Barium Swallow : Patient Clinical Details

He admits to a 25 pound weight gain over the last few months. The patient was

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

There seem to be an increasing application of Roen-en-Y gastric bypass today by some surgeons. This is a restrictive procedure that has minimal mal-absorption issues and it makes part of an array of bariatric surgeries. However, the most commonly used procedure is biliopancreatic diversion or Scopinaro, which have been used for more than two decades and are popular in with many surgeons more so in the developing countries. This process is intended to inhibit absorption of fat in a bid to trigger massive weight loss in patients who are morbidly obese. It restricts gastric thereby diverting bile and pancreatic fluids to the distal ileum (Consensus Development Conference Panel, 1991). This procedure therefore exposes a limited area of small bowel for the absorption of nutrients that need biliary and pancreatic fluids. The procedure and its variations are still common as indicated above including; biliopancreatic diversion with duodenal switch, which also result in malabsorption. It is however noted that most patients who undergo this procedure also experience severe protein and fat related malabsorption problems.

On Tuesday August 30, 2016 a Male 63 years of age came into Christus Spohn South Heath Center with a diagnostic order for chest and rib x-rays. He was being seen because of chest pain on his right side due to a fall. He had an extensive patient history of x-rays that went as far back as 2014. For the year of 2016 he received approximately 12 different x-ray series. For example, on January 12, 2016 he received a chest 1 view image and cardiac catheterization. On May 21, 2016 he received a chest 1 view and a complete 4 view foot. On May 30, 2016 he received a cardiac catheterization. On June 1, 2016 and again on June 2, 2016 he received a chest 1 view. On June 10, 2016 he received a catheterization. On August 25, 2016 he received a chest 2 view. On August 26, 2006 an upper extremity without contrast. The patient also has a history of open heart surgery and receives dialysis treatments and is on oxygen.

operation limits “food intake by creating a narrow passage from the upper part of the stomach

These scenarios is how miss Melisa Kain visited her physician, Doctor summer following persisted heartburn. The doctor ordered an esophageal motility study and 24 hour esophageal PH study to be done in the curative Gastrointestinal Laboratory. The nurse called the centralized service and scheduled the tests.

Social History: The patient is married and lives in Portsmouth with his wife. He has three adult children who are healthy. Following formal education, he has worked as a mechanic as well as owning various business on the Seacoast. He currently does not smoke, however has greater than 60-pack-year history of smoking. He quit nearly 30 years ago. He does drink a glass of liquor

The Endophagogastroduodenoscopy is an endoscopic test that dilates the esophagus, stomach and small intestine. This procedure is to diagnose and treat the gastrointestinal (GI) tract. When getting this procedure the physician would place a endoscope from your mouth to your throat with a long blendable tube that appears to be a video camera. A light is attached to visualize the upper part of the GI tract down to the video images.

While I was aware of fiberoptic endoscopic evaluations of swallowing (FEES), I had never experienced one. What an experience it was. Integrating the knowledge previously learned in class, to a useful examination tool in our field was in incredible learning experience. I believe the entire class would agree with that statement. It provided me with a unique learning experience.

A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right

Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.

patient was not having any pain or significant discomfort in the area. The throat was

• An upper gastrointestinal (GI) series. This is an X-ray exam of your GI tract involving the use of a chalky liquid that you swallow. The liquid shows up clearly on the X-ray.

The barium is then released from the bag and begins to flow slowly into your colon. As the barium begins to fill your bowel you will feel some pain and pressure, and an urgency to have a bowel movement. The doctor will watch the barium as it moves through your intestine on a TV screen, using a special “live x-ray” called fluoroscopy. You will be asked to turn to different positions, and the table may be tilted slightly to help the barium flow through your colon and to take x-rays from different directions. Sometimes a slightly different version of the test may be done. It is called a double contrast barium enema. If a double contrast study is being done, the barium will be drained out, and then air will be injected into your colon. As you can imagine with the air contrast study, the amount of cramping and pain increases, due to the expansion of the bowel with air. After all of the films are taken the enema tube is removed, and you are taken to the restroom to expel the remaining barium and air. One or two films may be taken afterwards, to check how much barium is remaining in your bowel. The entire test takes anywhere from thirty minutes to one hour. After the exam you may resume a regular diet, and be sure to drink plenty of liquids to replace those you have lost and to help flush the remaining barium out of your system.