Contrast media is when they increase the image of human anatomical construction which is non easy visualized. Contrast media have 2 ( two ) group which is positive contrast media and negative contrast media. In general, positive contrast media have an addition soaking up of x-ray and demo up white or Grey. Negative contrast media have deficiency of soaking up and demo up as dark or Grey. An illustration of each contrast media is like positive contrast media is iodinated compound, negative contrast media is like gaseous-air or C dioxide.A contrast media is a affair used to increase the contrast of construction or liquid in the organic structure. It is by and large used to heighten the visibleness of blood vas and GI tract.Few types of contrast media are in usage in medical imagination and they can be classified by imaging modes where this are used. Despite there have other type, most common contrast media agent work based on x-ray fading and magnetic resonance signal sweetening. Contrast media are extremely density pharmacological medicine agents used to visualise low-control tissue in the organic structure such as vascular, kidney, GI ( GI ) piece of land and bilious tree. The most often prescribed contrast media is iodine and Ba. When iodized compound fills the blood vas or Ba fills apportion of GI piece of land, these internal organ become seeable on radiogram. Then, the scrutiny will be easier to be done.

X-ray attenuation=

The most common types of contrast media is iodine and Ba. They are utilizing for increasing X ray based imaging method. Assorted of iodinated contrast media exist, with different happening between the osmolarity, viscousness and absolute iodine consist of different media. Non- ionic dimmers are frontward for their low osmolarity and toxicity but have a corresponding higher value with their usage.

Some clip, contrast media is safe to utilize but but it besides can do disposal of assorted contrast media. Chemical reaction can go on from minor to severe and besides in decease. The instances about 0.9 per 100000 instances. The consequence for increasing terrible reaction include strong allergic reactions, bronchial asthma, cardiac disease and beta- blocker use.The I is non the cause of allergic reaction to contrast media. This research shown that eve I is common is contrast media, I is non the cause of allergic reaction of contrast media. It is a misconstruing approximately allergic to contrast media related to the seafood. The truth is, likely perpetrator are the inert ingredient and the patient history about allergy reaction.

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The safety and effectual application of contrast media must follow easy to administrate, non-toxicity, a stable compound, concentrated in the required are when injected, quickly eliminated when necessary, non-carcinogenic, of appropriate viscousness for disposal, tolerated by the patient and cost effectual.

Contrast media is divide into two ( 2 ) categories=

negative contrast media which are radiolucent and low atomic figure

doing the portion which it is placed to be more readily penetrated by X ray that environing tissue, as they attenuate the x-ray beam less efficaciously than organic structure tissue, they appear darker an x-ray image. Gasseous are common used to bring forth negative contrast media on radiographic image.

Positive contrast media, there are radiopaque and are of addition atomic figure doing the portion in which it is placed to be less readily penetrated by X ray than the environing tissue. Barium and iodine based solution are used in medical imagination to bring forth positive contrast. Both positive and negative contrast media can be employed together in dual contrast scrutiny to bring forth a radiographic image.

Negative contrast media is air, that be introduced by the patient during an radiographic scrutiny. Example such as inspiration during chest skiagraphy or can besides be introduced by the radiographer as portion of the scrutiny in dual contrast Ba enema.Then Oxygen is introduce into pits of the organic structure for illustration in the articulatio genus when executing an angiogram to show the articulatio genus joint.Carbon dioxide can be introduced to colon when executing a dual contrast Ba enema instead so air, as it causes less immediate abdominal hurting every bit good as less procedural hurting and uncomfortableness.

Positive contrast mediais Ba solution and the cosmopolitan contrast media used for radiographic scrutiny of the GIT. The undermentioned features of Barium is high atomic figure ( 56 ) bring forthing good radiographic contrast indissoluble, stable, comparatively cheap, iodine based compound are divide into four ( 4 ) group depending their molecular construction. 4 group are ionic molecules, ionic dimers, non-ionic monomers and non-ionic dimers

Advantage of non-ionic and ionic contrast agents

Reduce the toxicity, consequence are link to hypertonicity, the alteration to about isosmotic has significantly decreased reaction in adult male, some study dramatic the side consequence and uncomfortable due to diminishing in vasodilation and attendant esthesis of heat and flushing.Myelography, can non utilize ionic contrast media for myelography.Decrease allergic reaction, 1/80000 dead likely from lessening osmolarity and lessening cardiotoxicity.

