Presentation
13 hours old. Large bile vomit. Examines normally.
Patient Data
Age: 13 hours (term)
Gender: Male
From the case:
Normal upper GI contrast study - neonate
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Normal position of the DJ flexure. No evidence of malrotation or volvulus.
Case Discussion
My process:
- NG tube in stomach. 10 ml Omnipaque 300 attached to tube.
- supine: inject 4 ml and watch stomach expansion; occasionally, the contrast will rapidly transit into duodenum (in which case skip the next step)
- right lateral: watch the contrast fill the duodenum and head posteriorly; wait for it to travel cranially before turning back supine
- supine: if you have timed it perfectly, the contrast will be filling the duodenum; confirm DJ flexure position and then watch the proximal jejunum fill to confirm it is left-sided
- suck out any remaining contrast in the stomach and flush the NG tube with water
Study details:
- screening time: 9 seconds
- total dose: 0.21 μGym2
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