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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Contrast:
Barium taken by mouth or nasogastric tube.
Technique:
With the patient supine, fluoroscope to observe the motion of the
diaphragm.
Put the patient in the left lateral position, and give the patient
barium, and take a lateral view of the esophagus.
Put the patient in the supine position, and give the patient barium,
and take a supine view of the esophagus.
Put the patient in the right lateral position to empty the stomach
and take a lateral view of the duodenal sweep.
When contrast is seen to enter the 3rd/4th part of duodenum, turn the
patient supine and document the position of the duodenal jejunal
junction with a spot film.
Move the patient from right to left lateral and back again to attempt
to induce gastroesophagel reflux (Note if you are using a nasogastric
tube for the exam, pull it above the gastroesophageal junction before
checking for reflux.)
Aspirate the stomach at end of exam if you have a nasogastric tube
down.
Views to Take:
AP view of the esophagus
Left lateral view of the esophagus
Right lateral view of the duodenal sweep AP view of the Ligament
of Treitz Views of reflux if present
References:
See References Chapter.
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
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