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PATIENT PREPARATIONFOR RADIOLOGICAL

PROCEDURE

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BARIUM SWALLOW,BARIUM MEAL

AND BARIUM ENEMA

NUR SHAHIRAH BINTI MHD NOOR

01201210038

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Content

Ind!"ton#

Cont$"nd!"ton#

Co%&'!"ton# P"tent &$e&"$"ton

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Barium swallow

Indications :

D(#&)"*"

An"e%" P"n

A##e##%ent o+ t$"!)eooe#o&)"*e"'

-#t.'"e A##e##%ent o+ #te o+ &e$+o$"ton

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Contraindications/

S.#&e!ted &e$+o$"ton

R# o+ "#&$"ton

Boe' o#t$.!ton

Complications

Le""*e +$o% "n .n#.#&e!ted&e$+o$"ton

A#&$"ton

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Patient preparation /

Oe$n*)t +"#tn*

Aod #%on* "nd !)en* *.% 4de!$e"#e #e!$eton# n o$"' !"t( "nd&)"$(n5

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Barium meal

Methods : Sn*'e !ont$"#t /!)'d$en "nd e$( '' "d.'t# to

de%on#t$"te *$o## &"t)o'o*(

Do.'e !ont$"#t / de%on#t$"te %.!o#"' &"tte$n

Indications/ D(#&e"

We*)t 'o##

U&&e$ "do%n"' %"##

GI )"e%o$$)"*e 4 $on de-!en!( "n"e%"

P"$t"' o#t$.!ton

A##e##%ent o+ #te o+ &e$+o$"ton 4 *"#t$o*$"6n

o$ LOCM

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Contraindications/

Co%&'ete '"$*e oe' o#t$.!ton

Complications / Le""*e +$o% .n#.#&e!ted &e$+o$"ton

A#&$"ton o+ #to%"!) !ontent# d.e to

B.#!o&"n

P"$t"' '"$*e oe' o#t$.!ton7nto "!o%&'ete o#t$.!tont)e %&"!ton o+

"$.% B"$.% "&&end!t#

Sde ee!t# o+ &)"$%"!o'o*!"'

"*ent# .#ed

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Patient preparation /

N' &e$ o$"' +o$ 9 )o.$# &$o$ to t)e

e5"%n"ton Sto& #%on* on t)e d"( o+

&$o!ed.$e 7 n!$e"#e# *"#t$!

%ot't( No !ont$"nd!"ton# to t)e

&)"$%"!o'o*!"' "*ent# .#ed

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After care /

T)e &"tent #)o.'d e "$ned t)"t )#

oe' %oton# '' e )te +o$ " +ed"(# "+te$ t)e e5"%n"ton "nd %"( ed6!.'t to :.#) ""(;

T)e &"tent #)o.'d e "d#ed to d$n"de

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Barium enema

Methods : Do.'e !ont$"#t / de%on#t$"te %.!o#"' &"tte$n

Sn*'e !ont$"#t /

!)'d$en

$ed.!ton o+ nt.##.#!e&ton

Indications/

Me'en" o$ "n"e%"

Inte#tn"' o#t$.!ton P"n

M"##

C)"n*e n oe' )"t

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Contraindications/

1= A#o'.te /

)To5! %e*"!o'on) P#e.do%e%$"no.# !o't#

) Re!t"' o( "/

$*d endo#!o&e t)n &$eo.# > d"(#:e5'e endo#!o&e t)n &$eo.# 2?)

2= Re'"te /

) In!o%&'ete oe' &$e&"$"ton) Re!ent "$.% %e"' 4 "t +o$ @10 d"(#

) P"tent +$"'t(

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Complications/

Boe' &e$+o$"ton; In!$e"#ed $# n /

n+"nt# "nd e'de$'(o#t$.!tn* neo&'"#%

.'!e$"ton o+ oe' "''

n:"ton o+ Fo'e( !"t)ete$ "''oon n!o'o#to%( o$ t)e $e!t.%

&"tent on #te$od t)e$"&(

)(&ot)($od#%

T$"n#ent "!te$"e%"

