COVID-19 Updates: Latest Information for Parents

Radiology

Fluoroscopy

What is a fluoroscopy exam?

Fluoroscopy photo

Fluoroscopy is an imaging technique that uses X-rays that take real-time or moving images of the internal structures of the body. The “movie” transmits to a TV-like monitor that helps doctors see how an organ or a body system work. This exam is used in a variety of diagnostic and therapeutic procedures. A radiologist and radiologic technologist perform these procedures together.

During this procedure, your child may be given contrast (special dye) that will highlight specific organs, joints and/or blood vessels so that it can be better seen during their exam. The contrast may be swallowed, injected or given by an enema, depending on the type of exam and what body part is being examined.

Here are some common exams that are performed at Rady Children’s:

1. ESOPHAGRAM

Quick facts:
An esophagram is an X-ray of the esophagus at work.

  • Your child will be awake throughout this exam.
  • This test usually takes between 15-30 minutes.
  • Your child can partake in normal activities and diet afterward.

A little about your body:

  • When we swallow food and liquids, they enter through our mouth, go down the esophagus and into the stomach. The esophagus is the tube which connects the mouth to the stomach (see diagram on left). This is what the doctors will be looking at for this exam.
  • This esophagram shows the doctors how the esophagus is working by taking X-ray pictures while your child swallows special liquid called barium.

What should I expect during my child’s esophagram exam?

The goal of the exam is to take X-ray pictures of the esophagus while your child is swallowing barium to see how the esophagus is working. Barium is used because of its ability to show up well on X-ray pictures.

  • Your child will be asked to lie down on a table while drinking the liquid barium.

**If your child is older or tall, they may be sitting or standing while drinking instead.

  • As your child drinks, the barium will begin to pass through the throat and esophagus. X-ray pictures will be taken as the liquid is being swallowed.
  • Once the barium has passed through the esophagus and the radiologist feels as though they have seen enough of the esophagus at work, the exam is complete.

What is barium?

Barium is a thick, chalky, liquid contrast. It is thick in consistency like a milkshake or smoothie. Barium shows up white on X-ray images.What is my role as a parent/guardian during the esophagram exam?

  • Parents and guardians are welcome to be present during exam to support their child.

Due to use of radiation, women who believe there is a possibility they may be pregnant or are pregnant will not be allowed in room while X-ray is being used. These women may be with their child during times when radiation will not be used.

  • Medical staff will instruct parents/guardians on where to stand while in the room to help the exam run smoothly.
  • Parents/guardians are encouraged to help their child relax and keep calm and still during the exam.
  • Parents/guardians are also a great help when encouraging the child to swallow liquid barium.
  • If your child has any comfort items such as stuffed animals, small handheld toys or blankets, you are more than welcome to bring those along.

Who will I meet during my child’s esophagram exam?

  • Nurse (R.N.)
  • Radiology technologist
  • Radiologist
  • Child life specialist* *Child Life is available depending on your child’s appointment time, needs and developmental level.

Is there anything else that I need to know after my child’s esophagram exam?

After an esophagramm your child can resume normal activities and diet.

  • Your child’s bowel movements may look white for the next few days due to the barium. This is normal, and your child should drink plenty of liquids to help their bowel movements return to normal.
  • Your child may have some minor constipation, drinking plenty of liquids will help this as well.
  • This information helps provide basic knowledge of an esophagram. Exam experiences may vary depending on your child’s age or developmental level.
  • Your nurse for the exam will explain the exam in detail, so please feel free to ask questions if needed. We as a hospital team are here to support both you and your child throughout your experience.

2. UPPER GASTROINTESTINAL SERIES (UPPER G.I.)

Quick facts:
Upper G.I. is an X-ray of the upper gastrointestinal tract at work.

  • Your child will be awake throughout this exam.
  • Your child can partake in normal activities and diet afterward.
  • An Upper G.I. is used to help find the cause of problems such as swallowing difficulties, unexplained vomiting, nausea, abdominal discomfort and severe indigestion. It can detect signs of problems such as ulcers, gastric reflux, hiatal hernia, or blockages or narrowing of the upper G.I. tract.

A little about your body:

  • When we swallow food and liquids, they enter through our mouth, go down the esophagus, into the stomach and pass through the small intestine. These three parts: esophagus, stomach and small intestine make up the upper gastrointestinal tract. This is what the doctors will be looking at for this exam.
  • This Upper G.I. exam shows the doctors how the upper gastrointestinal tract is working by taking X-ray pictures while your child swallows special liquid called barium.
  • Upper gastrointestinal tract: esophagus, stomach and small intestine make up this tract. See image above left.

What should I expect during my child’s Upper G.I. exam?

  • The goal of the exam is to take X-ray pictures of the upper gastrointestinal tract while your child is swallowing barium to see how the upper gastrointestinal tract is working. Barium is used because of its ability to show up well on X-ray pictures.
  • Your child will be asked to lie down on a bed while drinking the liquid barium.

