Preparation for X-ray of the stomach and duodenum

Screening examinations of the stomach during a medical examination are carried out on special X-ray diagnostic devices - gastrofluorographs - under the control of X-ray television scanning. The examination is carried out on an empty stomach. 20-30 minutes before it, the patient puts 2-3 Aeron tablets under the tongue to relax the stomach. A specially prepared highly concentrated suspension of barium sulfate is used as a contrast agent, and a fanulated gas-forming drug is used to stretch the stomach. X-ray photography is performed in several standard projections with the patient in vertical and horizontal positions. The resulting images are called "gastrofluorograms". Their size, unlike conventional X-ray films, is small - 10x10 or 11x11 cm, the number is 8-12. If pathological changes are detected in the images, the patient is usually referred for fibrogastroscopy. Conducting screening mass X-ray examinations is justified in those geographical areas where the incidence of stomach cancer is high.

Routine X-ray examination of the stomach and duodenum is performed according to clinical indications on a universal X-ray machine, which allows serial X-ray imaging under the control of X-ray television. Currently, two methods of contrasting the stomach are used: oral administration of barium suspension or primary double contrasting - with barium suspension and gas.

When using the first method, the patient comes to the X-ray room on an empty stomach. After a small sip of liquid aqueous suspension of barium sulfate, the radiologist evaluates the act of swallowing, the passage of the contrast mass through the esophagus, the condition of the esophageal-gastric junction. Then he distributes the contrast mass along the interfold spaces of the stomach and makes a series of X-rays recording the folded relief of the gastric mucosa. Then the patient drinks 100-150 ml of liquid aqueous suspension of barium sulfate, and the doctor studies the position, shape, size and outline of the stomach, its tone and peristalsis, the course of emptying, the condition of the pyloric canal and duodenum. Images are taken in different projections and with different positions of the patient's body.

If necessary, in addition to barium, the patient is given a gas-forming mixture to drink, as a result of which the stomach is stretched with gas and at the same time it becomes possible to obtain some additional diagnostic data. This method is called "double contrast of the stomach."

For primary double contrasting of the stomach, a special barium suspension is used, the density of which is 4-5 times higher than the density of the usual suspension. It is characterized by homogeneity, increased adhesion to the mucous membrane, and is resistant to flocculation, i.e. it does not precipitate in the acidic contents of the stomach. Before the examination, the patient is given metacin parenterally to relax the digestive tract. Then, in a vertical position, the esophagus is examined after 2-3 swallows of the barium suspension. After taking 50-70 ml of the contrast agent, the patient is asked to drink a gas-forming powder. Further examinations are carried out in a horizontal position. After several rotations around the longitudinal axis, during which a chemical reaction of gas formation occurs and the stomach is inflated and its mucous membrane is coated with barium, serial radiography of the stomach and duodenum is performed in various projections, usually in two or three anterior (direct and oblique) and two or three posterior (also direct and oblique). Fluoroscopy is performed mainly to select the best projections for radiography. Analysis of the results of the study is carried out on a series of radiographs.

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