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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 .

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 . Positioned the same as an AP & Lateral Soft tissue neck C-spine: ½ the mAs.

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 .

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RAO: PROJECTION COMMONLY TAKEN DURING ESOPHAGOGRAPHY .

RAO ESOPHAGRAM BAGAIN ATAS DAN TENGAH ESOPHAGUS .

. then tries to inhale against closed glottis.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.

swallow water through straw) COMPRESSION PADDLE Paddle inflated under stomach with patient in prone position Pressure applied to stomach region to create reflux .WATER TEST Positive if barium regurgitates into esophagus (LPO position.

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  .