Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Barium or a non-ionic water soluable contrast taken by mouth or nasogastric tube. If the clinical picture is highly suggestive for duodenal atresia, you may simply inject air through a nasogastric tube.
Use nasogastric tube or 8 french feeding tube with the tip in stomach - fluoroscope to check this first.
Don't over distend stomach with contrast.
Start with left side down.
Give 5-10 cc of contrast through the nasogastric tube.
Turn to right side down to facilitate gastric emptying.
When contrast is seen to enter 3rd/4th part of duodenum, turn the patient supine and document the position of the duodenal jejunal junction with a spot film.
Follow the contrast through the small bowel.
Aspirate stomach at end of exam if you have a nasogastric tube down.
Views to Take:
AP view of the Ligament of Treitz
AP views of the level of the obstruction
See References Chapter.
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