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Gastric volvulus with eventration of diaphragm is an uncommon occurrence. We report here case of a middle-aged woman who came with left-sided chest pain since 1 month, and occasional history of breathlessness in supine position. She was advised to have chest radiograph and ECG done. ECG was within normal limits. On chest radiograph, there was smooth, round, well-defined elevation of left hemidiaphragm with air fluid levels below it. Mediastinum was shifted towards right side. Based on that, barium meal was advised which showed contrast filling with alteration of axis of stomach. Organoaxial type of gastric volvulus is confirmed.
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Duodenal diverticulum is the second most common diverticulum of gastrointestinal tract. Among duodenal diverticulum, incidence of intramural duodenal diverticulum is 100 as per report till date. It is usually asymptomatic, but in middle or adult age, it may present with postprandial abdominal discomfort, often complicates in the form of bleeding, perforation or rarely neoplasm. So, this congenital duodenal deformity requires urgent definitive treatment. Here we presented a case presenting with postprandial abdominal discomfort with occasional vomiting. He was advised upper gastrointestinal endoscopy. It showed evidence of duodenal septa at the junction of 1st and 2nd part. Scope was negotiated through one channel. He was advised barium meal of stomach, duodenum and follow through, which ultimate demonstrated presence of a rare abnormality, duodenal intramural diverticulum, which if not treated, can produce severe complication in future.
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Objective To explore the diagnostic value of barium meal in gastroesophageal reflux disease(GERD).Methods The data of patients who performed barium meal from January 2003 to December 2012 were retrospectively analyzed,and the GERD detection rate and its relationship with gender and age were calculated and compared.The degree and position of reflux during barium meal in 454 patients in 2012 and the relationship between age and degree and symptom of reflux were studied.Results The GERD detection rate was 13.48％(2 743/20 353) from January 2003 to December 2012,and increased by years.The GERD detection rate in male and female were 13.73％(1 312/9 554) and 13.25％(1 431/10 799) respectively,and there was no significant difference (P ＞ 0.05).With the increase of age,the GERD detection rate increased aslo.In patients of age ≤30 years,31-60 years and ≥61 years,the GERD detection rate were 6.87％ (197/2 866),11.63％(1 096/9 421) and 17.98％(1 450/8 066) respectively,and there was significant difference (P ＜ 0.05).The mild reflux accounted for 242 cases,the moderate reflux accounted for 110 cases,and the severe reflux accounted for 102 cases in patients with GERD in 2012,and there was also an aggravating reflux degree with the increase of age.In patients ≤30 years,31-60 years and ≥61 years,the reflux degree were 10.26％(4/39),17.92％(38/212) and 29.56％(60/203) respectively (P ＜ 0.05).The position with left anterior oblique was most often,accounting for 95.37％(433/454).Conclusions Barium meal can be directly observed,and evaluate the degree of reflux and position.Barium meal is simple and intuitive,and can be used as one of GERD diagnostic methods.
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Objective To investigate the effect, preponderance and clinical significance of the examination of gastrointestinal transmitting function with small amount of barium meal. Methods Thirty cases of healthy subjects and 50 patients with constipation swallow 40 g barium meal once, then abdominal fluoroscopy or plain films were taken until barium meal being egested totally. Results The transit time of stomach, small intestine, colon, rectum and the whole digestive tract were (189?64)minutes, (330?108)minutes, (2239?659)minutes, (136?49)minutes, (2801?735)minutes in healthy subjects and (212?87)minutes, (366?94)minutes, (3665?1322)minutes, (650?219)minutes, (5973?2341)minutes in constipation patients respectively. The transit time of colon and rectum in constipation patients was obviously longer than that of healthy subjects (P0.05). Conclusion The pictures of the examination with small amount barium meal are clear, precise, reliable, and provide exact data for constipation classification.
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Objective To analysis the manifestation of primary gastric malignant lymphoma(PGL) under gastrointestinal barium meal(GIBM) and gastroscopy in order to increase preoperating diagnosis of PGL.Methods Values of gastrointestinal barium meal and gastroscopy were analyzed in diagnosing PGL.All PGL were verified by operation and pathology.Results Using GIBM preoperating diagnostic rate of PGL was 52 percent,including multituberculated type 8 cases,ulcerative type 4 cases,tumour type 3 cases,infiltrative type 3 cases,mixed type 7 cases;The gastroscopy preoperating diagnostic rate of PGL was 30.8 percent,including ulcerative type 7 cases,infiltrative type 4 cases,tumour type 5 cases,huge wrinkle type 6 cases,mixed type 4 cases.The barium meal combined with gastrscopy in diagnosing PGL was 71.4 percent.Conclusions Emphasizing the importance of PGL,deepgoing understanding to distinctive signs of PLG on X-ray and gastroscopy and a combined application of multiple diagnosing means might improve the diagnostic rate of PGL in preoperation.
