Stomach x-ray is a non-invasive radiopaque technique used to detect diseases of the stomach, as well as the cardiac esophagus and duodenum. With the help of stomach x-ray with barium, it is possible to assess the condition of the mucous membranes and muscle ball of the walls of these organs, their general shape and size, structural features of the cardiac and pyloric sphincters. Radiography is informative in the diagnosis of gastritis, gastric neoplasms, peptic ulcer, stenosis, protrusion, perforation, postoperative conditions. Stomach x-ray is performed with single or double barium contrast.
The main indications for stomach x-ray are various symptoms of diseases of the upper gastrointestinal tract. Clinically, they are manifested by dyspeptic syndrome, which includes loss of appetite, nausea, vomiting, heartburn, flatulence, belching with an extraneous odor, aversion to food, frequent unmotivated constipation or diarrhea, pain in the epigastric region. Stomach x-ray with barium is necessary for the diagnosis of the following pathologies:
- peptic ulcer of the stomach and duodenum 12;
- perforation of the ulcer;
- stomach tumor;
- stenosis of the pyloric department;
- hernia of the diaphragm with dystopia of the stomach and intestinal loops into the thoracic cavity.
In addition, stomach x-ray with barium is indicated as a control after surgery and monitoring of persons with congenital anomalies of the development of the stomach, esophagus.
Stomach x-ray is contraindicated in cases such as severe or unstable condition of the patient, suspicion of ongoing acute gastrointestinal bleeding, pregnancy in any trimester, younger childhood. Contrast-enhanced radiography is prohibited for persons with hypersensitivity to radiopaque substances and severe renal insufficiency.
Specific training is not required in most cases. When using barium contrast, it may be necessary to observe fasting 6-8 hours before the study. For some diseases, it is recommended to stop taking medications for this time, to give up alcohol and certain products (milk, carbonated drinks, etc.) for a few days. In urgent situations, gastric lavage can be carried out beforehand. Immediately before the stomach X-ray, the patient needs to undress to the waist, remove the chain. When using contrast enhancement with barium sulfate, the patient needs to drink 200 ml of thick white liquid with a metallic taste in small sips before the procedure.
Methodology of conducting
Stomach x-ray is carried out using a special device – a gastrofluorograph. Before the examination of the stomach, an overview X-ray of the abdominal organs is performed to exclude acute surgical pathologies (perforation of the organ wall, intestinal obstruction). Then the patient takes a few sips of barium, after which the esophagus and the cardiac part of the stomach are examined. Next, the stomach is tightly filled with barium (200-250 ml), and the radiologist evaluates morphological changes and the rate of evacuation of contrast from the stomach cavity.
A series of radiographs is performed. The study is carried out by polypocision: in several projections in the patient’s standing and lying position. According to the indications, double contrast of the stomach is used with the help of water-barium suspension and air. This method is necessary in cases where it is necessary to assess the elasticity of the gastric walls. The duration of X-ray astrography with barium is about 20-30 minutes, no somatic sensations occur during this period in the subject.
The resulting images are given to the patient within an hour after the procedure is completed. If a detailed description by a radiologist is necessary, the time for preparing the results may increase. Stomach x-ray usually does not cause complications or undesirable consequences.
Interpretation of results
According to the results of stomach x-ray, the structure of the walls of the lower esophagus, cardiac sphincter, stomach, pylorus, and the initial parts of the duodenum is evaluated. During the contrast of the stomach with barium , the following deviations may be detected:
- Defects of the gastric wall, its structural changes indicate the presence of ulcers, gastritis, protrusions, tumors.
- With stenosis, the lumen of one of the departments of the studied organs is significantly reduced, the opposite walls are adjacent to each other.
- Structural abnormalities of the cardiac sphincter of the esophagus speak in favor of the presence of GERD.
- The perforation of the stomach wall is indicated by a defect through which a contrast agent enters the abdominal cavity, and the accumulation of air under the domes of the diaphragm.
- Developmental anomalies and postoperative changes depend on the individual characteristics of the patient and the treatment performed.
Taking into account the data obtained during the stomach x-ray with barium, the attending physician establishes a diagnosis or directs the patient for further examination.