Types and Uses

I ) Iodinated ( intravascular ) is Iodine contrast media are normally classified as ionic or non Attic. Both types are normally used in radiology, because the interactions are comparatively harmless to the organic structure and solubility. Particularly, it is used to demo the vass, and the alterations in the tissues of skiagraphy and CT, but can besides be used for trials of urinary piece of land, uterus and tubes falopio. It can do patients to experience as if he had diabetes. It besides put the metallic gustatory sensation in the oral cavity of the patient.Modern endovenous contrast agents are typically based on I. This may be bound either in the organic ( non-ionic ) compound or an ionic compound. Ionic agents have been developed and is still widely used depending on the conditions but can do extra complications. Agents with covalent binding of organic I has fewer side effects because they are non separated into molecular constituents. Most of the side effects are due to injection of hyperosmolar solutions.There are many different molecules. Some illustrations of organic I molecules are iohexol, iodixanol and ioversol. Iodine Contrast Media-based water-soluble and non harmful to the organic structure. These contrast agents are sold as a solution of H2O that is colourless, the focal point is normally expressed as milligram I / ml. Modern iodinated contrast agents can be used about anyplace in the organic structure. The most often used in intrarena, except for assorted intents, they can besides be used intraarterially, intrathecally ( as in spinal diskography ) and intraabdominally – about any organic structure pit or possible infinite.

Iodine contrast agents used for Angiography, Venografi, VCUG ( Voiding Cystourethrography ) and HSG ( Hysterosalpinogram ) , IVU ( endovenous Urography )

II ) Ba ( Gastro-intestinal ) is Barium sulphate is used chiefly in imaging the digestive system. Materials such as a H2O soluble white pulverization that is non made to a slurry with H2O and given straight to the GI piece of land such as Barium clyster and DCBE ( Double Contrast Barium Enema ) , Barium swallow Double contrast Ba repast and Ba repast, Barium Follow Through and CT Pneumocolon

Barium sulphate, an indissoluble white pulverization normally used to increase the contrast to the GI piece of land. Depending on how it would be a compound that is assorted with H2O, thickenings, cloting agents and spirit to contrast agents. As Ba sulphate, the type of contrast agent is a mixture of opaque white. It is merely used in the digestive tract.It is normally swallowed or carried as an clyster. Upon review, he came out through a big stool.

Particular Preparation and Precautions

If patient Don non hold any jobs, they can fasting 4- 6 hours before the scrutiny. If patient have the undermentioned job, radiographer must cognize the safeguards and recognize extra hazard. The known history of allergic reaction such as tired, have had a reaction to the Contrast Media, have had a reaction to medication bosom disease, Myeloma Multipelor myelodysplastik syndrome ( diabetes critical )

If patient have any allergic reactions or reactions in the yesteryear, asked to take medicine Prednisolone 40 milligram, 12 hours before and 40 milligram, 2 hours before the examination.Inspection demands should be compared with the hazard.

Doctors normally recommend patient cheque this. If you are diffident about the hazard factors, delight state the physician about any allergic reactions or medical conditions.

For patients with Multiple myeloma or myelodysplastik syndrome, patient demand to imbibe adequate H2O ( to forestall desiccation conditions ) even though such scrutiny Urogram Intravenous ( IVU ) .

Patient attention during contrast media

Patient medical history should be province together with indicant of the process, list of the medicine taken by the patient, patient allergic reactions and past surgical procedure.Patient must do a program before started the scrutiny. Patient household member must attach to the patient to direct the patient go back place after the scrutiny.

Pre- process attention

The doctor must look into the patient medical history for brand sure that the indicant is suited with the scrutiny to be done.Patient must besides convey their medicine and medical specialty that their pickings now.Documented of informed consent of scrutiny must be prepared too.Patient past scrutiny must be recorded excessively.

Procedure attention

Cardiac proctor should be use to the all patient particularly anteriographic patient through out the procedure.All patient must hold endovenous trickle to easier for give the patient medical specialty and unstable resuscitation.

