X-ray examination of the small intestine

X-ray study of the small intestine started to develop already in the beginning of x-ray era after classic physiological experiments cannon. The systematic study of morphological and functional features of the small intestine in the Annex to the requirements of the clinic started and successfully develop only from the mid-thirties (B. M. stern, F. A. Fanarjyan, Gutzeit and Kuhlmann, Welz, Golden, Pansdorf and others). Currently the small intestine has the same object x-ray examinations, as well as other divisions of the digestive tube, and her features covered in a number of monographs.
The research itself is small intestine should be a natural continuation of the study of the stomach, as this way you can save physiology filling the small intestine and have a view about the presence or absence of any violation of an operational nature.
The basis of radiological examination of the small intestine is fluoroscopy, supplemented by radiography with a goal of documentation of the individual stages of the research after a certain period of time established depending on the pace of the motor function of the intestine, and the registration status of the relief of the mucous. Currently, documentation manifestations of motive activity of the small intestine can be successfully achieved when using macroframe fluorography and rentgenonegativee.
In healthy subjects contrast suspension, having flexura duodeno-jejunalis, quickly fills the initial loop jejunum, leaving the path of a particle of barium on the walls between the folds. Individual portions contrast mist moving uniformly going forward. Jerky movements forward, and antiperistaltic in healthy subjects is not observed. Under normal evacuation of the stomach jejunum is filled in 25-30 minutes, through 1,5-2 hours a large part contrast suspended almost motionless in the loops, which are located in the pelvis. By this time the top of the loop or completely empty, or between the folds remains small remnants barium suspension. This usually happens only in cases where timely comes complete emptying of the stomach as the nature of filling the small intestine is significant, depending on the pace of evacuation of the stomach (Fig. 105).

Fig. 105. Normal small intestine (x-ray).
Uniform distribution contrast mist. Ribbed pattern mucosa.

After 2.5-4 hours contrast suspension begins to act in a blind gut. Earlier or later date content transition of the small intestine in the blind indicates dysfunction motor function of the small intestine, hypermotor or hipopotamo nature. Such violations may be caused by various direct causes, mainly related to disorders of the nervous system.
X-ray view of the breadth of the lumen of the small intestine can be obtained by monitoring the movement of contrast mist. In a well toned intestine are defined uniform width ground clearance, fluctuating in the range of 2.5-3 cm in the upper loops and 2-2,5 cm at the bottom.
The relief of the mucous has a significant impact on the overall x-ray picture of the small intestine. Most of it has Cirrus figure due to the reduction in submucosal muscle layer and education carrinhovp folds (Fig. 106).

Fig. 106. The diversity of the normal relief mucosa of the small intestine (x-ray).

One cannot say that the terrain mucous only helps to clarify morphological characteristics. The main characteristic changes of the mucous strain relief - should not always be interpreted as a sign of abnormal swelling or hyperplasia. As the experience of studying functional variability of mucous in healthy people, not all types of strain relief small intestine mucous membrane should be considered a symptom of the inflammatory process. Of Prime importance in determining the condition of the mucosa of the small intestine has a degree of resistance radiographically detected changes.
The formation of mucous depends on the reactions of the nervous apparatus itself and submucosal layer in response to the primary contact with her a contrast agent. In this phase hydrodynamic balance submucosal layer is not yet undergoing a major violation, and mucous membrane forms an embroidered picture of the terrain from approaching and closely attached to one another folds. Next, after a short period of time folds gradually swell and thicken, while remaining soft and elastic. The relief is formed from high transverse folds separated wide contrast between. Then, growing physiological swelling of mucous membrane, which leads to the appearance of individual flakes of contrast, lying between papillae swollen mucosa, we get a picture of unstable spotted the picture of its relief.
Unmodified mucosa of the small intestine demonstrates the radiological examination in the above sequence, all of these stages of normal variability. This gave an opportunity to differentiate the functional state from pathological changes that swelling varying degrees detected immediately when coming into contact contrast suspension with the mucous membranes and remain stable throughout the study.