Cine Esophagram PRINT
I. Equipment (May vary between sites)
a. 1 bottle EZ HD (Thick Barium) (60mL water)
b. Liquid E-Z Paque (Thin Barium)
c. EZ Gas II 1 package (open)
d. Small medicine cup (fill to approx. 1 tsp. line with water)
e. 1 EZ Disk Barium Tablet ( in small medicine cup)
f. Cracker- Lorna Doone (hospital (nutritional services) can provide gluten free if necessary)
g. Barium pudding
h. 3 cups / 2 straws/ Spoon
II. Personnel
a. Radiologist/RA
i. Verifies order
ii. Administers contrast and takes spot images
b. Hospital Technologist
i. Prints order and relevant notes
ii. Documents patient history and pregnancy status prior to exam
iii. Assists the radiologist/RA during procedure
iv. Provides patient with aftercare instructions
III. Procedure
a. Scout image
i. Required for patients s/p endoscopy or surgical procedure (within 1 week)
ii. To be cleared by Radiologist/RA
iii. Upright Abdomen (on expiration, must include bilateral hemidiaphragms)
b. Esophageal images with patient standing
i. LPO, AP (entire esophagus)
1. Include spot images of the distal esophagus and EG junction (small mucosal irregularities are often obscured with fluoro loop store technology)
ii. Lateral cervical esophagus
c. Prone esophageal images
i. Single swallow of thin barium to evaluate motility (use motility and number markers)
1. Instruct the patient to swallow the entire bolus in one swallow (piecemealing and secondary swallows disrupt the primary parastaltic wave)
2. 5 single swallows, wait 30 seconds between each swallow
3. Add lead ruler to field of view for measurement purposes if hiatal hernia present (include HH measurement in dictation)
d. Esophageal images with patient standing
i. 2 barium coated cracker boluses with a swallow of thin barium to follow each
ii. 13mm Ba tablet
e. Patient Supine (turn off CINE)
i. Reflux check
IV. Required Images
a. See Procedure