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Sde ee!t# o+ &)"$%"!o'o*!"' "*ent#.#ed

C"$d"! "$$)(t)%" 7 dt $e!t"'d#ten#on

Int$"%.$"' "$.%

eno.# nt$""#"ton 7 "$.%&.'%on"$( e%o'.# 80 %o$t"'t(=;

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Patient preparation

3 d"(# &$o$ to e5"%n"ton /

- Lo $e#d.e det

On t)e d"( &$o$ to e5"%n"ton /

- F'.d# on'(

- P!o'"5 4 "t 0800) "nd 1800)

On t)e d"( o+ e5"%n"ton /

Pt t) &$o#t)et! )e"$t "'e#,"&$eo.# )o endo!"$dt# o$ " #.$*!"''(!on#t$.!ted #(#te%! &.'%on"$( #).nto$ !ond.t $e

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Adults

Not allergic to penicillin :

- A%o5!''n 1 * *ent"%(!n 120%* 1> %n &$o$ to &$o!ed.$e

- Fo''oed ( "%o5!''n >00%* o$"''(

9 )$ '"te$Allergic to penicillin or who havehad a penicillin more than once in

the previous month- "n!o%(!n 1* ( #'o n+.#on

oe$ 100 %n *ent"%(!n 120%*

%%ed"te'(

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Children ( %n &$o$ to &$o!ed.$e

- Fo''oed ( "%o5!''n 0? ($#

12>%* ,> ($# 2>0%*= o$"''( 9)$'"te$

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Allergic to penicillin

"n!o%(!n 20%* *1 ( #'o

n+.#on oe$ 100 %n *ent"%!n 2%**1 %%ed"te'( &$o$ to #t"$t o+&$o!ed.$e

OR- Te!o&'"nn 9%* *1 *ent"%!n

2%* *1 %%ed"te'( &$o$ to #t"$t

o+ &$o!ed.$e

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Aftercare :

P"tent# #)o.'d e "$ned t)"t t)e$

oe' %oton# '' e )te +o$ " +ed"(# "+te$ t)e e5"%n"ton

ee& t)e$ oe'# o&en t) '"5"te#

to "od "$.% %&"!ton P"tent %.#t not 'e"e t)e de&"$t%ent

.nt' "n( '.$$n* o+ #on &$od.!ed

( t)e B.#!o&"n )"# $e#o'ed

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THAN OU

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INTRAENOUSPELOGRAPH IP=

NURUL ARLIA SHAHIDAH BT

ABD ADIR0120121000?

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IP

INDICATION

CONTRAINDICATION COMPLICATIONS

PATIENT PREPARATION

CONTENT

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IP

An nt$"eno.# &(e'o*$"% IP=# "n 5$"( e5"%n"ton o+ t)e

dne(#, .$ete$# "nd.$n"$( '"dde$ t)"t .#e#odn"ted !ont$"#t

%"te$"' nKe!ted nto en#;

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INDICATIONS

T)e e5"% # .#ed to )e'& to d"*no#e #(%&to%##.!) "# 'ood n t)e .$ne o$ &"n n t)e #de o$'oe$ "!;

T)e IP e5"% !"n dete!t &$o'e%# t)n t)e

.$n"$( t$"!t $e#.'tn* +$o%/ dne( #tone#

en'"$*ed &$o#t"te

t.%o$# n t)e dne(, .$ete$# o$ .$n"$( '"dde$

#!"$$n* +$o% .$n"$( t$"!t n+e!ton #.$*e$( on t)e .$n"$( t$"!t

!on*ent"' "no%"'e# o+ t)e .$n"$( t$"!t

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dne( #tone #een on

IP

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A''e$*( to d(e; D"ete# %e''t.#, t"n* &''# to

!ont$o''ood #.*"$/

P$e*n"n!( A#t)%"

M.'t&'e %(e'o%"

