100 CARE OF PATIENT IN DIAGNOSTIC RADIOGRAPHY

Tea or coffee must be taken black or with skimmed milk only: they
are probably better avoided.

It is a misfortune of many patients referred for cholecystography that

their complaint includes some intolerance of fats. If the departmental
preparation for this examination requires containing fat to be
a meal

taken, it is wise to exercise some dietary discretion. Fried foods or full

cream are likely to have distressing results for such a patient. He will view
with greater equanimity the request to take some bread and butter with
a milky drink.

Taking the Contrast Medium

The most usual timing of the repletion radiographs is to bring the patient
to the X-ray department between nine and ten in the morning, some
of the contrast agent: that

is,
12 to 15 hours following ingestion
he will have taken light evening meal of the appropriate kind at possibly
a

by

or o'clock, followed the specified medium at 8.0 to 9.0 p.m.

6

Tablets or capsules should be swallowed whole and one at time with

a
draught of water. in powder form, its container
If

the contrast medium

is

should be filled with water and shaken until formed. This

is
suspension
a

glass of

by
should then be swallowed in one or two gulps, followed

a
fruit squash or water.
After this the patient must fast until the X-ray examination on the
fruit drink or water
If

following morning. he thirsty, he may have

is

according to his taste. In some instances, particularly when frying the

is
method of cooking, merely the smell of food has been thought to cause
contraction and emptying of the gall bladder, with consequent failure of
the examination. However though taste and smell have stimulating
a

in themselves they do not lead to evacuation

effect on the gall bladder,
of bile. Some radiologists prefer the patient to abstain from smoking
during this period.
Where departmental practice to take the repletion radiographs
it
is

little later in the day, or where special arrangement made to suit some
is
a

individual convenience, appropriate adjustments to the whole scheme of

events of course will be needed. However, should be kept in mind when
it

making any particular alterations that hardly suitable arrangement

is
it

which would require the patient to take the contrast medium in the
middle of the night. Consequently any appointments for the afternoon
should be carefully considered.
Once familiarity with attained, the departmental routine becomes
it
is

simple and we may again make the point that we sometimes underestim