Thursday, January 7, 2016

Barium


This barium swallow is in a patient with a history of trauma.

Challenge: What do you see?

Image shown under Fair Use.

5 comments:

Anonymous said...

Are we lookin at a hiatal hernia?

Craig Chen said...

yes you're right, it's a diaphragmatic rupture with a hiatal hernia
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Barium

The contrast outlines the hepatic flexture herniated through the dome of the left hemidiaphragm. The white arrows indicate the hiatus.

Source: UpToDate.

Anonymous said...

Just curious..WIth the history of trauma, what was the rationale for initiating a study with barium?

Craig Chen said...

yes, good catch! that's an important point - if you suspect GI tract injury, gastrograffin is better than barium. For this case, I found the picture with barium on UpToDate, and made up a case to go with it (deciding with trauma because of the epidemiology of diaphgramagic hernias) and totally missed your point. thanks for correcting it!

Anonymous said...

Thank you!