Preparation for X-ray of the stomach and duodenum

Verification studies of the stomach during clinical examination are performed on special X-ray diagnostic devices - gastrofluorographs - under the control of X-ray television inspection. The study is performed on an empty stomach. For 20-30 minutes before the patient puts under the tongue 2-3 tablets of an aeron for the relaxation of the stomach. As a contrast agent, a specially prepared highly concentrated suspension of barium sulphate is used, and for stretching the stomach a fanulent blowing agent is used. X-ray photography is performed in several standard projections with vertical and horizontal patient positions. The resulting images are called "gastrofluorogrammy." The size of them, unlike conventional radiography, is small - 10x10 or 11x11 cm, the number is 8-12. If the images show pathological changes, the patient, as a rule, is directed to fibrogastroscopy. Carrying out mass X-ray examinations is justified in those geophysical regions where the incidence of gastric cancer is high.

Planned X-ray examination of the stomach and duodenum is carried out according to clinical indications on a universal X-ray machine, which allows performing serial X-ray diffraction under the control of X-ray telescoping. Currently, two methods of contrasting the stomach are used: ingestion of a barium suspension or a primary double contrast - barium suspension and gas.

When using the first method, the patient is in the X-ray room on an empty stomach. After a small sip of the liquid aqueous suspension of barium sulfate, the radiologist evaluates the swallowing act, the passage of the contrast mass through the esophagus, the state of the esophageal-gastric transition. Then he distributes the contrast mass over the interlining spaces of the stomach and makes a series of X-rays that fix the folded relief of the gastric mucosa. The patient then drinks 100-150 ml of a liquid aqueous suspension of barium sulfate, and the doctor examines the position, shape, size and shape of the stomach, its tone and peristalsis, the course of emptying, the condition of the pyloric canal and duodenum. Pictures are produced in different projections and with different positions of the patient's body.

If necessary, in addition to barium, the patient is allowed to drink a gas-forming mixture, as a result of which the stomach is stretched by gas and it becomes possible to obtain some additional diagnostic data. This method was called "double contrasting of the stomach."

For the primary double contrasting of the stomach, a special barium suspension is used, the density of which is 4-5 times higher than that of a conventional suspension. It differs uniformity, increased adhesion to the mucous membrane, has a resistance to flocculation, i.e. Does not precipitate in the acidic contents of the stomach. Before the study, the patient is administered parenterally with metacin for the relaxation of the digestive canal. Then, in the vertical position, the esophagus is examined after 2-3 throats of barium suspension. After taking 50-70 ml of contrast medium, the patient is offered to drink gas-forming powder. Further studies are carried out in a horizontal position. After several turns around the longitudinal axis during which the chemical reaction of gas formation takes place and the stomach is blown and its mucous membrane is smeared with barium, serial x-ray of the stomach and duodenum is performed in various projections, usually in two to three anterior (straight and oblique) and two- three back (also straight and oblique). X-rays are mainly performed in order to select the best projections for radiography. Analysis of the results of the study is carried out on a series of radiographs.

[1], [2], [3]