Post-procedure attention

After the scrutiny, nurse or physician must detect the patient critical mark and the puncture site.The puncture site must be checked for shed blooding at patient.The doctor must cognize how to reply the inquiry related to the patient job and about 24 hours procedure excessively.

The trouble or complications that may originate

Despite the above accounts on this affair, the possibility of a simple reaction to the strong reaction is really low. The physician had to take into history the hazard ratio than when they propose some sort of review to you.Contrast media are other medical specialties that you know. Contrast Media is the latest to be safe. Like all medicines ( including drugs that frequently take the Panadol / Paracetamol ) , Contrast Media besides has the possible unwanted reactions. It is classified as low, moderate and terrible. Through a non-ionic contrast media, the possibility of reactions occur is really low or less. Most of the reactions were weak, impermanent and require no intervention, and occurred in the first 20 proceedingss after injection.

Examples of patient reaction to contrast media:

I ) weak reaction such as Nausea or emesis, Heat throughout the organic structure ( as if after exercising ) , Rubing on the organic structure ( impermanent or last for a few yearss, given the antihistamine drug ) , Flu

II ) reaction medium like Trouble external respiration ( like asthma ) , Hypotension ( bloodpressure dropped all of a sudden )

III ) Severe Reactions like Anaphylactic rare but can go on and non expected

.

INTRAVENOUS

UROGRAPHY

Introduction

Intravenous urography is a radiological apply to sing the unusual construction of urinary system ( from kidney to urinary vesica ) .This scrutiny will infix a injection.Then X ray will be taken at accurately clocking to take a image when a contrast spell follow through the urinary system. IVU is done because to observe the rock at urinary system that influence the urinary system.Intravenous urografi often called IVU or IVP. This research will be proposed to patients with jobs related to the urinary system ( vesica ) . It besides is one of many trials X raies to help in bring forthing an anatomic construction and processes that occur in the human excretory system. These trials show the kidney, womb and vesica. IVU is the appropriate trial for the probe of blood in the piss ( haematuria ) , hurting in the genital and kidney rocks. Inventories are required depending on the state of affairs. If proving is required every bit shortly as possible, supply is non needed. However, if it is in conformity with the clip prescribed by physicians, patients are required to fast nightlong / twenty-four hours and aims to empty the intestine. An agent ( drug ) to empty the intestine will be performed at the clip of assignment. If the patient has a history of asthma, allergic to iodine or a history of reactions to contrast media beriodin, medical specialty or other allergic reactions, or interpreter radiologist X ray should be notified. During the trial, patients lie on the x-ray tabular array. An X ray will be taken before the contrast medium injected into the patient ‘s blood nervus. The radiotherapist will put a little acerate leaf on the arm or manus vena for the injection. When the contrast medium injected into the vena, the patient may experience hot. These feelings will shortly vanish after the injection. X raies are taken and later, a force per unit area ring will be placed on the venters to demo clearly the nephritic system and better. This will do uncomfortableness but will non impact the patient ‘s external respiration. Radiographs ( x-ray ) will be taken. When the set released emphasized, patients need to empty the vesica and one more X raies are taken. Not all patients need a ring to the abdominal force per unit area. It depends on the image obtained for the patient ‘s urinary system. After this trial, the patient can return to day-to-day activities and no nutrient tabu. It is besides non available to prove long-run effects of this IVU.

INTRAVENOUS UROGRAPHY ( IVU )

Indication for IVU is suspected urinary piece of land pathology, Repeat infection, Hematuria, Trauma, Chronic pyelonepritis, Kidney rock, Renal carcinoma, Transitional cell carcinoma, Polycystic kidney, Anatomical fluctuation and Obstruction

Before patient spell to the scrutiny, patient must do a readying as advise by the physician

Particular readying

Fasting direction

Before examination start, patient can take a little measure of breakfast, and besides can take little sum of H2O 4 hr before examination.For patient who have diabetic, myeloma, nephritic failure H2O is recommended or allowed to them because to give the patient energy before examination.After scrutiny, patient can eat and imbibe as normal.

Medication direction

The radiographer should inquire if the patient have allergic or disease such as asthma or known allergic reactions.