S!'e !e'' d#e"#e P)eo!)$o%o!(to%" o$ "d$en"' t.%o$

dne( d#e"#e o$ dne( +"'.$e

CONTRAINDICATIONS
http://www.bladdercancerguide.com/laparoscopic-surgery-for-bladder-cancer-leads-to-good-long-term-cancer-control.htmlhttp://www.bladdercancerguide.com/laparoscopic-surgery-for-bladder-cancer-leads-to-good-long-term-cancer-control.html

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In #o%e &eo&'e, t)e nKe!ton o+ $"( d(e !"n!".#e #de ee!t# #.!) "#/ A +ee'n* o+ "$%t) o$ :.#)n*

A %et"''! t"#te n t)e %o.t)

N".#e"

It!)n*

He#

R"$e'(, #ee$e $e"!ton# to t)e d(e o!!.$, n!'.dn*/ E5t$e%e'( 'o 'ood &$e##.$e

A #.dden, +.''od( "''e$*! $e"!ton t)"t !"n !".#e$e"t)n* d6!.'te# "nd ot)e$ '+et)$e"tenn*#(%&to%# "n"&)('"!t! #)o!=

C"$d"! "$$e#t

COMPLICATIONS

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To ot"n %"*e# &$o&e$'(, t # ne!e##"$( to &$e&"$et)e oe' to $ed.!e t)e

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2= Boe' &$e&"$"ton/

Food $e#t$!ton#/

&.ttn* t)e &"tent on " 'o$e#d.e det, "odn*

d"$( &$od.!t#,+$.t, e*et"'e#, n.t#, $!e, )o'e *$"n $e"d#, "nd $ed%e"t ?8 ) e+o$e t)e e5"% "ndtot"' +"#tn* +o$ "t 'e"#t 9 ) e+o$e

Sod.% d)(d$o*en &)o#&)"te ENEMA CASEN=/one ene%" 12 ) "nd "not)e$ 30 % e +o$e t)e e5"%;

A'te$n"te'(, t)e "d%n#t$"ton o+ "n o$"' oe'e"!."nt #.!) "# #od.% &!o#.'+"te%"*ne#.%!t$"teCITRAFLEET= d##o'ed n " *'"## o+ !o'd

"te$ t"en n to do#e# 18 "nd 12 ) e+o$e t)e#!"n; P"tent# %.#t d$n 2>0%' o+ "te$ o$ ot)e$

!'e"$ :.d# &e$ )o.$ .nt' oe' %oe%ent# )"e!e"#ed;

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MICTURATINGCSTOURETHROGRA

M MCUG=

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MCUG

INDICATION

CONTRAINDICATION

COMPLICATIONS

PATIENT PREPARATION

CONTENT

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A !(#to.$et)$o*$"% &$od.!e# #&e!"'#ed 5$"(&!t.$e#; T)e#e )e'& "##e## t)e #t$.!t.$e "nd+.n!ton o+ t)e 'oe$ .$n"$( t$"!t, n &"$t!.'"$t)e '"dde$ Q!(#toQ= "nd t)e .$et)$" " t.e

)!) t"e# .$ne to t)e o.t#de o+ (o.$ od(=;

I%"*e# "$e "'#o t"en )'e t)e &"tent &"##e#.$ne;

P"##n* .$ne !"n e !"''ed %!t.$"tn* o$odn*, )en!e t)e n"%e; T)# # done to #ee)et)e$ .$ne :o# ""( !o$$e!t'( +$o% t)e'"dde$;

MCUG

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U$n"$( t$"!t n+e!ton %o#t !o%%on n !)'d$en=

To -nd t)e !".#e o+ .$n"$( n!ontnen!e

To 'oo +o$ " !".#e o+ $e&e"ted .$n"$( t$"!tn+e!ton#;

To !)e! +o$ #t$.!t.$"' &$o'e%# o+ t)e '"dde$"nd t)e .$et)$";

To 'oo +o$ en'"$*e%ent )(&e$t$o&)(= o+ t)e&$o#t"te o$ n"$$on* o+ t)e .$et)$" n %en.$et)$"' #t$!t.$e=

To 'oo +o$ nK.$e# to t)e '"dde$ o$ .$et)$";

