APPENDIX I Products and Manufacturers 1. Barium products A. Upper G I tract a. E-Z-HD (E-Z-Em). Contains 98% barium sulfate (340 g), simethicone, and other additives; addition of 65 ml of water pro­ duces 135 ml of suspension of 85% w/w or 250% w/v b. Liquid Sol-O-Pake (E-Z-Em), 45% w/w or 72% w/v barium sulfate suspension c. HD 200 Plus (E-Z-Em)-225% w/v. d. Novopaque, 40% w/w or 60% w/v barium sulfate suspension with sodium saccharine flavouring. This is a pre-mixed liquid bar­ ium in 355 ml cans or 3.71 litre containers. e. Micropaque 92% w/v. No longer available in Canada. f. Polibarpowder. (E-Z-Em) Supplied in a 100-gjug; suspension from 27% w/w to 50% w/w can be obtained with appropriate quan­ tity of water g. Baricon (E-Z-Em). Contains 95% barium sulfate (340 g). Addi­ tion of 70 ml of water produces 83 w /w suspension B. Small bowel a. Ultra-R (E-Z-Em), 95% barium sulfate powder with simethi­ cone and additives. Can be diluted to 45%, 50%, 55%, or 60% w/w (72%-110% w/v) b. Enterobar (E-Z-Em), 50% w/v barium suspension C. Double-contrast colon a. HD85 (E-Z-Em), 85% w/v suspension (2000 ml) b. Polibar Liquid (E-Z-Em), 55% w/w or 100% w/v barium sul­ fate suspension (1900 m1) c. Liquid Polibar Plus (E-Z-Em), 57% w/w or 105% w/v sus­ pension d. Colobar (E-Z-Em), 56% w/w or 100% w/v barium sulfate sus­ pension (2000 ml) D. Single-contrast colon a. Polibar Liquid (E-Z-Em). Dilute 1 volume Polibar Liquid with 5 volumes of water to obtain 15.4% w/w or 17.5% w/v sus­ pension b. Baroperse Enema Kit (E-Z-Em). Contains 340 g Barosperse c. Unibar 100 (E-Z-Em), 56% w/w or 100% w/v barium sulfate suspension (2000 m1) 222 Appendix I: Products and Manufacturers d. Unibar 110 (E-Z-Em), 60% w/w or 110% w/v suspension (2000 ml) E. Barium suspension for CT a. Baro-cat (E-Z-Em), 1.5% w/w barium suspension b. E-Z-Cat (E-Z-Em), 4.5% w/w concentration; dilutes to 1.1% w/w suspension (225 m}) c. Readi-Cat (E-Z-Em), 1.2% w/w barium sulfate suspension (450 ml, 2000 m}) d. Esopho-Cat (E-Z-Em), 3% w/w barium sulfate paste for coating of esophagus 2. Water-soluble contrast for upper GI tract in adults only (very dan- gerous in children) a. Gastrografin (adults only) b. Hypaque (Winthrop) c. Renografin (Squibb) d. Omnipaque (Winthrop) e. Isovue (Squibb) f. Ioxyglate, Hexabrix (Mallinckrodt) g. Hypaque powder for oral CT contrast (Winthrop) 3. Effervescent Tablets a. E-Z-Gas2, effervescent granules (E-Z-Em). Contain sodium bicarbonate 2.21 g, citric acid 1.53 g, simethicone 0.02 g; produce no less than 400 ml CO2 b. Unik-Zoru, tablets or granules (E-Z-Em). Produce 280 ILg of gas per dose c. Baros, granules (E-Z-Em) 4. Methylcellulose a. Enterocel (E-Z-Em), 500-ml concentration of methylcellulose b. MC (E-Z-Em), 1% w/v hydroxypropylmethylcellulose so­ lution 5. Enteroclysis catheters a. Maglinte enteroclysis catheter (Cook Inc, E-Z-Em), 155 cm x 13 French catheter with balloon and torque cable b. Gianturco catheter (Cook Inc.). Has flexible guide for stiffen­ ing and torque control c. Bilbao Dotter catheter (Cook Inc.). Has a curved tip for direc­ tional control. 12 and 14 Fr available in various lengths d. Muller catheter. (Cook Inc.) Has variable curve tip control 6. Enema tubes and tips Various enema bags with various sizes, tips with and without cuff are supplied by E-Z-Em. Cuffs should not be used in children 7. Film. a. T-Mat L Film (Eastman Kodak) b. Cronex 7 Film (Dupont) c. High-Ortho Film (Konica) d. Fuji Xray Film (Fuji) Various products are available that are suitable for examination of the gastrointestinal tract. This appendix lists only the products with which the authors have clinical experience. APPENDIX II Further Reading 1. Margulis AR, Burhenne HJ, eds (1988). Alimentary Tract Radiology, 4th Ed. St. Louis: C.V. Mosby. 2. Meyers MA (1986). Computed Tomography of the Gastrointestinal Tract including the Peritoneal Cavity and Mesentery. New York: Springer­ Verlag. 3. Gelfand DW (1984). Gastrointestinal Radiology: Performing and Interpret­ ing Fluoroscopic Examinations. New York: Churchill Livingstone. 4. Kelvin FM, Gardiner R (1987). Clinical Imaging of the Colon and Rectum. New York: Raven Press. 5. Laufer I, ed (1979). Double Contrast Gastrointestinal Radiology, with Endoscopic Correlation. Philadelphia: W.B. Saunders. 6. Nolan JD (1980). The Double Contrast Barium Meal: a Radiological Atlas. Aylesbury: HM & M. 7. Hunt RH, Waye JD (1981). Colonoscopy: Technique, Clinical Practice and Colour Atlas. London: Chapman and Hall. 8. Blackstone MO (1984). Endoscopic Interpretation: Normal and Pathologic Appearances of the Gastrointestinal Tract. New York: Raven Press. 9. Cotton PB, Williams CB (1984). Practical Gastrointestinal Endoscopy. Ox­ ford: Blackwell Scientific. 10. Nahum H, Fekete F, margulis AR (1976). Radiology of the Postoperative Digestive Tract, Trans AE Oestreich. New York: Masson. 