Bowel readying

Patient before scrutiny can take low-residue vegetable and H2O before get downing fasting. 2 yearss before scrutiny, patient must avoid eating green veggies, so patient is recommended to eat meat, murphies and cereals. Patient besides must take 2 tablets of laxative such as dulcolax to cleansing the intestine a twenty-four hours before scrutiny. Administered IVU must prior to Babies, The aged, Those with cardiac or nephritic damage, Diabetic, Patient with history of asthma or terrible allergic reaction and Patient with a history of old reaction to contrast media

If the patient is female, inquire about her 28 yearss regulation. If she feels that she might be pregnant, allow the patient do the gestation trial foremost. If she is confirmed to be pregnant do another assignment for her.

Preparation before IVU scrutiny.

Ask the patient to alter to hospital gown and urinate for empty the bladder.Keep the patient valuable things to radiographer of maintain it to safe placeThen, inquire the patient lying on the x-ray tabular array and make the x-ray venters. Contrast media will be given after preliminary radiogram through vena on the forearm.At the early phases, some compaction may merely be applied to the lower venters by agencies of tablets and belt or may merely a caput down joust of the table.The process of urine flow from kidney to bladder will take merely at least 30 proceedingss to complete.Then, the concluding phases is when post- micture between the last movie is taken. But it depends on image delayed as good.

Precaution taken before the disposal of contrast media.

Radiographer or radiologist should cognize about the patient and their medical history. The low- osmolarity contrast media besides should be utilizing to the patient that have high risk.Then, radiographer or radiotherapist must see the high hazard factor which are related to the administer of IVU contrast medium such as Previous inauspicious reaction to contrast media, Severe renal, Asthma, Hypertension to iodine, Epilepsy, Hyperthyrolism, Severe respiratory disease and Diabetic

The expired day of the month of contrast media should be checked. The. temperature of contrast media besides must at same to personify temperature. If non, radiographer must set the contrast media into a poached H2O. The radiographer and radiotherapist must alarm about the consequence, reaction, indicant and the process of the scrutiny. must besides ever look into the exigency streetcar and be used to it.

Make sure the contrast volume, dosage and strength or process be undertaken. If the patient have history with contrast media t the yesteryear, the patient likely will holding a fatal reaction if the scrutiny is done. So the great are must be under position to avoid the bad chances.

Preparation of injection site

Washing manus right and drying it. Then, clean the country of the tegument to be injected with isopropyl intoxicant or 1 % Iodine. Use intoxicant swabs and one time the country become swabs, it should non been touch once more.

During scrutiny / injection

Radiographer should cognize where physicians can be reach in instance of exigency. Always evaluate the patient ital mark and ticker carefully the patient respiration, pulse, blood force per unit area, patient coloring material and degree of consciousness.

After injection

Leave the patient for 15 minute and record all information and it ‘s disposal.

If the patient is all right, the patient can go place. But if non, patient have to wait until experience better.

Procedure of IVU

Make sure that all the devices needed are already and available for injection process. Conform patient medical history and look into the allergic reactions. Comfort the patient and explicate the process, besides gain consent. Choose a vena utilizing the standards already discussed. Put the unfertile cotton wool ball over the site. Remove the needle and give force per unit area to the site until the hemorrhage stopped. Guarantee the patient no allergic reactions to the plaster.

Essential standards for the ideal endovenous contrast agent is Water soluble, Heat, Non-antigenic, Available at the right viscousness and denseness, Low-viscosity ~making them easy to administrate, Persistent plenty in the country of involvement to let its visual image, Lower or the same osmolarity compared to plasma, Non-toxicity, both locally and systemically and Low cost

Everyday IVU process

Preliminary movie

Film size ( 35 x 42 centimeters )

Patients are in a place to lie on the boundary of the AP venters to include the symphysis pubic bone and the stop. To inspect, stock list venters and values for any exposure and calcifications of the nephritic piece of land

Extra movies to find the place of any opacities

35 grades posterior to the nephritic country

Function to see the stock list in the patient ‘s intestine, Identify the patient ‘s nephritic position, Determining the appropriate sum of exposure factors and Sing patients and place any pathology

Immediate movie

Film size ( 24 x 30cm )

AP based on the patient ‘s nephritic country to see nefrogram

5 minute movie

Film size ( 24 x 30cm )

