Normal upper GI contrast study - neonate

Case contributed by Dr Jeremy Jones

Presentation

13 hours old. Large bile vomit. Examines normally.

Patient Data

Age: 13 hours (term)
Gender: Male
Fluoroscopy

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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