University of Mosul�College of Medicine
Lecture: ( 1b)
Subject/year: 2023-2024
Lecturer: Dalal Ahmed Ramadhan
Department: surgery
Date: 30-12-2023
What is barium meal radiology?�
A barium X-ray is a radiographic (X-ray) examination of the upper gastrointestinal (GI) tract ( stomach & Duodenum ) .
used to diagnose abnormalities of the GI tract, such as tumors, ulcers and other inflammatory conditions, polyps, hernias, and strictures.
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How do you do a barium meal?
For a barium swallow or barium meal, the barium sulphate powder is mixed with water (and sometimes flavouring) then swallowed. X-rays are taken as you swallow the mixture.
The stomach is a muscular organ that lies between the esophagus and duodenum in the upper abdomen. It lies on the left side of the abdominal cavity caudal to the diaphragm at the level of T10.
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The stomach ("normal" empty volume 45 mL) is divided into distinct regions:
cardia: the area that receives the esophagus (gastro-esophageal junction)
fundus: formed by the upper curvature; portion of stomach above GEJ level .
body (corpus): the main central region of the organ; central two-thirds portion from the cardia to the incisura angularis .
pylorus (antrum): the lower section of the stomach that facilitates emptying into the small intestine, located on the right of the midline at the level of L1.
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Presentation
Patient presents with shortness of breath and fatigue for several months.
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Plain radiograph of the chest:
Retro cardiac opacity with gas-fluid level
DDX: hiatus hernia.
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sliding hiatal hernia
Barium swallow/meal study:
There is up ward herniation of the fundus of the stomach & gastroesophageal sphincter through the esophageal hiatus to the thoracic cavity.
Dx: sliding hiatal hernia
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Presentation 60 y old male presented with
Vomiting with central lower chest and upper abdominal pain
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curling of the nasogastric tube in a dilated proximal esophagus indicative of esophageal atresia.
Gas is seen distally in the gastric cavity indicating tracheo-esophageal fistula
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Radiographic Findings:
Thickened gastric rugae (> 5mm) secondary to edema
Mucosal nodularity
Antral narrowing (indicative of h. pylori)
Erosions: manifest by small mucosal defects that collect contrast.
Dx: gastritis.
Benign gastric ulcer :
Location: Most commonly occur on the lesser curvature or posterior wall of the stomach within or near the antrum
Shape: Ulcer crater is smooth and round or oval
Penetration: The ulcer projects beyond the normal margin of the gastric lumen
Mucosal Folds: Extension of smooth gastric folds to the ulcer crater margin
Ulcer Collar: An edematous mucosal band across the ulcer neck
Hampton 's Line: A thin mucosal line across the ulcer neck due to ulcer extension into the sub mucosa
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Barium meal study:
Radiographic Findings: gastric ulcer en-profile
A well defined outpouching filled with contrast ,Seen in the lesser curvature . With Hampton's Line.
DX: benign gastric ulcer .
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Barium meal study:
Radiographic Findings: gastric ulcer en-face
A well defined rounded collection of contrast , Extension of smooth gastric folds to the ulcer crater margin.
DX: benign gastric ulcer .
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Barium meal study
There is large irregular outline filling defect involve the lesser & greater curvatures of the stomach , with shouldering sign.
Dx: gastric malignancy
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Barium meal study shows : Irregular stenosis with rigidity of the greater curvature in the lower film & most of the body & pyloric antrum in the left sided film of the stomach at prepyloric gastric antrum ca.
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