AP based on the patient ‘s nephritic country to find whether the waste merchandises decently or non if you take a less healthy diet and the dosage of contrast required

farther

Compaction can be used in some centres at this clip to fasten pelvicalyceal systems to show any defects nucleus and a movie taken at 10 proceedingss in the nephritic country

Compaction should non be used in instances such as nephritic gripes, or nephritic hurt after venters surgery

5minute movie

Compaction is released to show the system and ureter pelvicalyceal

25 minute movie ( release )

Film size ( 24 x 30cm ) 15 & A ; deg ; caudal angulation centered 5 centimeters above the upper boundary of symphysis pubic bone to show vesica dilatation

Post micture movie

15 & A ; deg ; caudal angulation centered 5 centimeters above the boundary line of symphysis pubic bone to demo the vesica successfully, and returns one time the lower terminal of the ureter to normal dilatation

The scrutiny will take about 1 hr, but if delayed movie or have job, it could make until 2 hr or more.

Disadvantage of IVU, Require kidney map, Insensitive in little multitudes, Cant distinguish cyst from solid tumours and Merely indirect visualize procedure country kidney and urinary piece of land

Advantage of IVU is, Relatively cheap, Good position of the urinary piece of land, Standardize and easy available, Most detail visual image of pelvicalyceal system, Easy and honoring to communicating.

The lone trouble arises from the contrast media. These troubles are minor, such as itchiness, tired of trouble external respiration, blood force per unit area falls ( normally temporarily ) and rare patients with dangerous ( anaphylaxis ) .Rarely hurting and uncomfortableness occurs when the abdominal compaction done, but the compaction is normally stopped when you told the translator that operates X ray of your scrutiny.

Signs of patients who need to undergo IVU is, Trauma, Heamaturia, Renal gripes, diagnostician who was found in urinary piece of land ( vesica ) , Infection of the vesica, Infections of the kidney and malignant neoplastic disease ( tumour )

Equipment isX-ray power generator is simple, 40-60 kilowatt, The basic tools imaging, Abdominal Compression Tools, Film combined in different sizes

tablet. Intravenous instrument is 50ml panpipes, acerate leafs, gluey tape, Options acerate leafs, straight / butterfly size 16, 19, 21, 23 and mensurating blood force per unit area

Contrast agent like illustrations of typical 70 kilograms adult with normal blood urea values ( 2.5 – 7.5mmol / L ) , Contrast media should be warmed to personify temperature before injection, Main Product, iodine component milligram / milliliter Dose Route, opamidol 300 300 Niopam 50ml I.V, Omnipaque, 350 350 50ml Iohexhol I.V, Urograffin

370 370 50ml Diatrozates I.V

The typical exposure is STAIN kV ma F.F.D Grid Focus Film / Screen

AP Abdomen 100cm 60-75 50-70 Broad yes Regular, Tomogram 20

@ 9cm 60-75 70-120 Broad yes Regular 100cm

Barium

Swallow

INTRODUCTON

A Ba sup is a medical imagination process used to do scrutiny to the upper GI ( GI ) piece of land, which includes the gorge and, to a lesser extent, and the stomach.The contrast media that seeable to x- beam is barium sulphate. As the patient swallows the Ba, it cover the gorge with a thin bed of the Ba. This allow the hollow construction to be imaged. , they will look as black topographic point, as opposed to the white produced by relatively-dense Ba. As such, it is utile in produce a contrast to the Ba, to bring forth a dual contrast image, to supply better visual of the contrasting characteristics within the muscolar bed of the gorge. In instances where a leak is suspected or desired to be demonstrated, contrast imagination affecting the usage of H2O soluble contrast media incorporating I is used.As with all X raies, the Ba sup technique green goods radiation, and may enlighten the patient unnecessarily. The Ba sup should be used merely if required, and, although it can non be replaced by endoscopy as for the Ba clyster, it should be avoided as for kids and pregnant adult females.

