UGI

FINDINGS:Thepatientswallowedbariumandeffervescentgranules[withoutdifficultyoraspiration].
Theoralandpharyngealphasesofswallowingarenormal.Triggeringofswallowingreflexisnormal/delayed.Oraltransferis
normal.Pharyngealcoordinationisnormalwithoutnasalregurgitation,laryngealpenetrationorsubglottic/tracheal
aspiration.Coughreflexwas/wasnotelicited.Contrastisclearedfromhypopharynxafterswallowingwithoutpoolingof
contrastwithinvalleculaorpyriformsinuses.Cricopharyngealmusclerelaxationisnormal(nocricopharyngealmuscle
hypertrophyorachalasia).Noposteriorpharyngealthickening(ienoedema/hematoma/abscess).
Normalesophagealmucosaandmotility.Nointrinsicorextrinsiclesions.Nohiatalhernia.Nogastroesophagealrefluxis
demonstratedduringthisexamdespitemaneuverstoelicitreflux.Normaltransitofa13mmbariumpillthroughesophagus
intostomachwithoutdifficulty.
Normalgastricmucosaandfolds.Normalduodenalbulb.
IMPRESSION:Normal[esophagram][UGI].
LEAKSTUDY
FINDINGS:Patientisstatuspost[surgery].Singlecontrastleakstudywasperformedin[upright]position.Patientwas
givenasmallamountofwatertoexcludeaspiration.Preliminaryimageovertheabdomenshows[postopchangesfrom
recentsurgery].Smallamountofwatersolublecontrast(Gastrograffin)wasgiven[orally][viatube][followedbythin
barium].Noevidenceforcontrastextravasationtosuggestleak.[Contrasttransitsacrossanastamosiswithout
delay.Minimal/mildnarrowingatanastamoticsitelikelyrepresentsexpectedpostoperativeedema.][Subsequently,limited
CTscanwasperformedacrossanastomoticsitetoexcludeanysubtlecontrastextravasation].
IMPRESSION:Noevidenceforpostoperativeleak[atanastamosissite].
SBFT
FINDINGS:Scoutimagedemonstrate[normalbowelgaspattern].SinglecontrastSBFTwasperformedwiththin
barium.Multiplesequentialoverheadimageswereobtainedalongwithintermittentfluoroscopicexamination.Thesmall
bowelis[ofnormalcourseandcaliber].Jejunalandilealmucosalfoldarenormal.Nointrinsicorextrinsicmasslesionsare
identified.Thetransittimefromstomachtocecumis[]hr[]minwhichiswithinnormallimits.Theterminalileumappears
normal.
IMPRESSION:NormalSBFT.
MODIFIEDENTEROCLYSIS
FINDINGS:Modifiedenteroclysiswasperformedusingthinbariumandair(fordoublecontrastimagingofsmallbowel)via
an8frfeedingtubeplacedunderfluoroscopicguidancewithtip[near/distalto]ligamentofTrietz.Approximately[]ccofthin
bariumwasgiven.Intermittentfluoroimageswereobtained[alongwithmultiplesequentialoverheadimages].Scoutimage
obtainedpriortoexamdemonstrates[].Thesmallbowelis[ofnormalcourseandcaliber].Jejunalandilealmucosalfoldare
normal.Nointrinsicorextrinsicmasslesionsareidentified.Theterminalileumappearsnormal.Thetransittimefrom
proximaljejunumtocecumis[]hr[]minwhichiswithinnormallimits.
IMPRESSION:Normaldoublecontrast(modifiedenteroclysis)imagingofsmallbowel.
RYGB
FINDINGS:Patientisstatuspost[RYGB].[single/double]contrastfluoroscopicimagingwasperformedwith[water
solublecontrast][barium].Nocontrastextravasationtosuggestleak.Esophagusandthegastricremnantarenormalin
appearance.Gastrojejunalanastamosisisnormalwithout[stricture/ulceration/leak].[Mildnarrowingatgastrojejunal
anastamosismostlikelyrepresentsexpectedpostsurgicalmucosaledema].Contrasttransitsfromgastricremnantto
efferentloopwithoutdelay.Efferentloopisunremarkablewithoutstrictureordilatation.Jejunojejunalanastamosisis
unremarkable.Noretrogradefillingofafferentloop.[Noafferentloopdilationtosuggestpossibleafferentloop
syndrome].
IMPRESSION:Normal[single/double]contrastevaluations/p[RYGB].
FUNDOPLICATION
FINDINGS:Patientisstatuspost[Nissen/Toupetfundoplication][Hill/Collisgastropexy].[single/double]contrast
fluoroscopicimagingwasperformedwith[watersolublecontrast][barium].Nocontrastextravasationtosuggest
leak.Thereisexpectedpostoperativenarrowingatsiteoffundoplicationalongwithpseudodefectatgastriccardia.No
evidenceofslippedfundoplicationorgastroesophagealreflux.Normalesophagealandgastricmucosa.
