› Duodenum
› Jejunum
› Ileum
Duodenum
⦿8 - 10 inches in length
⦿DEFINISI :
Pemeriksaan radiologis dengan
menggunakan kontras media untuk
memvisualisasikan esofagus,gaster
dan duodenum secara dinamik dengan
fluoroskopi dan radiografi.
BATASAN
⦿Perforasi
⦿Alergi kontras
⦿Obstruksi total upper GI
PROSEDUR
⦿Varises esofagus
⦿Achalasia esofagus
⦿Striktur esofagus
⦿Atresia esofagus
⦿Esofagitis
⦿ Tumor esofagus
⦿Fistula esofagus
⦿Divertikulum dan spasme esofagus
KELAINAN GASTER
Cricopharyngeu
s Muscle
At level of C5-C6,
Part of upper
esophageal
sphincter (UES)
Esophagu
s
Single Contrast
Double Contrast
Double
Contrast
Identation of
A.A
Indentation of
L.main
bronchus
Single Contrast
Single Contrast
Double Contrast
L.
A
Heart .
L.
V.
Double Contrast
Indentation of
L.main
bronchus
Double Contrast
Single Contrast
Single Contrast
Ampulla
Normal Varient
Fundus
Body
Single Contrast
Aortic
Arch
Double Contrast
Narrowing:
Could be peristalsis
So other shot is
advised
Double Contrast
(Supine Position) Supine
Position:
Note Barium
Distribution in the
Fundus due to gravity
Angular Notch
Incisura
Angularis
Antrum Bod
y
Barium Meal + Follow-Through
(Erect Position)
DJJ: Barium
Normal Position= Left Meal
side
Angular Notch
Incisura Angularis
Duodenal
Cap
Pyloric
Canal
2nd Part of
Duodenum
Ileu
m
Barium
Follow-Through
Barium Follow-Through to Cecum
(Erect Position)
DJJ:
Normal Position= Left
2nd Part of side
Duodenum
3rd Part of
Duodenum
Single Contrast
Esophagus
Proximal
Dilatation
s
Narrowin
g
(Stricture)
Benign
Stricture:
The transitional Zone
looks smooth and free
of filling defects
Proximal
Dilatations
Distal
Narrowing
Single Contrast
Malignant Stricture:
-The transitional Zone looks
Irregular & ill defined
- Presence of many filling
defects
DDx:
Adeno CA
Sq. Cell
CA
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
Single Contrast
(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
Single Contrast
Well Defined
Contrast Filled
(Oblique)
left cervical level
sac
Pharyngeal Pouch
(Zenker's
Diverticulum):
occurs in an area of anatomic
weakness known as Killian's
dehiscence
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 is irregular and spiculated.
Single Contrast
Irregular
Multiple Filling
Defects
(Esophageal
Varices)
Double Contrast
Contrast Filled
Speculated
Lesion
(Gastric Ulcer)
Double Contrast
Ruga
e
Contrast Filled
Outpouching at
the Greater
Curviture
(Malignant Gastric
Ulcer)
Barium Meal + Follow-Through
Contrast Filled
Speculated
1st Part of Lesion
duodenum (Duodenal Ulcer)
2nd Part of
duodenum
4th Part of
duodenu
m
3rd Part of
duodenum
Barium Meal, Double Contrast
Speculate
d Mass
Ulcer
Pyloru
s
Stomach
Barium Meal, Double Contrast
(Erect Position)
DDx:
Pyloric
Stenosis
Mushroom’s Sign
(or apple core
Sign)
String’s
Sign
Shoulder’s
Sign
Coin in esophagus. Frontal view of the neck and upper chest shows a
round metallic foreign body (white arrow) that lies in the midline just
above the aortic knob (red arrow).
Coins in the esophagus are round in appearance on the frontal view
whereas coins in the trachea are usually seen on end and are linear in
shape
ESOPHAGITIS
= Orthopantomogram