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Objective To investigate the diagnostic value of barium stury of small bowel obstruction due to various bowel diseases.Methods Barium meal study and enteroclysis (small bowel enema)were performed in 23 patients with incomplete small bowel obstruction due to small bowel diseases confirmed by operation.The imaging data were retrospectively analysed.Results Of the 23 patients,14 cases were malignancy,9 cases were benignant.Conclusion Both barium meal study and enteroclysis( small bowel enema) with air-barium double-contrast technique are of diagnostic value in incomplete small bowel obstruction due to small bowel diseases.
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Objective To assess short term results of papilla functional status after endoscopic sphincterotomy (EST) with thin-barium meal examination.Methods From August, 2001 to December, 2003, eighty-nine patients were included for endoscopic sphincterotomy. Size of EST was (0.5～1.5) cm. Patients were prospectively followed on the short term-period (7 days, 6 months and 1 year) by clinical and thin-barium(100/100 V/W) meal examination which would be observed biliary gas and barium reflux from duodenal papilla.Results The patient number of gas reflux shows: 19 of 89 cases(21.3%) in one week, 5 of 36 cases(13.9%) in six months, 13 of 23 cases (13.0%)in one year; barium reflux with thin-barium meal examination shows: 11 of 89 cases(12.4%) in one week, 3 of 36 cases(8.3%) in six months, 2 of 23 cases(8.7%) in one year. In the size of EST more than 1.1 cm, these were nine patients (47.4%) with gas reflux, and seven patients (36.8%) with barium reflux, and five patients with gas-barium mix reflux. 6 month and 1 year after sphincterotomy, includes EST size 1.2 cm,2 cases and 1.5 cm,3 cases.Conclusion Thin-barium meal examination of papilla function after endoscopic sphincterotomy is an efficient procedure. Incidence rate of gas reflux and thin barium reflux were closely related to the size of EST.
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Objective To explore the value of barium meal examination in cartilagionous tracheobronchial ectopia of the esophageal wall.Methods 5 cases of cartilaginous tracheobronchial ectopia in the esophageal wall were found by barium meal examination,all 5 cases were confirmed operatively and pathologically.Results All the 5 cases showed stenosis in the lower part of the esophagus,the “pendulum-like” sign below the stenosis was seen in 4 ases . Conclusion The radiologic manifestations of cartilaginous tracheobronchial ectopia in the esophageal wall are characteristic,and the correct diagnosis may be established preoperatively.
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An accurate early diagnosis of congenital midgut malrotation is essential to prevention of catastrophic effects of volvulus. To evaluate the usefulness of radiologic examinations in diagnosing intestinal malrotation, we retrospectively analyzed radiologic findings and operation records of 17 intestinal malrotation patients, who were radiologically diagnosed. The age range of the patients studied were from 1day to 12years. The presenting symptoms were vomiting, vomiting with abdominal pain, abdominal distention, diarrhea and failure to thrive. The viewpoints of this analysis were the location of duodeno-jejunal flexure on barium meal and cecal location on barium enema. Sixteen of 17 patients, who were radiologically diagnosed, were surgically proven, but one patient with annular pancreas was false positive. In the case of 3 surgically proved patients, malrotation was suspected on barium meal prior to the barium enema, but final diagnosis was determined on barium enema examination. We concluded that a barium enema should be performed on all children with suspected malrotation where the initial upper gastro-intestinal study was normal or suspicious on account of the small incidence of false positive and false negative barium meals.
Subject(s)
Child , Humans , Abdominal Pain , Barium , Diagnosis , Diarrhea , Early Diagnosis , Enema , Failure to Thrive , Incidence , Intestinal Volvulus , Meals , Pancreas , Retrospective Studies , VomitingABSTRACT
Objective To analyze the imaging features of gastrointestinal stromal tumor(GIST).Methods Imaging features and differential diagnosis of GIST proved surgically and pathologically in 21 cases were studied retrospectively.Results The lesions occurred in esophagus in 1,stomach in 15,small intestine in 3 and colon in 2.The findings of barium meal examination included flattened or shifed mucosal folds(6/21),filling defect(8/21) and extralumially oppressed sign(2/21).CT showed extralumial or intraluminal mass with homogeneous density in 12 cases,liquid-dense necrosis in 6 cases and calcification within tumor in 2 cases.Remarkable enhancement was noted in all tumors,heterogeneous and homogeneous enhancement were showed in 17 and 3 cases respectively.Conclusion GIST is one of the most common gastrointestinal mesenchymal tumors.CT is an effective and useful modality in the diagnosis of GIST.