BARIUM SWALLOW

Barium is a strong contrast that give high quality on the image. Barium sup is related to barium repast. The indicant for contrast sup is dysphagia, anemia, hurting, assesment of trachea- osophagus fisture and assesment of the site of the perforation. If no contraindication, contrast media is E-Z HD 250ml, gastrografin, LOCM. Gastrografinshould non be used for the probe of trachea- osophageal fistulous withers or when aspirationis possibility and Ba should non be used for perforation is suspected. The equipment ofbarium sup is rapid consecutive skiagraphy ( 2 frames per second ) , or videofor recording may be need for appraisal of the laryngopharynx and upper osophagus deglution. Complication of Ba sup is escape of Ba from an unsuspected obstructor and aspiration. Barium sup is oftenly for upper GI piece of land. The upper GI piece of land consist of oropharynx, hypopharynx, gorge, tummy and first portion of the duodenum. The purpose of a contrast scrutiny is to do lineation crisp image of the construction. The most contrast media been utilizing is barium sulphate suspension, even though ionic and non- ionic contrast agent can be used. The Ba sup and repast can therefore moderately be split into a figure of sub scrutiny when the clinical image has a define way.

Preliminary movie is required for a water- soluble survey if have obstructor. The technique is patient demand to be in vertical RAO place to do the gorge out from spinal column. Barium is swallowed and take movie of the upper and lower gorge and it rapid consecutive skiagraphy is needed, it will execute in right lateral, RAO and PA place. To demo the tracheo- oesophageal fistulous withers in babies, a nasogatric is use to the degree of mid- gorge, and the contrast is inserted to the distend of the gorge. This will do the contrast media through a little fistulous withers. This is of import to do to take image of x-ray in sidelong projection during injection of contrast media. Some survey says that baby should be examine in the prone place while lying on the perpendicular tilting tabular array, the best consequence are possible when kids lying on the side of horizontal tabular array. When the scrutiny is done to the kids by giving Ba utilizing bottle is of import that it be performed foremost, before they aspiration into the air passage from overspill. Overspill may do the wrong diagnosing of the tracheo- oesophageal fistulous withers. If it non possible to cognize wheter contrast media in the bronchial tube is due to a little fistulous withers, which is difficult to see, or due to aspiration.

Patient readying is patient should fasting at least 6 hours before the scrutiny but 5 hr if consider adequate by some. It is advise that this should be the instance even if the lone Ba sup is indicated, in instance position of the gaster are found to be required, this avoid the patient holding the repetition scrutiny. Patient jewelry ar any artefact should be take and patient gown must be worn. Patient must be informed about the process, so they can give their consent. Make certain the patient follow the direction and fasting period. The scrutiny is used to patient that have high dsyphagia or definite oesophageal symptom, ever have normal OGD, but are still diagnostic, quiet frequently motility upset may the ground. The contraindication when aspiration during consumption. Contrast agent is barium sulfate suspension or H2O soluble contrast medium. The extra equipment of this scrutiny is disposable cup and tissue.

The technique, if there any uncertainty that the patient may draw a bead on, the initial sup is best out utilizing a water- soluble contrast media, even aspiration of Ba has been by some to be comparatively amendss. Aspiration may non be suspected but unsuspected ‘silent aspiration ‘ may be appear unless utilizing the technique.

Ask the patient to stand erect in the AP place on the fluoroscopy tabular array and keep cup of Ba in their left manus, as when the machine turning the patient, is normally on the left. The arm must be in the bole without patient disturb it motion around the escalating screen passenger car. Then, the patient is turn to sidelong place as for the appraisal of possible aspiration. Then, inquire patient to take the liquid and keep in their oral cavity until has ask by the radiotherapist to get down it. This is to give the radiographer a opportunity to center on the country of involvement and optimise the collimation. The patient so get down the Ba and exposure is irradiate. Then the patient is turn into the sidelong place and same process when Ba in oral cavity and when it swallow gaining control it. Patient of Ba sup ever present with clinical symptom of GOR. Patient ever have feeling of retrosternal uncomfortableness and have no other symptom. The Ba survey can be utile as an addition the other trial, GOR patient have little suspension hernia that can non see on endoscopy. Patient readying and contraindication are as the for the upper sup. The extra equipment is disposable cup, little cup for sparkling agent, tissue and a straw may be required for consumption of the Ba when the tabular array is horizontal. Technique apply is Anterior buttocks ( AP ) and sidelong projection can be taken of the gorge as old describe for the Ba sup. A more utile position of distal tierce of gorge is utilizing by the erect left posterior oblique taken when patient is ask to get down. Then, the patient is ask to take the effervescent granules followed by the citric acid. It is of import to affect patient that this will bring forth gas in the tummy and will and will give them experiencing to burp. Then, the patient is ask to get down another Ba while in the LPO place and image can be gaining control of the lower gorge. The patient will revolve 360 degree ask by radiotherapist at ain gait, this will guarantee the coating of all facet of the stomachic mucous membrane ready for appraisal of the tummy. To demo the reflux really occur, patient can lying head downward, but it may limited the bearing on the truth appraisal of true extent of reflux. The Ba can observe the jobs of narrowing of the gorge, hiatal hernia, unnatural enlarge vena of the gorge that can do hemorrhage, ulcers, tumours and polyps. There have some complication when patient taking the Ba such as allergic reaction for patient that allergic to barium sulphate, irregularity and Ba may show in windpipe. After patient get place, tell the patient that his stool will in light colour because of the Ba for 1-3 yearss, patient besides have to eat veggies and imbibe batch of plenty H2O to elation of the irregularity. Patient must rapidly name the physician if holding emesis, hemorrhage, hurting or problem in external respiration. If patient have no past gesture during 2-3 yearss, must name the physician besides.

