Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed images, with KUB
CPT4 code
Name of the Procedure:
Radiological Examination of the Upper Gastrointestinal Tract Common names: Upper GI series with air contrast, Double contrast barium meal.
Summary
An upper gastrointestinal (GI) radiological examination with air contrast uses high-density barium and an effervescent agent to visualize the esophagus, stomach, and small intestine. The procedure helps doctors diagnose problems in the upper GI tract using X-ray images enhanced by barium and air contrast.
Purpose
This procedure assesses and diagnoses abnormalities such as ulcers, tumors, blockages, or inflammatory conditions in the upper GI tract. The goal is to obtain detailed images that can help identify the cause of symptoms like persistent nausea, abdominal pain, difficulty swallowing, or unexplained weight loss.
Indications
- Unexplained upper abdominal pain
- Persistent nausea and vomiting
- Difficulty swallowing (dysphagia)
- Unexplained weight loss
- Suspected ulcers or tumors
- Chronic acid reflux or heartburn (GERD)
- Detecting structural abnormalities or blockages
Preparation
- Fast for 8-12 hours before the procedure.
- Avoid smoking and chewing gum as these can stimulate gastric secretions.
- Inform the healthcare team about any medications you're taking; adjustments might be necessary.
- Undergo any preliminary diagnostic tests as advised, such as blood tests or an EKG.
Procedure Description
- The patient will be asked to drink a high-density barium solution, followed by an effervescent agent that helps to produce gas and expand the GI tract.
- X-ray images will be taken while the patient is in various positions to ensure comprehensive imaging.
- The process may include additional images taken after some time (delayed images) to assess how the material moves through the digestive tract.
- An abdominal X-ray (KUB - Kidneys, Ureters, Bladder) may also be performed as part of the exam.
- The entire procedure uses real-time fluoroscopy to guide the image capture.
Duration
The procedure typically takes about 30 minutes to 1 hour.
Setting
Performed in a hospital radiology department or specialized outpatient imaging clinic.
Personnel
- Radiologist (a doctor specialized in reading medical images)
- Radiologic technologist
- Potential supportive nursing staff
Risks and Complications
- Mild abdominal discomfort or bloating due to the effervescent agent
- Constipation from the barium contrast
- Rare allergic reactions to the contrast material
- Bowel obstruction, although rare
- Possible aspiration of barium if not properly swallowed
Benefits
- Provides highly detailed images of the upper GI tract, aiding in accurate diagnosis
- Non-invasive alternative to endoscopic examinations
- Helps guide further treatment plans based on the findings
Recovery
- Patients can usually resume normal activities immediately after the procedure.
- Drink plenty of fluids to help clear the barium from your system.
- A mild laxative may be recommended to prevent constipation.
- Follow-up visits as needed based on test results.
Alternatives
- Endoscopic procedures like esophagogastroduodenoscopy (EGD)
- MRI or CT scans of the abdominal area
- Ultrasound imaging for soft tissue evaluation
- Pros: Endoscopic procedures allow for direct visualization and biopsy. Cons: They are more invasive than a radiological exam.
Patient Experience
During the procedure, the patient might experience mild discomfort from the gas produced by the effervescent agent and the sensation of fullness from the barium. Post-procedure, there may be temporary changes in bowel habits and stool color. Pain management is rarely needed, as discomfort is usually minimal. Instructions will be provided to ensure the patient's comfort and proper recovery.