Radiographic positioning for barium enema
This presentation is the property of its rightful owner.
Sponsored Links
1 / 19

Radiographic Positioning for Barium Enema PowerPoint PPT Presentation


  • 546 Views
  • Uploaded on
  • Presentation posted in: General

Radiographic Positioning for Barium Enema. Presented by Aries Paul Zeta, RRT Property of Davao Doctors College. 10 – Miller’s Routine Sequence of Radiographs. AP – to include flexures Left lateral rectum AP – 15 – 25 degs. Cephalic(CR) to include rectum.

Download Presentation

Radiographic Positioning for Barium Enema

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Radiographic positioning for barium enema

Radiographic Positioning for Barium Enema

Presented by

Aries Paul Zeta, RRT

Property of Davao Doctors College


10 miller s routine sequence of radiographs

10 – Miller’s Routine Sequence of Radiographs

  • AP – to include flexures

  • Left lateral rectum

  • AP – 15 – 25 degs. Cephalic(CR) to include rectum.

  • 15 – 25 degs.RPO – to include Left colic

  • Right lateral – to include rectum


Radiographic positioning for barium enema

Cont…

  • Prone PA – to include flexures

  • Prone PA with 15 – 25 degs caudal angulation (Angle Prone)– to include rectum.

  • 15 – 25 degs LPO- to include the right colic flexure.

  • Supine – AP tightly collimated ileocecal region proj. taken in 2 – 3 degs obliquity.

  • Using horizontal central ray, upright proj. of both flexures and lateral rectum.


Modification of positions for barium e nema

Modification of Positions for Barium Enema

Usually used in the hospital


Scout film

Scout Film

First exposure of the procedure should be a plain radiograph of the abdomen area.

Advice the patient to lie down on the radiographic table, the MSP of the patient should be inline with the MSP of the Table.

Center the CR at the level of the L4 or the level of the iliac crest.

Respiration is suspended during expiration.

L4


Sim s position

Sim’s Position

Sims position – relaxes the abdominal muscles and decreases pressure within the abdomen.

Instruct the patient to lie on their side away from the tech. let the lower arm of the patient to be put at the back of his body. The up side knee should be flex for support and lower side extremity should not be flex or bent.

Wearing gloves, coat enema tip with water-soluble lubricant.(KY jelly or any sterile lubricant). On expiration, direct enema tip toward the umbilicus proximally 1 to 1.5 inches. After initial insertion, advance up superiorly and slightly anteriorly. Do not force enema tip.

Tape tubing in place to prevent slippage. Do not inflate unless directed by radiologist. Ensure IV pole/enema bag is no more than 24 inches (60cm) above the table. Ensure tubing stopcock is in the closed position and no barium flows into the pt.


Left right position of the recto sigmoid area film 10x12cm lengthwise

Left/Right position of the recto sigmoid areaFilm: 10x12cm lengthwise

True lateral position of the Recto sigmoid

CR should be 5-7cm above the level of the pubic symphysis in the midaxillaryplane


Ap recto sigmoid area film 10x12cm crosswise

AP (recto sigmoid area)Film: 10x12cm crosswise

AP view of the Rectum & Sigmoid should be included

CR 5-7 cm above the level of the pubic symphysis

5-7cm above pubic symphysis


Ap single contrast film 14x17cm

AP (Single Contrast) Film: 14x17cm

An Entire colon filled with contrast media should be demonstrated including the splenic flexure and the rectum.

CR is at the level of the L4 or at the level of the iliac crest

L4


Ap double contrast film 14x17cm lengthwise

AP Double ContrastFilm: 14x17cm lengthwise

Patient lies in a supine position MSP is in line with the MSP of the table

An Entire colon filled with positive and negative contrast media should be demonstrated including the splenic flexure and the rectum.

CR is at the level of the L4 or at the level of the iliac crest

L4


Rpo position optional film 14x17cm lengthwise

RPO Position(optional)Film: 14x17cm lengthwise

Instruct the patient to lie on his right side making an angulation of 35-45deg

It is taken primarily to demonstrate the Left Colic(splenic) flexure and ascending colon should be visualized.

CR is at the level of the L4 or at the level of the iliac crest


Lao position optional film 14x17cm lengthwise

LAO Position (optional)Film: 14x17cm lengthwise

It is taken primarily to demonstrate the right colic (hepatic) flexure and sigmoid portion of the colon

CR is at the level of the L4 or at the level of the iliac crest


Right lateral decubitus film 14x17cm lengthwise

Right Lateral DecubitusFilm: 14x17cm lengthwise

Best demonstrate the “up” medial side of the ascending colon and the lateral side of the descending colon, when the colon is inflated with air due to gravity.

CR at the level of the L4 or at the level of the iliac crest


Left lateral decubitus film 14x17cm lengthwise

Left Lateral DecubitusFilm: 14x17cm lengthwise

Best demonstrate the “up”, medial side of the descending colon and the lateral side of the ascending colon, when the colon is inflated with air.

CR is at the level of the L4 or at the level of the iliac crest


Ventral decubitus film 10x12cm lengthwise

Ventral DecubitusFilm: 10x12cm lengthwise

A cross table view of the recto sigmoid area

Demonstrate the air-fluid level of the recto sigmoid area

CR is at 5-7 cm above the level of the pubic symphysis in the midaxillary plane


Pa axial position angle prone film 10x12cm or 11x14cm crosswise

PA Axial position (Angle Prone)Film: 10x12cm or 11x14cm crosswise

Rectosigmoid area must be less superimposition than in the PA projection because of the angulation of the CR

Center it the midline of the body with an angulation of 30-400caudad at approximate level of the anterior superior iliac spines.


Supine position film 14x17cm lengthwise

Supine position Film: 14x17cm lengthwise

A postevacuation radiograph view of the colon is taken after the procedure is done

If inadequate satisfactory delineation of the mucus the patient may be given hot beverage (tea/coffee) to stimulate evacuation


Radiographic positioning for barium enema

After carePatient is advised to drink plenty of water, or laxative is taken to remove excess barium sulfate.


Acknowledgement

Acknowledgement

  • Radiographic positioning demonstrated by Davao Doctors College Interns


  • Login