IMPRESSION:Normal[single/double]contrastevaluations/p[fundoplication].
DCBE
FINDINGS:Scoutfilmdemonstrates[appropriatebowelprepandunremarkablebowelgaspattern].Airandbariumwere
introducedretrogradeviarectaltube[afterdigitalrectalexam].Fluoroscopicandoverheadspotimageswereobtained.The
colonisvisualizedinitsentirety.Thecolonicmucosaandhaustralpatternisnormal.[Nofocalnarrowing/constrictinglesions
orpolypsarenoted].Refluxisseenintoanormalappearingterminalileum.Appendixis[not]visualized.Excessbarium
wasdrainedoutattheendoftheexamandtherectaltubewasremoved.Postevacuationimageofrectumisnormal.
IMPRESSION:NormalDBCE
HSG
FINDINGS:Negativepregnancytestwasconfirmedpriortoexam.Endometrialcanalwascannulatedwith[]frcatheter
and[]ccof[]wasinstilledinasterilefashion.Theendometrialcavityis[normalincontourwithoutanyfilling
defects].Contrastisseeninthefallopiantubesbilaterallywhichare[normalincourseandcaliber].Thereisfree
intraperitonealspillofcontrastbilaterally.
IMPRESSION:NormalHSG(hysterosalpingogram)
VCUG
FINDINGS:Bladderwascatheterizedwith[58]frfeedingtubeusingsteriletechnique.Preliminaryimagedemonstrates
[normalbowelgaspattern].[]ccofcystoconrayIIwasinstilledundergravityover[]fillingcycles.Fluoroscopicimages
wereobtainedoverbladderandkidneysduringfillingandvoidingphases.NoevidenceforVUR.Noureteroceleisseen
duringfillingphase.Voidingphasedemonstratesnormalurethra.[Minimal]postvoidresidualvolume.
IMPRESSION:NormalVCUG
PEDSUGI
FINDINGS:SinglecontrastUGIwasperformed.[]ccofdilutedwatersolublecontrastwasadministeredorally[via
bottle].Noaspiration.Stomachisnormalinsize.Pylorusisunremarkable.Contrastemptiespromptlyinto
duodenum.Noobstructionoftheduodenum.LigamentofTrietzorduodenaljejunaljunctionliesin[normal/abnormal/low]
position.[IncidentalnoteofGERrefluxduringtheexam].
IMPRESSION:Nomalrotationorduodenalobstruction
PEDSENEMA
FINDINGS:Singlecontrastenemawasperformedwith[]ccwatersolublecontrastintroducedretrogradegentlyvia[]frtube
undergravity.Entirecolonwasfilled.Colonisnormalinsizeandposition.Rectosigmoidrelationshipisnormal.Cecumis
locatedinrightlowerquadrant.Postevacuationimageshows[].
IMPRESSION:NoevidenceforHirschsprungdisease,meconiumileus,meconiumplugsmallleftcolonsyndrome,ileal
atresia,orcolonicstricture.
ERCP
TECHNIQUE:ERCPwasperformedby[gastroenterologist].Usingsideviewingendoscope,majorpapillawascannulated
andwatersolublecontrastwasinjectedandmultiplefluoroscopicimagesweresaved.PleaseseeGIreportfordetails
regardinginterventionperformed.Totalfluorotimewas[]min.
FINDINGS:Thereisgoodfillingoftheintraandextrahepaticbileducts.CHDmeasures[]mm,CBD[]mm,and
pancreaticduct[]mmatheadandtapersnormallydistally.Nofocalbiliarystrictureorfillingdefectsareidentified.[Thereis
fillingofthecysticductandgallbladder.Thegallbladderisgrosslynormal.]
IMPRESSION:NormalERCP.
LAPBANDEVAL
HISTORY:POD#[]s/padjustablegastriclapbandplacement
FINDINGS:Scoutimageshowsgastriclapbandin[properorientation]with[normal]phiangle.LimitedUGIwithwater
solublecontrastshowspromptcontrasttransitthroughthebandwithoutpoolingwithingastricpouchofdistalesopahgus.
Gastricpouchmeasures[]cmindiameter.Stomaldiameteris[]mmwithoutevidenceforstomalstenosis.[Gastricpouchis
notseengivenunadjustedband.]Noherniationofdistalstomachthroughthebandtosuggest[anterior/posterior]prolapsed
orsymmetricpouchdilationorgastricerosion.Noextravasationofcontrast.Reservoirandtubingappearintact.
