X-ray examination( hereinafter RI) is a projection of human organs, obtained by passing through them special rays, which their inventor Conrad Roentgen himself called X-rays. The study is based on the ability of body tissues to absorb X-rays to one degree or another.
Accordingly, solid fabrics( bones) in the picture are seen perfectly, and soft - in the form of dark structures. Therefore, to investigate organs such as the stomach, esophagus and others, came up with a special method - an X-ray with the help of a barium substance that absorbs radiation well.
Indications
RI of the stomach and esophagus is performed to confirm or exclude any pathology:
- gastric ulcer;
- hernia of esophagus;
- disturbances of the swallowing reflex;
- tumors.
RI of the esophagus and stomach can also be carried out as part of a study of other GIT organs directly related to them.
Contraindications
Procedure is not prescribed in case of:
- pregnancy;
- permanent gastric bleeding;
- of the patient's severe condition.
In these situations, alternative methods of examination, such as fibrogastroscopy or MRI, are prescribed.
Preparation of
As with any type of medical examination of internal organs, it is also necessary to prepare for fluoroscopy in advance.
X-ray radiation is one of the types of gamma radiation, and there are norms that can be given to a patient in one procedure.
Pause before the next study should be sustained, so if the patient came unprepared - the doctor will take a picture, but can not see anything there. This is bad for the patient himself, as time is lost for treatment. Therefore, some rules must be observed:
- It is forbidden to use products that increase gas formation( rye bread, legumes, vegetables and other fiber containing fiber) before the RI, since bowel movements can block access to parts of other organs.3 days before the test, it is advisable to start taking preparations that reduce gas production - Espumizan, activated charcoal, etc.
- The stomach during the examination should be empty, since some of the food on the stomach wall will not give the contrast mixture to flow mucous, and this can be interpreted in the picture astumor. Therefore, in order to avoid an erroneous diagnosis, one should become hungry in the evening, and come to the examination with an absolutely empty stomach.
How do X-rays of the esophagus and stomach?
Before examining directly the stomach and esophagus, an overview fluoroscopy of internal organs is made, allowing to judge their condition, and the presence in the surrounding tissues of gas accumulations.
The study of the esophagus and stomach can be carried out by the following methods:
- traditional;
- for Trendelenburg;
- by double contrasting.
When a barium suspension( barium sulphate solution) passes inside the digestive tract, the radiologist will have an idea of the defects of the mucous membranes, and the time of its progress will give an opportunity to judge the constriction or obstruction of the organ.
Traditional method
A barium mixture is prepared mechanically, and the patient drinks a couple of sips. Control of its progress along the esophagus is carried out by means of translucence, while the function of the esophagus is studied.
The outline of its shadow is the reflection of the inner surface. In order to achieve an even distribution of the mixture and examine all the walls of the organ, the examination is also carried out in the horizontal position of the patient.
The mixture is not for long in the esophagus - when exhalation the esophageal sphincter relaxes and the barium passes into the stomach. The contrast mass is distributed along the mucosa and fills the spaces between the folds. For a better distribution, the contrast medium is smeared with palpation.
After examination of the mucosal relief, the patient is given another 150-200 ml of contrast medium. In this case, also in different projections the shape, position and size of the stomach is determined, and the course of its emptying is investigated.
Trendelenburg
Trendelenburg study implies a special position of the patient - the pelvis is raised at an angle of 45 degrees with respect to the head. This position is used to detect the hernia of the diaphragm - the organs are displaced to the diaphragm, and thanks to the contrast material, the doctor can see if they fall into the chest cavity.
The study on Trendelenburg is contraindicated for the elderly, with cardiovascular disease, sclerosis and limited respiratory function.
Double contrasting of
With this method of investigation, air is introduced into the stomach together with the contrast mixture. Applied for injection of air mass tube - compressor( gastric tube).This allows you to straighten its folds for better distribution of barium.
And also with the help of this method determine tumors, polyps and other changes of the mucosa, hidden deep in the folds of the stomach.
What does the snapshot show?
