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Contrast Examinations

In general the contrast medium used to evaluate the GI tract is a suspension of barium sulfate as it is cheap and easy to use. In patients at risk for aspiration, such as (pre-)term neonates, non-ionic contrast agent is preferred because of the lower risk of dehydration. Ionic water-soluble contrast media are used when a large amount of contrast medium is a

Fig. 5.1a,b. Normal radiographs of abdomen in an infant with anatomic position and normal intestinal gas distribution. Peripheral (AP) low (lateral) location (single arrow) depicts colon; asterisk depicts small bowel b a

Fig. 5.1a,b. Normal radiographs of abdomen in an infant with anatomic position and normal intestinal gas distribution. Peripheral (AP) low (lateral) location (single arrow) depicts colon; asterisk depicts small bowel

Fig. 5.3a,b. A neonate with a highly distended duodenum and stomach due to duodenal atresia. No passage of gas seen distally

Fig. 5.3a,b. A neonate with a highly distended duodenum and stomach due to duodenal atresia. No passage of gas seen distally b a needed, such as in enemas for hydrostatic reduction of an intussusception.

If bowel perforation or predisposition for pulmonary aspiration is suspected, barium is contraindi-cated because of the risk of granuloma formation in both lungs and the peritoneal cavity, in the abdomen adhesions or peritonitis. The reported side-effects of water-soluble contrast media such as hypothyroidism in neonates and allergic reaction in later life are rare.

In evaluating for abnormalities of the proximal digestive tract (proximal or few loops seen), contrast will be given orally or via a feeding tube placed in the stomach or selectively in another intestinal location. For suspected abnormalities of the ileum or below (distal or many loops seen), the contrast will be administered rectally.

Contrast examinations will elucidate the anatomy and the motility pattern of the GI tract.

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Constipation Prescription

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