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Ch. 13 Bontrager (lower gastrointestinal system) Problem Solving
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Ch. 13 Bontrager (lower gastrointestinal system) Problem Solving
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Ch. 13 Bontrager (lower gastrointestinalsystem) Problem Solving
A radiograph of a double-contrast BE projection shows an obscured anatomic side marker.
The technologist is unsure whether it is an AP or PA recumbent projection. The transverse
colon is primarily filled with barium, with the ascending and descending colon containing a
lesser amount. Which position does this radiograph represent?
PA prone. Because the transverse colon is an intraperitoneal aspect of the large intestine
located more anteriorly, it will fill with barium in the PA prone position.
A radiograph of a lateral decubitus projection taken during an air-contrast BE shows the
upside aspect of the colon is overpenetrated. The following factors were used during this
exposure: 120 kVp, 30 mAs, 40-inch SID, and compensating filter for the air-filled aspect of
the large intestine. Which of these factors must be modified during the repeat exposure?
Even with the use of a wedge compensating filter, a reduction in kVp is required. Because
less Barium sulfate is used during air-contrast procedure, the kVp range should be 90-100.
A radiograph of an of an AP axial BE projection of the rectosigmoid region shows there is
considerable superimposition of the sigmoid colon and rectum. The following factors were
used during this exposure: 120 kVp, 20 mAs, 40 inch SID, 35 degree caudad CR angle, and
collimation. Which of these factors must be modified or corrected for the repeat exposure?
The CR was angled in the wrong direction. The AP axial projection requires a 30 to 40
degree cephalad angle.
A BE study performed on a hypersthenic patient demonstrates that in the majority of the
radiographs, the left colic flexure was cut off. What can be done during the repeat exposures
to avoid this problem?
Use two 14-x 17 inch landscape IRs for the AP/PA and oblique projections, one centered
higher and lower. Because hypersthenic patients have a wider distribution of the large
intestine, two landscape-placed cassettes will ensure that all pertinent anatomy is
demonstrated.
A technologist has inserted an air-contrast retention tip for a double-contrast BE study. He is
not sure how much to inflate the retention balloon. Should he inflate it as much as the patient
can tolerate, or is there a better alternative?
retention catheters should be fully inflated only by the radiologist under fluoroscopic
guidance.
A student technologist is told to place the patient on the x-ray table in a Sims position in
preparation for the tip insertion for a BE. Describe how the patient should be positioned.
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