On the radiographs you can see:
- organ size change;
- foreign inclusions;
- excessive filling with gas or liquid of the stomach cavity;
- violation of patency;
- change in mucosal relief, wall thickness;
- violation of peristalsis.
Also the study helps to diagnose some gastrointestinal diseases.
Achalasia
This is a disease of the esophagus, characterized by difficulty in swallowing. Pathology can be accompanied by a decrease in the tone of the esophagus in the thoracic region and a violation of the peristaltic function of the intestine.
The radiograph shows a beak-shaped narrowing of the esophagus in the lower part, and in the upper part - an extension.
Hernia
In this disease, some organs of the abdominal cavity are displaced into the thoracic cavity through the esophageal opening of the diaphragm. The lower part of the esophagus, the loops of the small intestine, and the stomach can move.
This hernia may not manifest itself, and is diagnosed during RI or EGD.
Stomach cancer
A doctor may suspect malignant formation if an additional shadow is visible in the picture, since the cancer tumor is more dense in structure than surrounding tissues.
In contrast, the contours of the gastric wall are curved, which can also be diagnosed as a neoplasm.
Barrett's syndrome
This disease is a complication of reflux disease, in which non-characteristic cylindrical cells are found in place of the normal flat epithelium on the mucosa of the esophagus. This condition is considered precancerous, so early diagnosis of the disease is important.
Decoding: norm and deviation
The esophagus, filled with contrasting mass, resembles a tube and is a continuation of the pharynx. Contrast mass in the normal state of the esophagus moves freely, the contours of its shade are even.
A normal stomach is located in the upper part of the abdominal cavity, mainly to the left of the midline. When examined in the stomach clearly distinguish:
- cardiac department;
- arch;
- body;
- antral department;
- the gatekeeper's channel.
The folds of the gastric mucosa are variable formations. In the area of the body of the stomach, straight, longitudinal, parallel folds are defined. In the area of the antral region, the folds are oblique and then converge to the canal of the gatekeeper.
Reviews
Svetlana V. 40 years:
A diaphragmatic hernia has been detected, so I take x-rays with barium every year. The procedure is completely harmless in terms of unpleasant sensations, the only negative is the opposite taste of chalk in the mouth after drinking the mixture. And it takes a lot of time, because "they take pictures in different positions. Compared with gastroscopy, the results also wait a long time, my results are being prepared for 24 hours.
Tatiana K. 39 years:
She had an x-ray of the stomach with a barium mixture. I have not experienced any unpleasant moments before, or after the procedure. There was no nausea from taking the barium, no pain in the stomach, although I was examined for gastritis. The procedure took about 7 minutes. Although I doubt that X-rays with gastritis will give some results, for me it's better to do a gastroscopy, albeit unpleasant. But in the results you can be sure. By the way, fluoroscopy was done for free to me, which is a plus.
Price
Cost of roentgenography of the esophagus and stomach in Moscow:
| Clinic | X-ray of the stomach( RUB) | X-ray of the esophagus( RUB) |
|---|---|---|
| Family clinic( Khoroshevskoye shosse) | 2200 | 1500 |
| CM Clinic( Klary Zetkin st.) | 2800 | 2300 |
| Best Clinic( Spartakovskiy pere.) | 5200 | 4200 |
| OJSC "Medicine"( Tverskoy-Yamskaya per.) | 8100 | 5900 |
| European MC( Spiridonievsky per.) | 18100 | 9700 |
Pros and cons of
The advantages of this method include:
- availability;
- is relatively inexpensive;
- use of images for consultation with other specialists.
To drawbacks:
- difficulties in evaluating the function of the organ;
- ionizing radiation;
- lack of information without the use of contrast agents.
Safety Measures
Each X-ray room patient wonders if X-ray irradiation is harmful and how often it can be used for diagnosis.
In its physical nature, X-rays are an example of ionizing radiation. It is dangerous for cells, because it destroys the structure of DNA. But there are two things you need to know:
- We live all the time under conditions of a certain radiation radiation, ie about 3 millisievert( unit of radiation) per year we get from space.
- If a person does once a year an X-ray in two projections, he will receive an irradiation dose of 0.03 millisievert, that is, 100 times less than the background in which we live.