Barium Meal and Follow Through

Barium is a substance that shows up on x-ray and a barium meal is when your child would swallow some liquid or solid containing barium and we would watch it go into the stomach, and then the intestine, and follow this through the intestine. It is very helpful to look for anatomical abnormalities such as a twist in the bowel, called malrotation, and abnormalities called strictures (although most of this information can now be gained by an abdominal MRI scan, which does not involve radiation).

The barium meal however can be helpful in younger children as it doesn't involve any requirement for anaesthetic. The radiation is a reasonable amount and therefore if the barium meal is not going to help significantly with a diagnosis, we usually avoid its use. It is however, extremely useful for the diagnosis of malrotation when the gut is not formed in the correct direction. In this circumstance the bowel can twist and cause a significant problem. The main feature of this is vomiting, which doesn't necessarily need to contain the green substance called bile. Evidence in the literature suggests that abdominal ultrasound and abdominal MRI scan are much less helpful for making the diagnosis or excluding the diagnosis of malrotation than a barium meal, hence this remains the diagnostic test of choice for this indication.

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