DIGESTIVE AND UROGENITAL SYSTEMS
Section I. THE DIGESTIVE SYSTEM
Examination of the digestive system includes a number of different technical
procedures in which various items of equipment and materials are used. The method
used will vary in certain details, depending upon the desires of the radiologist. The
various components of the digestive system are nearly always examined selectively; for
example, the esophagus, the stomach, the duodenum, the colon, and the gallbladder.
Examination of each of these parts often constitutes a procedure in itself. In the
discussion that follows, each part is considered as a unit. Except under emergency
conditions, each of these examinations requires a previous appointment.
The esophagus lies immediately posterior to the trachea. It penetrates the
diaphragm and enters the stomach by way of the cardiac orifice. Consider the
esophagus as being divided into three portions--cervical, thoracic, and abdominal.
Each may use specific radiographic reference points. The cervical portion is located
above the upper situs of the mediastinum. The thoracic portion is between the superior
aspect of the mediastinum and the diaphragm. The abdominal portion is between the
diaphragm and the stomach.
a. Preparation of Patient and Scheduling. The study of the esophagus
usually entails the combined use of fluoroscopy and radiography. Therefore, for
practical reasons, this examination should be scheduled. No special preparation of the
patient is required other than that the stomach be fairly empty so that it can
accommodate the contrast medium without undue discomfort.
b. Preliminary Procedure. Everything should be in complete readiness when
the patient reports for the examination. This generally requires the following.
(1) A routine setup of the fluoroscopic and radiographic facilities should be
accomplished. This includes checking the x-ray unit for correct factors and operational
readiness, mounting the footrest or shoulder braces, and checking to make certain that
the proper type and numbers of cassettes (including identification material) are readily
available for spot-film exposures. Ensure the digital monitor, TV, or videotape is ready
for use. At the start of each day, the above equipment should be tested to ensure
(2) Protective aprons and gloves should be laid out for the radiologist and
other medical personnel.