upper gastrointestinal angiography

Upper gastrointestinal angiography is a commonly used examination method for digestive tract diseases. It refers to the digestive tract angiography of the upper part of the duodenum. The upper gastrointestinal tract examination includes the oropharynx, esophagus, stomach and duodenum. Contrast agent is enriched during angiography, which is what the patient calls "swallowing syrup." At present, most of the use of tinctures, such as barium sulfate, the addition of gum arabic to make silicone paste, sometimes combined with foaming agent for double comparison, can more clearly show the small lesions in the digestive tract. Basic Information Specialist classification: Digestive examination classification: X-ray Applicable gender: whether men and women apply fasting: fasting Tips: Dinner for the first day of dinner, fasting after dinner (including not eating milk, strong tea); fasting and water ban after the morning (including not taking drugs). Normal value In the positive position of the swallowing, the upper middle transparent area is an epiglottis, and the small cystic structure on both sides is an epiglottis. The larger filling cavity below the epiglottis is a pear-shaped nest with a diamond shape and bilateral symmetry. The transparent area in the middle of the sulcus is the throat. Do not mistake the lesion. The piriform fossa meets at the midline and is introduced downward into the esophagus. There is a physiologically narrow area at the confluence, which is about 1 cm long and is equivalent to the sixth cervical vertebra. Lateral observation, epiglottis? In the upper front, the pear-shaped nest is below the back. When swallowed, the pear-shaped fossa shrinks, moves up and becomes smaller, and is wider at rest. Most of the tincture in the pear-shaped fossa is temporarily filled, and it is discharged into the esophagus in a moment. After the swallowing, the esophagus was located to the left of the midline. The contour is smooth and tidy, the tube wall is flexible and flexible, and the width can reach 2~3cm. The right atrium can be seen in the aortic arch and left main bronchus. The right anterior oblique position is a common position for observing the esophagus. Three indentations are visible at the leading edge, from the top to the bottom of the aortic arch and the left atrial pressure. The mucous membrane of the stomach is filled with sulcus between the folds and is densely striped. Wrinkles are strips of transparent shadows. The folds of the small curvature of the stomach are parallel and neat, and gradually become thicker and larger in the transverse direction or obliquely. The fundus folds are thick and curved, slightly reticulated. Gastric sinus mucosal folds are mainly parallel to small bends, and sometimes oblique. The gastric mucosa is plastic and can change its shape by itself. The thickness of the gastric submucosa, the tension of the mucosal muscle layer, and the contraction and relaxation of the muscular layer, as well as the amount of service, and the weight of the pressure, have an effect on the thickness and orientation of the mucosal wrinkle. Generally, the width of mucosal folds in the body is not more than 5 mm. In the case of low-tension angiography, the diameter of the duodenum can be doubled, and the feather-like folds disappear, and the annular folds or the turtle-shaped pattern are arranged in a row. The inner edge of the lower part can be relatively straight or slightly convex, and some can have a shoulder-like protrusion at the middle of the inner edge of the lower edge, which is called the ankle part, where the nipple is located, and the lower part is relatively straight. Vertical creases can be seen in the straight section. The duodenal papilla is easy to display and is located near the inner edge of the middle section of the lower part. It is a circular or elliptical transparent area, generally no more than 1.5 cm in diameter. Clinical significance Esophageal angiography can be found in the characteristic changes of esophageal cancer - the interruption and destruction of the esophageal mucosa, this feature is the most important, and is also a typical manifestation of early esophageal cancer. Other features include esophageal wall filling defects, sputum shadows, soft tissue block shadows, and esophageal stenosis. In contrast, the esophageal wall can be seen to be stiff and creepy. Clinically, it is often found that some doctors only perform esophageal angiography to diagnose esophageal cancer. Our experience is that simple esophageal patch examination is not enough for the diagnosis of esophageal cancer, especially for small early esophageal cancer, which is often ignored. In addition, in order to perform surgical resection and reconstruction of the digestive tract, the stomach should be known before surgery. Therefore, we recommend that a complete upper gastrointestinal angiography should be performed. The diagnostic accuracy rate of upper gastrointestinal angiography is related to the contrast range, the contrast technique, and the interpretation of the angiographic results, ie the diagnostic level of the radiologist. Precautions Before the test: dinner 1 day before dinner, fasting after dinner (including no milk, strong tea); fasting after the morning, no water (including not taking drugs). At the time of examination: patients with critical and inconvenient movements need to be accompanied; with the doctor. Contraindications: intestinal obstruction, allergic to iodine. Inspection process During the examination, the patient stands or lies on the examination table and performs a series of examinations according to the radiologist's arrangement. Contrast the contrast agent and take a picture during the angiography. Not suitable for the crowd There are no special taboos. Adverse reactions and risks Nothing.