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Comprehensive Guide to Large Intestine Anatomy and Barium Enema Procedure

Explore the anatomy of the large intestine from the iliocecal valve to the rectum and learn about the Barium Enema procedure, contraindications, room preparation, equipment setup, and imaging techniques.

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Comprehensive Guide to Large Intestine Anatomy and Barium Enema Procedure

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  1. Chapter 15 Lower GI

  2. Large Intestine Anatomy • From Iliocecal valve (Terminal Ileum) • ____________ • Appendix • ____________ colon

  3. Large Intestine Anatomy • __________ flexure (Right Colic) • __________ Colon • ___________Flexure (Left Colic) • ___________Colon

  4. Large Intestine Anatomy • __________ Colon • Rectum • _____________ • Anus

  5. Large Intestine Anatomy • ___________ – Pouches of the large intestine • __________ Coli

  6. Colon Orientation • Anterior aspects – _______________ • Posterior aspects – __________________________colon

  7. Barium and Air DistributionSupine • Air within the anterior aspects • ________________________ • Barium within the posterior aspects • ___________________________

  8. Barium and Air DistributionProne • Air within ____________ aspects • Rectum, Ascending, and Descending • Barium within ___________ • Transverse and Sigmoid

  9. Intestine Purpose • __________ – Primarily done in Small • Absorption – Primarily done in Small • _______________ – Primarily done in Small Some done in Large

  10. Moving it • Elimination _______________ – Large Intestine • Movement – Peristalsis Small and Large • ____________in Large

  11. Barium Enema • Patient prep • ______________ • Bowel prep • _________________ • Cleansing __________ • ________________________________

  12. Contraindications to Laxatives • Gross ______________ • Severe _____________ • Obstruction • Inflammatory Condition • ________________

  13. Room prep • ______________ • _____________ • Gloves • Have everything ready _____ the test

  14. BE Equipment • Determine if it’s ___________ Contrast • Enema tip • Single or Double • Check ___________ • _________

  15. Barium Prep • Barium bag • Mixed with _____________(Cold is debatable) • _________– Scald mucosal linings • Bag should not be more than ______ the table

  16. Tip Insertion • TALK EACH STEP WITH THE PATIENT • Have Barium ____________to tip • Place pt in ____________ position • Lubricate tip • Have pt take in a ____________it out

  17. Here It Comes!! • On expiration insert tip into rectum • Toward ____________________ • Insert only _____________ • __________________________ • Some rads will want to insert and some want you to inflate.

  18. During Fluoro • Assist the radiologist • Control the _______________ • Switch out spot films if applicable • Help the patient roll • _________________ • Prepare for the _________________for the best

  19. After The Radiologist Leaves • Work _____________ • Encourage the patient

  20. Once your overheads are done • Ensure you did not miss ____________ • Place the enema bag ____________ • _______ as much as possible into the bag • Assist the patient to the ________

  21. Barium Contraindications • Any possibility of a _____________ • Bowel ______________ • If there is a contraindication • _______________iodinated contrast.

  22. Other than the routine • Babies • ___________ • ___________ • Un-prepped

  23. BE Imaging Routine • Scout kVp – 75-80 • AP kVp - 100 • RPO (RAO) • LPO (LAO) • Lt Lateral • AP and/or PA Axial • Post Evac kVp – 75-80

  24. AP / PA BE • Position as a KUB • Center at crest • Have pt hold breath

  25. RPO • 45° Oblique • Center at crest or _______________ • Center to mid body mass • Shows __________________ • Same as _______

  26. LPO • 45° Oblique • Center at crest • Shows ________________ • Same as ___________-

  27. Lt Lateral Rectum • Place pt on lt side • Center at ______________ • Shows rectum

  28. AP Axial(Butterfly) • Supine • ________________ • Center _____________ASIS • Mid sagittal

  29. PA Axial • Prone • _______________ • Center at ____________ • Mid sagittal

  30. Post Evac • PA or AP • Position as a routine KUB

  31. Air Contrast Additional Positions • Right and Left Decubitus • X-table Rectum

  32. Right Lateral Decubitus • Place patient in true ___________ • Using a x-table grid holder place center of the cassette at the __________ • Center CR to cassette • Ensure arms are up • Shows ______________

  33. Left Lateral Decubitus • Position patient in true left lateral • Center as RLD

  34. X-table rectum • Lie the patient prone • CR to go _______________ • Center at ____________ and mid coronal

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