Why do a Fluoroscopic exam?

Fluoroscopic exams are used to analyze the flow of certain contrast agents through specific parts of the body to determine if there is an anatomic abnormality in that area. This includes the gastrointestinal (GI) tract (Barium Swallow, Upper GI Series, Small Bowel Studies, and Barium Enema), the female genital tract ((Hysterosalpingogram), the urinary tract (Cystograms and Voiding Cystourethrograms), vascular studies (Phlebograms), and joint studies (Arthrograms).

How are Fluoroscopy exams done?

The method of the exam depends on the body part being examined:

Barium Swallows, Upper GI (UGI), or Small Bowel (SBFT) Studies: These tests are utilized to assess various clinical conditions including swallowing difficulties, reflux (GERD), ulcer disease, bleeding, and inflammatory conditions, among others. These exams may be done alone or in combination. For each of these exams you will be asked to swallow a liquid preparation of barium, which is “dense” enough to show up on the x-ray exam to outline the part of the GI tract being examined. You will be standing up and/or lying down on an x-ray table as the fluoroscopic images are obtained.

Barium Enema (BE): This test analyzes the lining of the colon as a screening exam for colon cancer, or when there is a specific clinical question regarding inflammatory bowel disease, diverticular disease or other clinical problems. For this exam liquid barium is introduced into the large intestine (colon) through a short tube inserted in the rectum. You will be lying on an x-ray table, and during the filling of the colon with barium and air you will be asked to turn in various directions to optimally coat the lining of the colon so that it can be analyzed. Fluoroscopically guided images are obtained during and after filling the colon.

Cystograms and Voiding Cystourethrograms (VCUG): These tests are used to assess the integrity and/or function of the urinary bladder. For each of these, a water soluble contrast agent is instilled by placing a small soft catheter (tube) directly into the bladder. Fluoroscopically localized images of the bladder are taken in various projections while you lie on an x-ray table for a cystogram, and for a voiding study images are also obtained as you void.

Hysterosalpingograms (HSG): This test is utilized as part of the infertility work up when there is a clinical question of an abnormality of the lining of the uterus or blockage of the fallopian tubes. For this test a speculum is introduced into the vagina and a small tube is inserted into the cervix through which a water soluble contrast agent is injected into the uterus. Fluoroscopic images are then obtained as the contrast is injected to outline the shape of the uterine cavity and to determine if contrast “spills” properly out of the fallopian tubes.

Phlebograms: This is a test occasionally used to analyze for blockages (clots) in the leg veins. While you lie on an x-ray table a water soluble contrast agent is quickly injected intravenously into a vein on top of your foot. This is followed by rapid acquisition of fluoroscopically guided images over your leg, from ankle level through hip level in various projections.

Arthrograms: These exams are used to analyze joints for specific clinical questions regarding integrity of the internal structure of a joint. Arthrograms can be done independent or in conjunction with MRI of the joint following the arthrogram. The shoulder, knee, elbow, wrist and hip joints can be assessed by this method. You will be lying on a x-ray table. After numbing the skin and under fluoroscopic guidance, the radiologist will insert a needle into the joint space to be examined. During fluoroscopic observation the water soluble contrast is injected to distend the joint capsule and images are then obtained.

How do I prepare for my Fluoroscopy examination?

PLEASE READ CAREFULLY (Note: For pediatric preparations, please call (770) 980-8970)

• UPPER GI - Nothing to eat or drink 8 hours before exam

• UPPER GI Series and SMALL BOWEL - (Length of exam will vary depending on how quickly the barium passes through the bowel – 20 minutes to 3-4 hours) Nothing to eat or drink 8 hours before exam

• SBFT/ENTEROVU - (Length of exam could vary up to 3-4 hours) Nothing to eat or drink 8 hours before exam

• BARIUM ENEMA (BE) - See Below

Patient Instructions For ADULT BARIUM ENEMA or ADULT INTRAVENOUS UROGRAMS

The day before the exam
(This preparation should cause marked laxative effect)

Obtain a 10 oz. bottle of citrate of magnesia and 3 Ducolax tablets from a drug store.
LUNCH: Clear liquid diet – The following liquids are permitted: clear fruit juices, carbonated beverages and non-carbonated beverages, gelatin or plain Jello, coffee or tea (without cream or milk), bouillon.

• 1:00 PM Drink one full glass or more of water or above liquids..
• 3:00 PM Drink one full glass or more of water or above liquids.
• 4:00 PM Drink bottle of citrate of magnesia, cold or with ice cubes.
• 5:00 PM SUPPER: SAME AS LUNCH
• 6:00 PM Drink one full glass or more of water or above liquids.
• 7:00 PM Take 3 Ducolax tablets with one full glass or more of water.
• 8:00 PM Drink one full glass or more of water or above liquids.
• 9:00 PM Drink one full glass or more of water or above liquids.

Morning of Exam (for morning appointment)

How will I learn about the results?

A written report of your fluoroscopic exam will be sent promptly to the physician who ordered the exam and it will be reviewed with you. If this exam is on an urgent basis the results will be sent to your doctor immediately via phone or fax. If your doctor requests the images, depending on whether or not the exam was a conventional fluoroscopic procedure or a digital one, your physician may receive films, a CD or images via our secured Internet web browser link between Cascade Radiology Imaging’s database and your referring physician. .