Barium

Enema

INTRDUCTION

Barium clyster is a type of contrast media used for analyzing the colon utilizing x-ray. Colon is situated between little bowel and rectum. Barium clyster of the little bowel is created to demo the little bowel from duodenum part until to the ileo ceacal. By go throughing to the tummy contrast media is straight to the duodenum, a better flow of the contrast media can be achieved and diminish the chances hazard of the tummy liner. It use x-ray scrutiny to bring forth the image of big bowel. It have 2 different type of contrast media which is different technique contrast media, Ba sulphate will be injected through rectum to see the clearer position of big intestine image. But for dual contrast agent, air will be injected to rectum. Barium clyster or dual contrast media is a scrutiny utilizing a white liquid called Ba that will be inserted by the rectal tubing insert into rectum until it full the big bowel. Then, the X ray will be taken. This scrutiny is done to place the abnormalcies of bowel including diverticulosis, diverticulitis, polyps, colonic abcesess, unnatural colon motion, dilation of the colon and Hirschsrungs disease in babies. Disease that can be found in the colon is appendicitis, celiac spure, colonic polyps, crohn disease, diarrhoea, lower GI hemorrhage and ulcerative inflammatory bowel disease.

BARIUM ENEMA

Hazard from the Ba clyster

big bowel will experiencing uncomfortable. Pregnant adult female might non be advise to taking Ba clyster because it will dangerous the babe and the female parent. The terminal of the tubing will be inserted to the bowel and it can do infection. The patient readying is patient must cleansing the intestine before the scrutiny because to easy the scrutiny be done and it can be done by ‘cleansing clyster ‘ . Laxative must be given to clean the intestine. Patient must non eat at midnight before scrutiny. When patient arrive to the scrutiny, the adviser will look into if the patient follow the direction by it last twenty-four hours of feeding and imbibing. Patient will be recognize when the staff inserted the tubing. Patient will experience uncomfortable. The a few X ray will be taken. After the scrutiny, the radiotherapist will measure the image and the patient will come back after a hebdomad to take his x-ray image. If there have some abnormalcies, the physician will discourse about the surgical or the scrutiny following. On the twenty-four hours of scrutiny, patient must imbibe a large glass of a plentifulness of H2O, do non eat or imbibe until the scrutiny os finish, lying on the left side and enter a suppositori rectal medicine and delay until 15-20 minute before traveling to post gesture. Empty the blader before scrutiny. For babies and kids under 12 old ages old, there have of import things which is they need to imbibe a plentifulness varies with intestine readying. Give kids a soft nutrient such as porridge, fruit and soup. Vegetables are non allowed. Milk and fluid is acceptable. Make non give the infant laxative. By the twenty-four hours of the scrutiny, no nutrient is allowed. Liquid merely give 2-3 hr before the scrutiny. After the scrutiny, patient can non drive place by it self. They must convey their household members or their friend. It besides for patient safety and because to avoid vision job consequence by musculus relaxent. Drink a batch of H2O and eat veggies to faster the station gesture because to descreate the Ba in the bowel and the stool will be in white coloring material. Before the examiantion, patient is needed to alter to hospital gown and take off all the jewelry. To avoid patient bacome to strive the musculus relaxent must be injected. Patient will be lie down and blanket will be cover patient and radiotherapist will be inserted a tubing to patient rectum. If the tubing is soft, the patient will non experience pain but experiencing uncomfortable. The Ba and gas will be in patient bowel and patient will experiencing like distended and want to past gesture. The x-ray unit will be variuos angle. There are four positioning when do the Ba clyster scrutiny which is prone, because patient back got tubing at the rectum. Then, hampton view, the patient have to angle 45 degree caudad for show the rectum and utilizing casette 14×14. patient right side down and in conclusion patient left side down. Patient have to