• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.162-165
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• 2016

Barium sulfate is an inert material used as a radiographic contrast medium during upper gastrointestinal contrast studies for evaluation of patients with dysphagia. Oral barium aspiration is an uncommon but well-reported complication of this procedure. While barium aspiration of small amounts may not cause any symptoms, massive barium aspiration can be life-threatening, particularly in elderly patients with multiple comorbidities. In this case report, we describe an elderly patient with multiple comorbidities who presented with thyrotoxicosis and dysphagia, and then died after massive barium aspiration. Despite administration of intensive medical care with ventilator support and therapeutic bronchoalveolar lavage to remove the aspirated barium, the patient died of multiple organ failure 9 days after barium aspiration. Clinicians should pay attention to elderly patients with predisposing factors for aspiration in whom upper gastrointestinal barium contrast studies are indicated, and should consider other diagnostic tools for evaluation of dysphagia in this population.

• Journal of the Korean Society of Radiology
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• v.10 no.6
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• pp.395-401
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• 2016

Upper gastrointestinal series is a diagnostic test that X-ray passes through the stomach after administering contrast media such as barium or gastrografin. Upper gastrointestinal series with an advantage of no side effect except temporary constipation or abdominal pain has been widely used to diagnose diseases of the gastrointestinal system. However, image degradation and diagnostic accuracy frequently occurred when improper movement and breath control were carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. The movie of the upper gastrointestinal series was made for improving inspection accuracy and image quality. The examinees encouraged to see the movie for waiting time before doing upper gastrointestinal series. In this study, image quality and diagnostic accuracy was examined for the effect of the movie about upper gastrointestinal series. 60 patients composed of each 10 people from 30s to 80s were selected randomly among both 2,940 examinees in 2014 and 3,076 examinees in 2015. Image quality was evaluated by the full width at half maximum of profile for each image using the Image J. The measurement of the full width at half maximum showed 0.208 mm and 0.133 mm for after and before seeing the movie. Thus it was verified that the movie education could improve the image quality and diagnostic accuracy for upper gastrointestinal series.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.120-124
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• 1998

The incidence of Hypertrophic pyloric stenosis (HPS) in premature infants is rare, the presentation is not typical, and the diagnosis delayed due to uncertain diagnostic criteria in abdominal ultrasonography (US). We report two premature infants with HPS diagnosed by US and upper gastrointestinal (UGI) contrast study. Patient 1. A premature female infant (birth weight 1950 gm at 34 week's gestation) with the onset of intermittent vomiting at 9 days of age was evaluated. US was normal at 13 days of life, however, abnormal at 41 days of life (pyloric muscle length 16.5 mm). Patient 2. A premature male infant (birth weight 1470 gm at 29 week's gestation) with the onset of intermittent vomiting at 10 days of age was evaluated. US showed pylorospasm at 11 days of life, however, findings compatible with HPS at 57 days of life (pyloric muscle thickness 11 mm). UGI contrast study at 48 days of life showed similar findings in both cases. Both patients had undergone pyloromyotomy. In conclusion, the diagnosis of HPS in premature infants requires careful follow-up by US and UGI contrast study.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.87-93
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• 2011

Upper gastrointestinal contrast studies were performed to compare the quality of images using two different commercialized barium products in 10 healthy beagle dogs of each group; 30% barium suspension in group 1, and 35% dilute barium suspension in group 2. Contrast media were administered through gastric tube at a dose rate of 10 ml/kg in all groups. All procedures were evaluated by three criteria: the quality of the images obtained, the transit time and the distensibility of the bowel. The imaging in group 1 showed good image quality, a rapid transit time, and good distensibility of bowel loop.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.301-305
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• 2012

The purpose of the present study was to prove our empirical tendency of relatively high small intestinal diameter (SI) to fifth lumbar vertebral height (L5) ratio, which has been used in dogs. In this study, the ratio of SI/L5 was determined in small breed dogs weighing less than 5 kg. In addition, the effect of large volume of contrast media on the intestinal dilation was determined by performing upper gastrointestinal contrast study. Abdominal radiography and upper gastrointestinal series were performed in twelve healthy dogs weighing less than 5 kg. Small intestinal diameter (SI), fifth lumbar vertebral height (L5), and twelfth rib diameter were measured on abdominal radiographs. The range of values of SI/L5 is from 1.03 to 2.26 in plain radiography, and from 1.55 to 2.5 in contrast studies. Contrast agent significantly increased small intestinal diameter, and could be considered as mildly dilated intestinal model. Therefore, a value of 2.1 for SI/L5 is recommended as the upper limit of the normal range suggesting nonobstructive intestinal dilation.

• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.391-394
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• 2012

The purpose of the present study was to prove our empirical tendency of relatively high small intestinal diameter (SI) to fifth lumbar vertebral height (L5) ratio, which has been used in dogs. In this study, the ratio of SI/L5 was determined in small breed dogs weighing less than 5 kg. In addition, the effect of large volume of contrast media on the intestinal dilation was determined by performing upper gastrointestinal contrast study. Abdominal radiography and upper gastrointestinal series were performed in twelve healthy dogs weighing less than 5 kg. Small intestinal diameter (SI), fifth lumbar vertebral height (L5), and twelveth rib diameter were measured on abdominal radiographs. The range of values of SI/L5 is from 1.03 to 2.26 in plain radiography, and from 1.55 to 2.5 in contrast studies. Contrast agent significantly increased small intestinal diameter, and could be considered as mildly dilated intestinal model. Therefore, a value of 2.1 for SI/L5 is recommended as the upper limit of the normal range suggesting nonobstructive intestinal dilation.

• Journal of Veterinary Clinics
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• v.17 no.2
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• pp.411-415
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• 2000

For comparison with conventional barium-gastrointestinal study, modified method using barium and methylcellulose was performed in 16 normal dogs (4-8 kg) divided into two groups. The group 1 received 8ml/kg of 40% w/v barium suspension only, and group 2 had taken 15 ml/kg of 0.6% w/v methylcellulose after administration 4 ml/kg of 40% w/v barium suspension by feeding tube. The barium suspension was prepared mixing full strength-barium suspension with water and methylcellulose solution was produced by blending methylcellulose sterilized water Sequential radiographs, lateral and ventrodorsal projections were obtained at 5 minute, 20 minute,40 minute. 60 minute and every 30 minutes thereafter, until the contrast is seen in the large intestine Inage qual- ity was rated by three veterinary radiologists as " poor" " fair ". "good", or "excellent" We analyzed the relationship between image quality,, transit time. Between two techniques, the modified method with 4ml of 40% w/v barium suspension and 15 ml of 0.6% w/v methylcellulose showed much better image quality ["excellent" result in 7 of the 8 subjects (88%)] and shorter transit time (107 minutes) toe the cecum. In addition, the best image quality was obtained at 20 and 40 minutes after admin-istration of contrast agent. It call be concluded the modified gastrointestinal study using methylcel-lulose after administration of barium suspension was a simple technique and easily improved the image quality and diagnostic accuracy of gstrointestinal disorders in small animal.racy of gstrointestinal disorders in small animal.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.39-42
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• 2013

Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.608-612
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• 2019

Gastric volvulus (GV) is an uncommon pathology, with 10-20% of cases occurring in children, typically before one year of age. It often occurs in people with congenital diaphragmatic hernias, intestinal malrotation, eventration of the diaphragm, paraesophageal hernias, wandering spleens, asplenism, or intra-abdominal adhesions. We report a rare case of chronic GV after left hemihepatectomy for hepatoblastoma in a child. The patient was a 9-year-old boy who complained of upper abdominal pain and postprandial upper abdominal distension for one year. At the age of 4 months, he was diagnosed with hepatoblastoma and had undergone left hemihepatectomy. The upper gastrointestinal contrast study revealed chronic organoaxial gastric volvulus. After a surgical procedure involving adhesiolysis and an anterior wall gastropexy, the patient improved and the symptoms resolved. Although GV is a rare disease, it should be suspected in a patient with a previous abdominal surgical history who is complaining of abdominal distension and pain.

• Journal of radiological science and technology
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• v.22 no.2
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• pp.17-21
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• 1999

There were four types of stomach contour included eutonic, hypotonic, steerhorn, and cascade. The aim of this study is to clarify relationship between incidence of stomach cancer and contour variation of the stomach. Double-contrast upper gastrointestinal study was performed in 1,546 patients, who had dyspepsia or other gastrointestinal tract symptoms. The radiographs were classified into the four types including eutonic, hypotonic, steerhorn, and cascade according to stomach contour in relation to body build. We also reviewed pathologic reports on endoscopic biopsy or surgical specimen. We studied the presence of relationship between incidence of stomach cancer and variation of stomach contour. We also examined the incidence of gastritis and gastric ulcer to the stomach contour variation. Of total 1,546 patients, eutonic stomach were 438(28.3%), hypotonic 911(58.9%), steerhorn 102(6.5%) and cascade 95(6.2%). Stomach cancer was found in 139(31.7%) of 438 eutonic stomachs, in 135(14.8%) of 911 hypotonic, in 42(41.2%) of 102 steerhorn, and in 24(36.9%) of 95 cascade (p=0.001). In hypotonic stomach, the incidence of stomach cancer was lower compared to the other three types significantly (p<0.05). Gastritis or gastric ulcer was found in 146(33.3%) of eutonic stomach, in 293(32,1%) of hypotonic, in 36(35.2%) of steerhorn, and in 26(27.3%) of cascade (p=0.640). In conclusion, gastric contour variation seems to be a factor affecting development of stomach cancer. The patients with hypotonic stomach may have lower incidence of stomach cancer than that of the other types. There was no relationship between the contour and gastritis or gastric ulcer.