**If your child is older or tall, they may be standing while drinking instead.

  • As your child drinks, the barium will begin to pass through the upper gastrointestinal tract. X-ray pictures will be taken as the liquid is digested and moving through the tract.
  • Your child will be asked to roll from side to side while the X-ray pictures are being taken.
  • Once the barium has passed through the tract and the radiologist feels as though they have seen enough of the tract at work, the exam is complete.

What is barium?

Barium is a thick, chalky, liquid contrast. It is thick in consistency like a milkshake or smoothie. Barium shows up white on X-ray images.

What is my role as a parent/guardian during the Upper G.I. exam?

  • Parents and guardians are welcome to be present during exam to support their child.

Due to use of radiation, women who believe there is a possibility they may be pregnant or are pregnant will not be allowed in room while X-ray is being used. These women may be with their child during times when radiation will not be used.

  • Medical staff will instruct parents/guardians on where to stand while in the room to help the exam run smoothly.
  • Parents/guardians are encouraged to help their child relax and keep calm during the exam.
  • Parents/guardians are also a great help when encouraging the child to swallow liquid barium.
  • If your child has any comfort items such as stuffed animals, small handheld toys or blankets, you are more than welcome to bring those along.

Who will I meet during my child’s Upper G.I. exam?

  • Nurse (R.N.)
  • Radiology technologist
  • Radiologist
  • Child life specialist* *Child Life is available depending on your child’s, appointment time, needs and developmental level.

Is there anything else that I need to know after my child’s Upper G.I. exam?

  • After an Upper G.I. your child can resume normal activities and diet.
  • Your child’s bowel movements may look white for the next few days due to the barium. This is normal, and your child should drink plenty of liquids to help their bowel movements return to normal.
  • Your child may have some minor constipation, drinking plenty of liquids will help this as well.
  • This information helps provide basic knowledge of an Upper G.I. exam. Exam experiences may vary depending on your child’s age or developmental level.
  • Your nurse for the exam will explain the exam in detail, so please feel free to ask questions if needed. We as a hospital team are here to support both you and your child throughout your experience.

3. VOIDING CYSTOURETHROGRAM (VCUG)

Quick facts:

  • VCUG is a video X-ray of the bladder and urinary tract at work.
  • Your child will be awake throughout this exam.
  • Your child can partake in normal activities afterward.

A little about your body:

  • Our kidneys make our urine, which then flows down the ureters and into the bladder. Our urine is supposed to flow down, but sometimes urine can flow back up the ureters and into the kidneys. This is called reflux.
  • Sometimes, reflux is only shown while we void. A VCUG can show reflux occurring by taking X-ray pictures of the urinary tract while the child is voiding.

What should I expect during my child’s VCUG exam?

  • The goal of the exam is to take X-ray pictures of the bladder and urinary tract while the child is voiding to look for reflux.
  • To fill the bladder, a tiny catheter is placed into the urethra. Before catheter is placed, a nurse will clean the area with cold soap to get rid of germs.
  • After catheter is placed, the radiologist will come into the room to take the X-ray pictures.
  • Once the radiologist is in the room, they will start to fill up the bladder with contrast. The contrast is used because of its ability to show up well in X-ray pictures.
  • When the bladder is full, the radiologist will take two side-view pictures before the child is asked to void on the table.
  • Voiding on the table is the most important part of the exam, as the pictures taken while the child is voiding will show whether reflux is present or not. While the child voids, the catheter slides out.
  • After the bladder is empty, the exam is complete.

What is reflux?

Vesicoureteral reflux is the backward flow of urine from the bladder into the kidneys. Normally, urine flows down from the kidneys through the ureters to the bladder.

What is voiding?

To drain urine from the bladder (urinating)

What is my role as a parent/guardian during the VCUG exam?

  • Parents and guardians are welcome to be present during exam to support their child.

Due to use of radiation, women who believe there is a possibility they may be pregnant or are pregnant will not be allowed in room while x-ray is being used. These women may be with their child during times when radiation will not be used such as catheter placement.

  • Medical staff will instruct parents/guardians on where to stand while in the room to help the exam run smoothly.
  • Parents/guardians are encouraged to help their child relax and keep calm during the exam.
  • Parents/guardians are also a great help when encouraging the child to void at the end of the exam.
  • If your child has any comfort items such as stuffed animals, pacifiers, small handheld toys or blankets, you are more than welcome to bring those along.

Who will I meet during my child’s VCUG exam?

  • Nurse (R.N.)
  • Radiology technologist
  • Radiologist
  • Child life specialist* *Child Life is available depending on your child’s appointment time, needs and developmental level.

Is there anything else that I need to know after my child’s VCUG exam?

  • After a VCUG, your child may feel a little sore the next few times they have to urinate. This is normal, and drinking extra liquids may help to relieve soreness more quickly.
  • The radiologist in the room may give you preliminary results, and will send a report to your physician who requested the VCUG exam.
  • Detailed results and next steps can be discussed with your physician who requested the VCUG exam.

This information helps provide basic knowledge of a VCUG exam. Exam experiences may vary depending on the following factors:

  • Whether your child is male or female
  • Your child’s age and developmental level
  • Use of “anxio mask”

Your nurse for the exam will explain the exam in detail, so please feel free to ask questions if needed. We as a hospital team are here to support both you and your child throughout your experience.