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ESOPHAGOGRAPHY

P R E S E N TA N
DW I R A D I S A L I M 1 2 1 0 0 1 1 5 1 4 1

PRESEPTO R
D R . H I D A Y A T W A H Y U A J I , S P. R A D

S M F I L M U K E S E H ATA N R A D I O L O G I
RSUD AL-IHSAN 2016
Definisi
• Suatu pemeriksaan radiologi yang menggunakan Barium Sulfat atau
dengan istilahlainnya barium swallow
Tujuan
• Mempelajari bentuk dan fungsi dari dari pharyng sampai esophagus

Indikasi
• Anatomical anomaly
• Impaired swallowing mechanics
• Foreign body obstruction
• Esophageal reflux
• Esophageal varices
ANATOMI – ORAL CAVITY
mastikasi

Penelanan

peristalsis
ANATOMI – PHARYNX (3 PART)
ANATOMI – ESOPHAGUS
ANATOMI
ESOFAGUS PADA MEDIASTINUM
RINGKASAN DARI DIGESTI MEKANIK
Oral cavity

• Mastication (chewing)
• Deglutition (swallowing)
Pharynx

• Deglutition
Esophagus 1-8 seconds

• Deglutition
• Peristalsis (waves of muscular contractions)
Stomach 2-6 hours

• Mixing
• Peristalsis
NB : menjadi chyme
Positioned the same as an AP & Lateral
Soft tissue neck C-spine: ½ the mAs.
Done to assess the patency
of the airway
Expose Nasopharynx * masses
during
Adnoids * foreign bodies
inspiration
* enlarged adnoids (kids)
* epiglottitis (kids)
Oropharynx

Hyoid bone
Esophagus

Trachea
ESOPHAGRAPHY & UGI PROSEDUR

Medium Kontras diperlukan

Menambah atau mengurangi


kepadatan jaringan
positif atau radiopaque

Seperti substansi kapur


BARIUM SULFAT Lebih menyerap pada x - ray

BaSO4
WATER-SOLUBLE
IODINATED CONTRAST MEDIA
INDIKASI
• Perforasi Viscus
• Prosedural Presurgical
Kontraindikasi
• Hipersensitif terhadap iodine
FLUOROSKOPI
Kemampuan untuk melihat dan merekam anatomi
dalam gerak ( Mengevaluasi fungsi dan bentuk )
PROSEDURAL FLUROSKOPI
RAO: PROJECTION COMMONLY TAKEN
DURING ESOPHAGOGRAPHY
RAO ESOPHAGRAM
BAGAIN ATAS DAN TENGAH ESOPHAGUS
DIAGNOSIS UNTUK ESOPHAGEAL REFLUX
Breathing exercises (two types)

The water test

Compression paddle technique

The toe-touch test

BREATHING EXERCISES
Valsalva maneuver
• Patient takes in deep breath and holds in breath
while bearing down as if trying to move the
bowels.
Mueller maneuver
• Patient exhales, then tries to inhale against closed
glottis.
WATER TEST
Positive if barium regurgitates
into esophagus (LPO position,
swallow water through straw)

COMPRESSION PADDLE
Paddle inflated under stomach
with patient in prone position

Pressure applied to stomach


region to create reflux
TOE-TOUCH MANEUVER

Effective for reflux and hiatal hernia


POSTFLUOROSCOPY PROJECTIONS
Esophagogram

Routine
• RAO (35°-40°)
• Llateral
• AP (PA)
Special
• LAO
• Soft tissue lateral
EVALUATION CRITERIA RAO ESOPHAGOGRAM

Entire esophagus
demonstrated

Esophagus midway
between spine and heart

Optimal exposure factors


LATERAL ESOPHAGOGRAM
Entire esophagus
demonstrated

Esophagus midway
between spine and heart

Arms not superimposing esophagus

True lateral position

Optimal exposure factors


AP (PA) ESOPHAGOGRAM

No rotation

Optimal exposure
factors
LAO ESOPHAGOGRAM

Entire esophagus demonstrated

Esophagus midway between spine and


hilar region

Optimal exposure factors


ADDITIONAL IMAGING PROCEDURES
Video Esophagraphy
• Swallowing dysfunction

Computed Tomography
• Tumor staging

Magnetic Resonance Imaging


• Varices

Ultrasound
• Tumors
• Varices
• Polyps
Nuclear Medicine
• Reflux
• Barrett’s
HATUR NUHUN 

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