Esophagram Single Contrast PRINT
I. Equipment (May vary between sites)
a. Contrast
i. Gastrografin (not to exceed 120mL without radiologist approval)
ii. Alternative water soluble contrast (approved by radiologist)
iii. Thin Barium
iv. 1 EZ disk Barium Tablet (small medicine cup) (barium pudding or applesauce in the room)
b. 1 Cup/1 Straw
II. Personnel
a. Radiologist/RA
i. Responsible for administering contrast and taking spot images
b. Hospital Technologist
i. Documents patient history and pregnancy status prior to exam
ii. Assists the radiologist/RA during procedure
iii. Provides patient with aftercare instructions
III. Procedure
a. Scout image
i. Required if patient 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. Single contrast barium only
i. Patient standing or table tilted semi upright
1. LPO, AP (entire esophagus)
2. Lateral cervical esophagus
ii. Prone or Supine (LPO) esophageal images
1. Single swallow of thin barium to evaluate motility
2. Consecutive swallows
3. Valsalva hiatal hernia evaluation
4. Reflux check
iii. Patient standing, or table tilted semi-upright (administer tablet with barium exams only)
1. Administer 13mm barium tablet with 150 ml’s of water (if tablet sticks, save image, if tablet remains lodged after 5 minutes, advise pt not to eat for 45 minutes (liquids ok))
c. Gastrografin Esophagram
i. Scout and post procedure images of surgical site should be obtained
ii. Spot images of the surgical site in different projections
IV. Special Considerations
a. If 13mm barium tablet sticks in vallecula- have patient swallow a tbsp. of barium pudding or applesauce
b. Follow contrast allergy protocol if using Gastrografin
c. Do not use Gastrografin for patients with elevated aspiration risk
d. If unable to confirm leak status, consider CT follow up (discuss with radiologist)