Flocculation Of Barium Research Articles

The normal upper gastrointestinal examination in the ferret.

Upper gastrointestinal examinations were performed in 11 unsedated ferrets and 4 ferrets sedated with ketamine and diazepam. Each animal received a 8-13 mL/kg body weight dosage of barium liquid (30% weight:volume). Radiographs were made immediately and at 5, 10, 20, 40, 60, 90, 120 and 150 min (mins) after the barium was administered. Gastric emptying began immediately. Mean total gastric emptying was longer in sedated ferrets (130 +/- 40 min versus 75 +/- 54 min); however, this difference was not statistically significant (p = 0.18). Small intestinal transit time was less than 2 h in all ferrets. The barium-filled small bowel was best visualized on the 20- and 40-min radiographs and did not exceed 5-7 mm in width. Flocculation of barium in the small intestine and adherence of barium to the stomach mucosa was seen in almost all animals. The longitudinal colonic mucosal folds in the colon were well visualized in the normal upper gastrointestinal study and aided in distinguishing small intestine from large intestine. The use of ketamine and diazepam sedation did not significantly affect the parameters evaluated in the upper gastrointestinal study series.

Adult celiac disease and its complications.

Classic radiographic findings described in adult celiac disease--lumen dilatation, flocculation of barium, hypersecretion, thickening of folds--are nonspecific or are secretion related artifacts. The small bowel enema technique and CT make it possible to demonstrate specific diagnostic features of the disease and its complications. This substantially modified approach to the diagnosis of adult celiac disease is presented together with correlative pathology. Examples of the complications of celiac disease--ulcerative jejunoileitis, lymphoma, hyposplenism, carcinoma, and the cavitary lymph node syndrome--are illustrated.

Radiologic abnormalities and autonomic neuropathology in the digestive tract of the ketonuric diabetic Chinese hamster.

Barium x-ray patterns of ketonuric diabetic Chinese hamsters displayed marked dilatation of the stomach, small and large intestine. Hypomotility was manifested by flocculation of barium in the small and large bowel. Impaired transit time was further characterized by prolonged emptying of the stomach (mean 570 min diabetics; 200 min controls) and delayed stool formation (mean 230 min diabetics; and 100 min controls) and passage (mean 457 min diabetics; 210 min controls). Ultrastructural analysis of Auerbach's myenteric plexuses of the small intestine indicated acute degeneration in certain distal, unmyelinated axons. Swelling, deposition of glycogen, aggregation of neurofilaments and dense accumulation of lamellar bodies were observed. The severity and frequency of barium flocculation, glycogen deposition, aggregation of neurofilaments and lamellar inclusion bodies in axons were directly related to duration of ketonuria. The data strongly suggest that autonomic neuropathology in the plexuses of Auerbach may be a critical factor underlying gastrointestinal dysfunction in the ketonuric diabetic Chinese hamster.

Upper gastrointestinal studies with acid and alkaline barium sulfate suspensions.

Many studies have been reported indicating that the contents of the stomach and small intestine influence the appearance of administered barium sulfate suspensions (1, 5, 9). This depends on the type of barium suspension used: plain barium sulfate versus preparations containing suspending agents. Frazer et al. (9) demonstrated that in normal subjects hypertonic solutions and long-chain and certain short-chain fatty acids cause a segmentation pattern in the small bowel apparently secondary to increased mucin secretion stimulated by these substances. Chang and Carroll (6) described marked mottling and flocculation of barium in the stomach in patients with hyperacidity and a frothy, foamy, and bubbly appearance in those with hypoacidity. Bryk and Robinson (4) showed that, in pyloric obstruction due to duodenal ulcer, hypersecretion and hyperacidity lead to precipitation and layering of barium while in neoplastic obstruction with its associated hypoacidity precipitation and layering are less common. Knoefel et al. (13) performed in vitro studies which indicated that the precipitation of barium was related to the volume and acidity of the gastric juice and its mucoprotein content. In the small bowel abnormal patterns have been described with duodenal ulcer (2), the Zollinger-Ellison syndrome (7, 15, 22), the malabsorption syndrome (5, 19), and a large number of other conditions which alter the bowel contents (2). These studies have indicated that the abnormalities noted are most prominent with plain barium sulfate suspensions and are completely or almost completely eliminated with the use of barium suspensions containing suspending agents. In duodenal ulcer and in the Zollinger-Ellison syndrome, it was postulated that the abnormalities were due to the large volume and the low pH of the gastric contents presented to the small bowel. A study in dogs (17) showed that instillation of 0.1 N HCl into the stomach increased the fluid volume of the ileum, increased its free acid content, and produced diarrhea. Multiple studies have been reported on the effect of administered acid or alkali on gastric emptying. These have generally agreed that in most normal adults acid solutions delay gastric emptying while isotonic solutions of alkali hasten emptying (11, 12, 18, 21). No studies, however, have been done on the roentgenographic gastric, duodenal, and small bowel patterns resulting from the use of barium sulfate suspensions whose pH has been adjusted to the equivalent of either the gastric or the duodenal contents. Acid barium (pH 1.7) has been recently described (8) as useful in evaluating clinical esophagitis, but its effect on the remainder of the gastrointestinal tract has not been described. No studies on the roentgenographic patterns produced by alkaline barium suspensions are available.

The radiological investigation of malabsorption syndromes.

1. The malabsorption syndromes have been classified into two main groups according to their main radiological features. 2. Group I contains those conditions predominantly associated with steatorrhoea. The significance and diagnostic value of the two main radiological features, flocculation of barium and dilatation of the small bowel, are discussed. 3. Group II contains those conditions with specific radiological features. The importance of radiology in this group, particularly in the accurate demonstration of the anatomical lesions of the small bowel, is stressed.

The clinical and roentgenological findings in steatorrhea of varying etiology.

In a survey of several conditions in which the common presenting sign was steatorrhea, clinical, pathological and radiographic studies suggested certain distinctions among the entities,—pancreatogenic steatorrhea, symptomatic sprue and idiopathic steatorrhea. The first of these differs clinically and roentgenographically from the two others. The moulage sign and flocculation of barium were not seen in our cases of pancreatogenic steatorrhea. In symptomatic sprue we have found that x-ray studies of the small intestine are of help in making the sometimes difficult distinction from the idiopathic syndrome. Above all, we found that repeated x-ray examinations of the small bowel are indispensable in all cases of steatorrhea, and we make a plea for its greater use in these cases.