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GI Studies

37 Upper GI Series

Anatomy

Esophagus, Esophagogastric Junction (Cardiac Orifice), Cardiac Sphincter, Cardiac Notch, Stomach, Greater Curvature, Lesser Curvature, Pyloric Orifice, Pyloric Sphincter, Fundus, Body, Pylorus, Angular Notch, Duodenum, Duodenal Bulb, Rugae

Projections

[Part], PA or AP

CR Location

[Part], PA or AP –

Evaluation Criteria

RAO Image Criteria: Entire stomach and duodenum visualized. Body and pylorus filled with barium, fundus filled with air.

PA Image Criteria: Entire stomach and duodenum visualized. Pylorus near the center of the image. Body and pylorus filled with barium, fundus filled with air.

Rt Lateral Image Criteria: Entire stomach and duodenum visualized. Pylorus and C-loop well visualized. Body and pylorus filled with barium, fundus filled with air. Spine in true lateral.

LPO Image Criteria: Entire stomach and duodenum visualized. Pylorus and duodenal bulb should be seen without superimposition of the stomach. Fundus should be filled with barium. On double contrast studies, duodenal bulb should be filled with air.

AP Image Criteria: Entire stomach and duodenum visualized. Diaphragm included for hiatal hernia. Fundus should be filled with barium.

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Hows & Whys of UGI Radiography

  • Where is the stomach located?
    • The stomach is located between the esophagus and the small intestine.
  •  How does the shape and position of the stomach vary?
    • The shape and position of the stomach vary depending on the body habitus of the patient. The taller and more slender (hyposthenic or asthenic) the person, the longer, lower and more J-shaped their stomach will be. The wider the person, the higher and more transverse the stomach will be.
  • What is the esophagogastric junction, and what controls it?
    • The esophagogastric junction (cardiac orifice) is the connection between the esophagus and the stomach, controlled by the cardiac sphincter.
  • What is the V-shaped structure between the esophagus and stomach?
    • The V-shaped structure is called the cardiac notch.
  • What is the greater curvature of the stomach?
    • The greater curvature is the lateral border of the stomach, extending from the cardiac notch to the duodenum.
  • What is the lesser curvature of the stomach?
    • The lesser curvature is the medial border of the stomach, extending from the esophagus to the pylorus.
  • What is the pyloric orifice, and what does it contain?
    • The pyloric orifice is the opening between the stomach and the small intestine, containing the pyloric sphincter.
  • What are the three subdivisions of the stomach?
    • The subdivisions are:
      • Fundus (top)
      • Body (middle)
      • Pylorus (distal)
  • What is the angular notch?
    • The angular notch is the narrowing near the stomach, leading to the pylorus.
  • What is the duodenal bulb?
    • The duodenal bulb is the widened area of the duodenum just distal to the pylorus.
  • What are the gastric folds inside the stomach called?
    • The gastric folds are called rugae.
  • What does an upper GI study evaluate?
    • It evaluates the form and function of the distal esophagus, stomach, and duodenum.
  • What is the usual contrast medium for an upper GI study?
    • Thin barium is the usual medium for upper GI studies.
  • When are double contrast studies preferred?
    • Double contrast studies are preferred to diagnose tumors, ulcers, or diverticulae.
  • What are the common indications for an upper GI study?
    • Peptic ulcers
    • Hiatal hernias
    • Gastritis
    • Tumors
    • Diverticulae
    • Bezoars
  • What are peptic ulcers, and what can happen if they are untreated?
    • Peptic ulcers are erosions of the stomach mucosa, which can perforate the stomach wall if untreated.
  • What is a hiatal hernia?
    • A hiatal hernia occurs when part of the stomach protrudes through the esophageal hiatus into the thoracic cavity.
  • What is gastritis?
    • Gastritis is inflammation of the stomach lining.
  • What are stomach polyps, and can they be cancerous?
    • Polyps are small masses on the stomach wall that can be benign or cancerous.
  • What are diverticulae?
    • Diverticulae are outpouchings or weak areas in the mucosal wall.
  • What are bezoars?
    • Bezoars are rare masses of undigested material, such as hair or wood products, that accumulate in the stomach.
  • Are there any major contraindications for an upper GI study?
    • No major contraindications exist, but barium sulfate should not be used if there is a history of bowel perforation, laceration, or rupture.
  • Why is barium sulfate contraindicated in cases of bowel perforation?
    • Barium sulfate is not absorbed by the body and must be surgically removed if it leaks into the peritoneum.
  • What contrast is used if barium sulfate is contraindicated?
    • Water-soluble, iodinated contrast (e.g., Gastrografin) is used.
  • What allergies should be checked if using iodinated contrast?
    • Check for allergies to iodine, seafood, table salt, or x-ray dye.
  • What dietary restrictions are required before an upper GI study?
    • The patient must be NPO (nothing by mouth) for at least 8 hours prior to the exam, usually after midnight.
  • What other activities should patients avoid before the exam?
    • Patients should not smoke or chew gum during the fasting period.
  • Why are fasting and activity restrictions necessary?
    • These activities increase gastric secretions, preventing proper coating of the stomach mucosa by the barium.
  • What projections fill the fundus with barium?
    • AP and LPO.
  • What projections fill the body and pylorus with barium?
    • PA, RAO and Rt Lateral.

 

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Radiographic Procedures Review Guide Copyright © by Carla M. Allen. All Rights Reserved.

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