What is the role of barium contrast studies in the workup of pediatric gastrointestinal (GI) bleeding?

Updated: Dec 19, 2018
  • Author: Wayne Wolfram, MD, MPH; Chief Editor: Robert K Minkes, MD, PhD  more...
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Imaging for nonemergency pediatric GI bleeding may begin with barium contrast studies (barium swallows, upper GI series, small bowel follow-throughs, or barium enemas) to point to foreign bodies, esophagitis, IBD, or polyps. For neonates with malrotation with midgut volvulus, oral contrast may reveal a "corkscrew" of small bowel or a "bird's beak".

When intestinal malrotation is suspected, an immediate upper GI contrast study should be performed to confirm the diagnosis of malrotation with midgut volvulus. Free air in the perineum suggests bowel perforation.

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