11. Binelson J. Castell DO (1988). Disease-A-Month. Esophageal Motility Dis­ orders, Vol. 34(6). Chicago: YearBook Medical Publications. 12. Oudkerk M (1981). Infusion rate in enteroclysis examination. Thesis. Lei­ den, The Netherlands: Leiden University. 13. Megibow AJ, Balthazar JE, eds (1986). Computed Tomography of the Gastrointestinal Tract. St. Louis: C.V. Mosby 14. Felson B (1976). Roentgenology of the Gallbladder and Biliary Tract. Or­ lando: Grune and Stratton. 15. Shirakabe H (1971). Double Contrast Studies of the Stomach. Tokyo: Bun­ rodo Co. Ltd. 16. Op Den Orth JO (1979). The Standard Biphasic Contrast Examination of the Stomach and Duodenum (Series in Radiology: Radiological examina­ tion of the GI tract). The Hague: M. Nijhoff. 17. Simpkins KC, ed (1988). The alimentary tract: the hollow organs and sali­ vary glands. In: A Textbook of Radiological Diagnosis, 5th Ed, Vol. 4. London: HK Lewis. 18. Sherlock S (1981). Diseases of the Liver and Biliary System, 6th Ed. Ox­ ford: Blackwell Scientific. 224 Appendix II: Further Reading 19. Fishman EK, Jones B (1988). Computed Tomography of the Gastrointesti­ nal Tract. New York: Churchill Livingstone. 20. Ponsky JL, Gauderer MWL, Stellato TA, Aszodi A (1985). Percutaneous approaches to enteral alimentation. Am J Surg 149:102-115. 21. Farrar CW (1979). Patterns of sigmoid colon and their implications for barium enema radiography. Med Radiogr Photogr 55:1-28. Index A 145-146 in computed tomography, Acidified barium in products for, 222 198 esophageal examination, tips for technologists, Bilbao Dotter enteroclysis 29 213-215 catheter, 222 Air enema, 84-85 tubes and tips for, 222 modified, 48, 138 Air insufflation Barium kitchen, 212-213 Biliary tract in computed tomography of Barium meal, 3-24 cholaniography colon, 201-202 contraindications and operative and in double-contrast barium precautions in, 4 postoperati ve, 172-173 enema, 64 double-contrast percutaneous transhepatic, in children, 153 in children, 129-134 182-188 in double-contrast in small bowel studies, 47 cholangiopancreatography, enteroclysis, 56 duodenum in, 16-24 endoscopic retrograde, in gastrostomy, 193 esophagus in, 6-8 188-192 Air reduction of indications for, 3-4 cholecystography, oral, intussusception in materials for, 4 169-172 children, 148 patient preparation in, 5-6 sonography, pediatric, 113 Anastomotic leaks, problems in, 23-24 sphincterotomy, 190-192 postoperative colon products for, 221 stent placement, 192 studies in, 99 single-contrast, in children, Biopsy of liver, 173-182 Appendectomy, postoperative 123-128 percutaneous, 173-177 colon studies in, 102 in small bowel studies, contraindications for, 174 Aspiration of barium 43-47. See also Small indications for, 173-174 fatigue, in childhood, 128 bowel studies, barium patient preparation in, 174 in swallowing study, meal in postprocedure care in, 177 117 stomach in, 8-15 procedure in, 174-177 swallowing function transjugular, 177-182 evaluation in, 38-39 contraindications and B Barium products, 221 precautions in, 177-178 Balloon paddle as compression for computed tomography, indications for, 177 device, 80 222 patient preparation in, 178 Baricon,221 double-contrast colon, technique of~ 178-182 Barium enema 221-222 Biopty gun in percutaneous double-contrast, 61-78 single-contrast colon, 222 liver biopsy, 175 in children, 152-155 small bowel, 221 Bupivacaine, 220 products for, 221-222 upper tract, 221 in percutaneous transhepatic and reflux small bowel Baro-Cat, 222 cholangiography, 182 study, 57-58 Baroperse Enema Kit, Buscopan, 218-219 222 in barium enema in children, 142-143, Baros granules, 4, 222 examinations, 78, 83 226 Index Buscopan (cant.) Colonoscopy,87-93 in operative in computed tomography compression techniques in, cholangiography, 172 of pancreas, 206 89-93 in percutaneous trans hepatic of stomach and ascending colon to cecum, cholangiography, 184 duodenum, 199 92-93 Diazemuls, 188, 220 in duodenography, 16 hepatic flexure, 91-92 Diazepam, 219-220 sigmoid colon, 88-90 in endoscopic retrograde splenic flexure, 90 cholangiopancreatogra­ transverse colon, 90-91 phy, 188 C contraindications for, 87 in percutaneous trans hepatic Carbon dioxide enema, 85 indications for, 87 cholangiography, 182 Carbon dioxide insufflation in patient preparation in, 62, 88 respiratory repression from, double-contrast barium postoperative, in cancer and reversal of, 36, 220 enema, 78 polyp follow-up, in small bowel enema Carboxymethylcellulose 102-103 preparation, 53 solution in small bowel procedure in, 88 Doppler sonography, enema, 138 Colostomy in children, and pediatric, 114 Chest pain, esophageal postoperative Double-contrast barium examination in, 29 loopagrams, 150-151 enema, 61-78 Childhood.