Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy
Mechanical pain on swallowing
Assessment of fistulae and perforation
Pre operative anatomical demonstration
Speech and Language therapy studies
Non specific, however low solar water soluble contrast agents are best
used in investigations where aspiration may occur.
Contrast Media and drugs (Typical Examples)
Volumes and concentrations are departmental / radiologist dependent.
Fluoroscopy with rapid film capability 10 frames/second
Fluoroscopy table with 90/20 tilt.
Special "feeding" equipment may be required, i.e. straws and feeding cups.
Injection administration equipment.
Patient Identification, Check Pregnancy state,
General psychological preparation and examination outline.
The stomach should be empty if a barium meal is likely to follow.
Define strict referral criteria to exclude clinically unhelpful examinations
Minimise fluoroscopy time and current
Introduce QA programme to make regular checks on and to optimize staff and equipment performance
Collimate X-ray beam to minimise size
Shield sensitive organs when possible
Install modern image intensifiers with sensitive (e.g. CsI) photocathodes and digital image processing
Use video recorder instead of cine camera during fluoroscopy wherever possible
Use spot film photofluoroscopy with modern image intensifier and 100mm camera instead of radiography whenever appropriate
Use pulsed systems with image storage devices in fluoroscopy.
Technique / Typical Film Series
The patient stands erect and rapid film sequences are taken whilst the
patient swallows the barium mixture, the series are generally taken for the
full length of the oesophagus in the PA, Lateral and Right Anterior
Oblique positions, with films taken prone to demonstrate oesophageal
Care must be taken to ensure that the patients arms and the drinking
equipment are kept clear of the image field.
Typical Film from Image Series
Record volumes and descriptions of contrast media and drugs
General patient psychological aftercare
Ensure the patient understands the procedure for receiving the
Warn the patient of the possibilities of constipation and appropriate
Aspiration of barium mixture
Leakage of barium into the peritoneum with and unsuspected perforation
Other Imaging Techniques