Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered
CPT4 code
Name of the Procedure:
Radiologic Examination, Upper Gastrointestinal Tract; Double-Contrast Study (including Scout Abdominal Radiograph(s), Delayed Image(s), and Administration of Glucagon)
Summary
A radiologic examination of the upper gastrointestinal (GI) tract using double-contrast imaging. This involves swallowing a high-density barium solution and an effervescent agent to create clear images of the esophagus, stomach, and the beginning of the small intestine. Glucagon may be administered to relax the GI tract and improve imaging quality.
Purpose
This procedure helps diagnose conditions affecting the upper GI tract, such as ulcers, tumors, inflammation, or structural abnormalities. It aims to provide detailed images that can inform accurate diagnosis and proper treatment planning.
Indications
- Persistent upper abdominal pain
- Difficulty swallowing (dysphagia)
- Unexplained weight loss
- Chronic acid reflux or GERD symptoms
- Suspected ulcers or tumors
- Follow-up for known GI conditions
Preparation
- Fasting: Patients should not eat or drink for at least 8 hours before the procedure.
- Medication adjustments: Patients may need to stop certain medications as instructed by their healthcare provider.
- Pre-procedure tests: Sometimes, a blood test or other diagnostics may be required beforehand.
Procedure Description
- Initial Assessment: A scout abdominal radiograph is taken.
- Administration of Contrast Agents: The patient swallows a high-density barium solution followed by an effervescent agent.
- Imaging: Multiple X-rays are taken to capture images of the GI tract. Additional delayed images may be taken to provide more detail.
- Glucagon Administration: If necessary, glucagon is administered to relax the GI tract for clearer imaging.
- Final Assessment: Radiologist reviews the images for abnormalities.
No anesthesia or sedation is typically required.
Duration
The procedure usually takes about 30 to 60 minutes.
Setting
Performed in a radiology department, hospital, or outpatient imaging center.
Personnel
- Radiologist
- Radiologic technologist
- Possibly a nurse for glucagon administration
Risks and Complications
- Exposure to low levels of radiation.
- Nausea or discomfort from swallowing barium.
- Rare allergic reactions to barium.
- Constipation from the barium.
- Possible complications managed by medical staff as needed.
Benefits
- Provides detailed images of the upper GI tract.
- Helps in accurately diagnosing GI conditions.
- Non-invasive with minimal discomfort.
- Results typically available quickly for prompt diagnosis.
Recovery
- Patients may resume normal activities immediately.
- Increase fluid intake to help clear the barium from the body.
- Possible mild constipation, manageable with diet adjustments or mild laxatives.
- Follow-up appointment if further evaluation or treatment is needed.
Alternatives
- Upper endoscopy (EGD): Provides direct visualization and biopsy options.
- CT or MRI scan: Offers detailed cross-sectional images without the use of barium.
- Pros and cons vary; alternatives should be discussed with a healthcare provider for suitability.
Patient Experience
- During the procedure, the patient might feel mild discomfort or a chalky taste from barium.
- Bloating or mild nausea from the effervescent agent is possible.
- Post-procedure, patients can manage mild constipation with fluids and dietary changes.
- Pain management is generally not required, and comfort measures are provided throughout the procedure.