Gastric exammination

The radiological
methods of the
gastrointestinal system
examination

The main methods of
examination
- Roentgenoscopy (fluoroscopy)
- Roentgenography
- Fluorography

The additional methods
- Roentgen polygraphy
- Roentgen kymography
- Tomography
- Roentgenoscopy with primary
magnification

The special contrast methods
- Double contrasting
- Pneumoparietography of the stomach

The roentgen anatomy and
examination of esophagus
- Width – from 1,5-2 см to 2 см;
- Length – 25-26 см;
- The parts of esophagus:
А) cervical;
Б) thoracic;
В) abdominal.

- Three physiologic narrowings:
А) at the level of cricoid cartilage;
Б) at the level of aortic arc;
В) at the level of cardia.
- The folds of mucosa – 2-3 см, parallel,
longitudinal;
- The velocity of contrast movement
is 4-6 sec.

peristalsis
narrowing (arc)
cardia

examination of the stomach
1. The survey roentgenoscopy.
2. The first stage of examination – the
patient drinks 1-2 swallows of contrast
(we can evaluate the folds of mucosa of
the stomach).
3. The second stage of examination –
tight filling. We can determine the
shape, size and position of stomach.

4. The stomach peristalsis:
- Superficial;
- Medium depth;
- Deep;
- Segmental;
- The velocity of peristaltic wave is 21 sec.

5. Parts of the stomach:
- Fundus;
- Cardiac part;
- Body;
- Sinus (or angle);
- Antrum;
- Pyloric part;
- Minor and major curvature.

examination of duodenum and
small intestine
1. The duodenum comes after stomach
and it has three parts:
- Superior (bulb of triangular shape);
- Descending (covers the head of
pancreas);
- Inferior.

2. Small intestine:
- duodenum;
- jejunum;
- ileum;
- Kerckring's folds of the mucosal layer.

examination of large intestine
1. The methods of examination:
- Per os;
- Irrigoscopy – contrast enema.

2. Roentgen anatomy and parts of the
large intestine:
- Caecum;
- C. ascendens;
- C. transversum;
- C. descendens;
- C. sygmoideum;
- Rectum.

3. Irrigoscopy:
- The first stage of examination – tight
filling of the bowel.
А) shape;
Б) size;
В) localization.
- The second stage of examination– the
evaluation of the mucosa folds (after
depletion of patient);
- The third stage of examination– double
contrasting (inflation of large intestine
with barium sulfate by Bobrov device).
The elasticity of the walls is determined.

The pathology of the
gastrointestinal tract
1. Esophagus:
- Esophageal diverticuli:
А) pulsational;
Б) tractional;
В) functional.
- Achalasia of esophagus;

Balon dilatation
Achalasia before
after

- Cancer of esophagus:
А) scirrhous;
Б) bowl-shaped (saucer-shaped);
В) medullar shape.

The symptoms of cancer:
- Stenosis of esophagus;
- Filling defect;
- Irregular borders;
- The delay of contrast media above the
level of stenosis;
- Deformation and absence of the folds;
- The absence of peristalsis at the level of
defect.

- Burn of esophagus:
The first examination is possible after 2-3
weeks.
Symptoms:
• Circular stenosis;
• Flat contours;
• Deformation – cone-, funnel-, ampullar.
- Foreign substances
Method by Ivanova-Podobed.

2. Stomach:
- Gastritis:
А) acute;
Б) chronic;
В) chronic hyperthrophic gastritis;
Г) rigid antral gastritis.

- The ulcer of stomach and duodenum:
Symptoms:
• “niche”;
• inflammative elevation of mucosa;
• folds convergention;
• the symptom of “pointing finger”.
Complications:
• hemorrhage;
• perforation;
• penetration;
• malignisation (transformation into
cancer).

- Cancer of stomach:
• polypous;
• bowl-shape;
• ulcerative cancer;
• diffuse;
• cancerous ulcer;
• cancer from polyp.

Symptoms:
• filling defect;
• the absence of the folds of mucosa;
• the absence of peristalsis at the defect
localization;
• stenosis of the lumen.

3. Large intestine:
- Inflammations:
А) colitis;
Б) chronic colitis;
В) chronic spastic colitis;
Г) unspecific ulcerative colitis.
Symptoms:
• spasm of intestine;
• smoothness of haustrum;
• smoothness of the folds of mucosa.

- Cancer of the large intestine
Symptoms:
• filling defect;
• irregular contours;
• circular stenosis;
• the absence of the folds of mucosa;
• evacuation disorders.

The roentgenologic picture of
the acute abdomen
1. Bowel obstruction.
- high;
- low.
Symptoms:
- Kloyber cups(at the background of
swallen bowel there is the presence of
horisontal level of fluid).

2. Perforate ulcer.
- Symptom of sickle (the presence of air
under the right cupola of the diaphragm).

Gastric exammination

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Gastric exammination