IMPRESSION:Normalpostopgastricband.
IVP
FINDINGS:Thescoutfilmdemonstrates[normalbowelgaspatternandnoobviousurolithiasis].
Followinguneventfuladministrationof[]ccIsovue370IV,renalnephrogramsare[promptandsymmetric]
bilaterally.Kidneysare[normalinsize,shape,andaxis].Thereis[nodilatation,fillingdefect,orabnormalmorphology]of
therenalcalycesorpelvis.
Uretersare[normalincourseandcaliberwithoutanyfillingdefects].Bothuretersarevisualizedintheirentirety.The
bladderis[normalinsize,shape,andcontour].Thereis[minimal]postvoidresidual.
IMPRESSION:NormalIVP.
MODIFIEDBARIUMSWALLOWSTUDY(MBSS)WITHSPEECHTHERAPY
TECHNIQUE:LateralvideofluoroscopywasperformedinconjunctionwithSpeechTherapy.Multipleconsistencieswere
usedtoevaluateswallowingfunction.
FINDINGS:
Oralphase:Mastication.Bolusformation.Prematurespillover.Aspirationbeforeswallow.
Pharyngealphase:Laryngealelevation.Epiglotticexcursion.Vallecullar/pyriformresidue.Penetration.Aspiration.Cough
response.
Esophagealphase:Stricture.Diverticulum.TEfistula.
IMPRESSION:[Moderate]oralandpharyngealdysfunction.SeeSpeechPathologyreportforrecommendations.
LUMBARPUNCTURE
TECHNIQUE:Risksandpotentialcomplicationswereexplainedandainformedwaswrittenconsent.Patientwasplacedon
pronepositiononfluoroscopytable.Backpreppedanddrapedinusualsterilefashion.1%LidocainewasusedforLocal
anesthesia.[L23orL34]interspacewaslocalized.Underfluoroguidance,a[22]Gspinalneedlewasadvancedalongthe
rightparamidlineinterlaminarspaceintothethecalspacewithasinglepass.Openingpressurewasmeasuredtobe[11]cm
ofwater.Approx[12]ccofclearCSFwaspassivelyobtainedandsenttolabforanalysis.Styletwasreplacedandthespinal
needlewasremoved.PatientwasplacedinleftlateraldecubituspositionmidwaythruCSFcollectiontohelpcontinueCSF
flow.Needlewasgenlyremoved.Noimmediatepostprocedurecomplications.Postlumbarpunctureinstructionswere
given.
IMPRESSION:successfulLPwithoutimmediatecomplication.
MYELOGRAM
TECHNIQUE:Risksandpotentialcomplicationswereexplainedandainformedwaswrittenconsent.Patientwasplacedon
pronepositiononfluoroscopytable.Backpreppedanddrapedinusualsterilefashion.1%LidocainewasusedforLocal
anesthesia.[L23orL34]interspacewaslocalized.Underfluoroguidance,a[22]Gspinalneedlewasadvancedalongthe
rightparamidlineinterlaminarspaceintothethecalspacewithasinglepass.Needleplacementwasconfirmedwithpassive
flowofclearCSF.Openingpressurewasmeasuredtobe[11]cmofwater.[]ccCSFwascollectedandsenttolabfor
analysis.[12cc]of[]wasintroducedintothecalsac.Subsequently,CTscanwasperformedfrom[T12S1].Noimmediate
postprocedurecomplications.
IMPRESSION:successfullumbarmyelogramwithoutimmediatecomplication.PleaseseeCTmyelogramreportfor
imagingdetails.
JOINTARTHROGRAM/INJECTION
PROCEDURE:Risk/benefitsandpotentialcomplicationswereexplainedandawrittenconsentwasobtained.[R/L]
[hip/shoulder]waspreppedinausualsterilefashion.1%Lidocainewasutilizedforlocalanesthesia.Underdirectpulsed
fluoroguidance,a22Gneedlewasdirectedinto[hip/shoulder]joint.Asmallamountofnonioniccontrast(Conray)wasused
toconfirmneedleplacement.Subsequently,[6080mgKenalogalongw/11.5ccof2%Xylocaine][2cc(20mg)Hyalgan]
[xccof1/200dilutedGad(Magnevist)mixture(alsocontaining3ccof2%Xylocaine)]wasinjected.Needlewasremoved
andtheinjectionsitewascleanedanddressed.Patienttoleratedprocedurewellwithoutimmediatecomplication.Total
pulsedfluorotimewas[]min.
IMPRESSION:Successful[R/L][hip/shoulder][intraarticularsteroid/hyalganinjection][arthrogramforintraarticularGad
placement].[PleaseseeseparateMRArthrogramreport].