Pediatric Upper GI PRINT
I. Equipment
a. Thin barium
b. Small baby bottle with nipple
c. 20ml syringe with catheter tip or “Christmas tree” adapter
d. 8Fr Feeding tube
II. Personnel
a. Pediatric Radiologist/RA
i. Responsible for imaging
b. Technologist at head
i. Responsible for holding patients arms
ii. Feeds patient or injects NG tube
c. Technologist behind control panel to save images (sites that do not have LIH on fluoro tower)
III. Procedure
a. Patient supine on table
b. Feed with bottle or syringe when instructed
c. Initial feeding on left side, then on back
IV. Required Images
a. Chest scout
b. Watch first swallow for aspiration in lateral projection
c. Lateral barium filled esophagus
d. AP barium filled esophagus
e. Right lateral of duodenum coursing down and back up (true lateral; include spine)
f. AP of duodenal C-loop
g. Left Lateral of C-Loop (true lateral; include spine)
h. 1 minutes intermittent fluoroscopy +/- provocative maneuvers for reflux
i. AP of stomach, C-Loop, and small bowel
V. Special Considerations
a. Invert all pediatric films before sending
b. SBFT- drink additional 2 oz post UGI. Films every 20min. for first hr, every 30min (2nd hr), hourly after 2nd hr. Some Rads may want TI spotted.
c. Teenage boys c/o dysphagia should be given 13mm barium tablet.
d. Down’s Syndrome- look for enlarged heart, tracheoesophageal fistula, duodenal web or atresia.
NPO GUIDELINES
Clear Liquids 2 hrs
Breast Milk 3 hrs
Formula 4 hrs
Solids 8 hrs