make all four this placement because to do the Barium flow in the bowel and the Barium must in watery. When the Barium in enter the rectum, have to halt the Barium. Double contrast demand to shoot gas that will give hurting to the patient. So the staff must make with quietly and careful. Stopped injected air when the air is arrive to the tranverse colon because air can travel by itself and merely Ba clyster scrutiny have dual contrast. A preliminary field abdominal movie is non necessary unless terrible irregularity render the effectivity of intestine readying doubtful and toxic megacolon is suspected. The technique is the patient lies on the one site on an incontinency sheet and catheter is insert into the rectum. It will taped steadfastly in place. Some radiotherapist choose to give relaxent half manner through the process. The extract of the Ba is started. The extract is discharge when the Ba reaches the hepatic flection. The differential examinationof low enteric obstructor in newborn contain five status which comprise about all cause. Hirschsprung disease, functional immatureness of the colon and colonic atresia involve in the colon. Then, two involve in the distal ileum meconium intestinal obstruction and ileal atresia. Infant eith low enteric obstructor required contrast clyster. Contraindication is merely perforation. Patient readying is when the babe already endovenous buttocks and it will be hydrated prior to the process. the colon will be microcolon, so the diagnosing will be meconium intestinal obstruction or ileal atresia for intervention of meconium intestinal obstruction, the chief is to run the H2O. Soluble contrast medium to the little intestine to environ the meconium. If it successful, meconium should be passed in the following hr. Barium clyster is used to observe colon malignant neoplastic disease and it besides used to measure the inflammatory of intestine disease. Barium must be in the colon to demo the abnormalcies of the colon and the inkiness of the colon. Colonoscopy is the other manner to find the jobs or the abnormalcies in the colon. Barium clyster is non good as colonoscopy. Colonoscopy can observe colon malignant neoplastic disease and polyps than Ba clyster that sometime can non observe it. Barium besides hard to observe the inflammatory bowel disease in the outlining of the colon. They besides can non take the polyps. Patient that can non be detect utilizing Ba clyster must make the colonoscopy for better position. The advantages by utilizing this scrutiny is can see the bottleneck of the intestine and besides can be utilizing for another intervention such as diverticular disease and fistula disease. The disadvantage by utilizing Ba clyster is patient might to make the intestine readying, experiencing some uncomfortable, patient besides need to keep the contrast and besides the air, no patient will wish this scrutiny and non precisely as colonoscopy scrutiny. Barium clyster is non wholly safe in utilizations because it can do to complication to the patient such as terrible ulcerative inflammatory bowel disease, toxic megacolon or perforation in the colon. But the trial must make in safety and careful when the patient have block bowel, ulcerative inflammatory bowel disease or blood diarrhoea. When patient do the single- contrast clyster, their colon will filled with Ba that differentiate the colon mark. Then, it can demo the colon form with Ba. When Ba leave out the bowel, the bowel will fall down. After the Ba is go forthing the bowel by station gesture, the bowel liner will be like hairy. The dual contrast Ba will do the bowel broadening that being cover by the Ba clyster run alonging with utilizing air for present the clear image mucous membrane form. Patient positioning must in many ways to do the Ba full the all country in the bowel. The Ba clyster can demo the X ray of a abnormalcies in bowel to easier the physician to do a diagnosing from a different conditions. Again, Ba clyster is a scrutiny of x-ray usage for diagnose the abnormalcies of the big bowel. Then the x-ray image will be taken by the radiographer when the Ba fill the colon by rectum. If have perforation on the bowel, the H2O soluble is used. It is similar to the Ba clyster scrutiny but the bring forthing of the image is non every bit good as Ba clyster.

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