It begins in right iliac region when it joins the ileum of the small intestine. It begins in right iliac region when it joins the ileum of the small intestine

It begins in right iliac region when it joins the ileum of the small intestine.

• It begins in right iliac region when it joins the ileum of the small intestine.

• The length is approximately 5 ft. (152cm) long and is greater in diameter than the small bowel (2.5 in diameter).

CECUM 

• CECUM 

• COLON 

• RECTUM

• ANAL

•                            

Ascending

• Ascending

• Transverse

• Descending

• Sigmoid

Rectal Ampulla

• Rectal Ampulla

• Anal canal

• Anus

It is a Radiographic study of the large intestine.

• It is a Radiographic study of the large intestine.

• Purpose:

• to study radiographically the form and function of the large intestine, as well as to detect any abnormal conditions.

Colitis

• Colitis

• caused by many factors including bacterial infection, diet, stress, and other environmental conditions.

• Diverticulum

• outpouching of the mucosal wall resulting from herniation of the inner wall of the colon.

• Neoplasm

• tumors in large intestine.

• Volvulus

• twisting of a portion of the intestine on its own mesentery.

Intussusceptions

• Intussusceptions

• telescoping of one part of the bowel into another.

• Polyps

• A polyp is an abnormal growth of tissue projecting from a mucous membrane.

Gross bleeding

• Gross bleeding

• Severe diarrhea

• Obstruction

• Inflammatory lesions (appendicitis)

• Pregnancy

The final objective is that the section of alimentary canal to be examined must be empty.

• The final objective is that the section of alimentary canal to be examined must be empty.

• 2 – classes of Cathartics

• Irritant cathartic – castor oil

• Saline cathartic – magnesium citrate or sulfate

High – density Barium Sulfate

• High – density Barium Sulfate

• It is excellent for use in double-contrast studies of the alimentary tract in which uniform coating of the lumen is required.

• Air contrast

• Carbon dioxide may also be used because it is more rapidly absorbed than nitrogen of air when evacuation.

Single contrast

• Single contrast

• 12 % - 25% weight / volume

• Double contrast

• 75% - 95% weight / volume

Closed system type enema

• Closed system type enema

• Open system type enema

3 – common enema tips

• 3 – common enema tips

• Plastic disposable
• Rectal retention
• Air contrast retention

 Sims position – relaxes the abdominal muscles and decreases pressure within the abdomen.

•  Sims position – relaxes the abdominal muscles and decreases pressure within the abdomen.

Describe the tip insertion to pt.

• Describe the tip insertion to pt.

• Place pt. in sims position. (pt. should lie on the left side, with the right leg flexed at the knee and hip

• Shake and inspect the enema container to provide good mixture. Allow the barium to flow through the tubing and from tip to remove any air in the system

Wearing gloves, coat enema tip with water-soluble lubricant.(KY jelly or any sterile lubricant)

• Wearing gloves, coat enema tip with water-soluble lubricant.(KY jelly or any sterile lubricant)

• On expiration, direct enema tip toward the umbilicus proximally 1 to 1.5 inches

• After initial insertion, advance up superiorly and slightly anteriorly. Do not force enema tip.

Tape tubing in place to prevent slippage. Do not inflate unless directed by radiologist

• Tape tubing in place to prevent slippage. Do not inflate unless directed by radiologist

• Ensure IV pole/enema bag is no more than 24 inches (60cm) above the table. Ensure tubing stopcock is in the closed position and no barium flows into the pt.

3 – Types of Examinations of Colon

• 3 – Types of Examinations of Colon

• Single – contrast Ba. Enema
• Double – contrast Ba. Enema
• Defecogram

Single – contrast

• Single – contrast

• utilizes only a positive contrast medium.

• Double – contrast

• Difference is that in an examination there is both air and barium.

 In which the entire colon is filled with a barium suspension.

•  In which the entire colon is filled with a barium suspension.
• Patient evacuates the barium and immediately returns to the fluoroscopic table for injection of air or other gaseous contrast into the colon.

The barium and the air are instilled in a single procedure as compared to the two-stage which reduces time and radiation to patient.

• The barium and the air are instilled in a single procedure as compared to the two-stage which reduces time and radiation to patient.

7 pumps, left lateral position

• 7 pumps, left lateral position

• 7 pumps, LAO position(left PA-oblique)

• 7 pumps, prone position

• 7 pumps, RAO position

• 7 pumps, right lateral position

• 7 pumps, RPO position

• +7 pumps, supine position

AP – to include flexures

• AP – to include flexures

• Left lateral rectum

• AP – 15 – 25 degs. Cephalic(CR) to include rectum.

• 15 – 25 degs.RPO – to include Left colic

• Right lateral – to include rectum

Prone PA – to include flexures

• Prone PA – to include flexures

• Prone PA with 15 – 25 degs caudal angulation (Angle Prone)– to include rectum.

• 15 – 25 degs LPO- to include the right colic flexure.

• Supine – AP tightly collimated ileocecal region proj. taken in 2 – 3 degs obliquity.

• Using horizontal central ray, upright proj. of both flexures and lateral rectum.