INDICATIONS

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P$e*n"nt o%"n

A!te !'n!"''( UTI

A''e$*( to t)e !ont$"#t

CONTRAINDICATIONS

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An "''e$*! $e"!ton to t)e d(e !ont$"#t "*ent= .#ed;

B'ood n t)e .$ne "+te$ to d"(#;

P"n n t)e 'oe$ &"$t o+ t)e t.%%( "do%en=;

S*n# o+ " .$n"$( t$"!t n+e!ton; T)e#e #*n# n!'.de/ P"n o$ .$nn* .&on .$n"ton;

An .$*e to .$n"te +$e

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C)'d$en !"n e"t "nd d$n no$%"''( .n'e## #&e!-!"''( n#t$.!tedot)e$#e ( t)e P"ed"t$! Con#.'t"nt;

P'e"#e en#.$e &"tent t"e# t)e$ .#."' &$e#!$ed %ed!"ton#

In+o$% t)e 5 $"( #t" + t)e &"tent )"# "n( "''e$*e# o$ + t)e(

)"e d"ete#; One &"$ent *."$d"n !"n $e%"n t) t)e !)'d

An MCUG # "n 5 $"( &$o!ed.$e t)e$e+o$e %et"' oKe!t# "&&e"$ on5 $"( %"*e# "od d$e##n* t)e !)'d n !'ot)n* t) #n"&&e$#"nd Re&'"!e %et"' n"&&( &n# t) "d)e#e t"&e;

G$'# o+ te'e (e"$# "nd oe$ '' e "#ed to te'' t)eR"do*$"&)e$ )en t)e -$#t d"( o+ t)e$ '"#t &e$od "#;

C.$$ent $"d"ton 'e*#'"ton &o'!( d!t"te# t)"t +e%"'e &"tent#)o )"e not *one t)$o.*) t)e %eno&".#e %.#t )"e )"d "&e$od t)n ten d"(# e+o$e t)e 5 $"( te#t;

PATIENT PREPARATION

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)tt&/;$"do'o*(n+o;o$*enn+o;!+%&*&

)tt&/#e"tt'e!'o.d#;!o%%("&&'!"ton#K&.$*.e#&$"!t!"'.$o'o*(&"d.;&d+

)tt&/;%"(o!'n!;o$*te#t#&$o!ed.$e#nt$"

eno.#&(e'o*$"%"#!#$##&$!20018? )tt&/&"tent;n+o)e"'t)%!t.$"tn*odn*!(

#to.$et)$o*$"%%!.*!.*

REFERENCES
http://www.radiologyinfo.org/en/info.cfm?pg=ivphttp://seattleclouds.com/myapplications/jpburgues/practicalurologyipad/uiv.pdfhttp://seattleclouds.com/myapplications/jpburgues/practicalurologyipad/uiv.pdfhttp://www.mayoclinic.org/tests-procedures/intravenous-pyelogram/basics/risks/prc-20018949http://www.mayoclinic.org/tests-procedures/intravenous-pyelogram/basics/risks/prc-20018949http://patient.info/health/micturatingvoiding-cystourethrogram-mcugvcughttp://patient.info/health/micturatingvoiding-cystourethrogram-mcugvcughttp://patient.info/health/micturatingvoiding-cystourethrogram-mcugvcughttp://patient.info/health/micturatingvoiding-cystourethrogram-mcugvcughttp://www.mayoclinic.org/tests-procedures/intravenous-pyelogram/basics/risks/prc-20018949http://www.mayoclinic.org/tests-procedures/intravenous-pyelogram/basics/risks/prc-20018949http://seattleclouds.com/myapplications/jpburgues/practicalurologyipad/uiv.pdfhttp://seattleclouds.com/myapplications/jpburgues/practicalurologyipad/uiv.pdfhttp://www.radiologyinfo.org/en/info.cfm?pg=ivp

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URETHROGRAM ANDHYSTEROSALPINGOGRAP

HY (HSG)CLARE MUSIH

012012100068

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OUTLINE

INDICATION

CONTRAINDICATION

COMPLICATION

PATIENT PREPARATION

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URETHROGRAM

Commonly performed v! "#e re"ro$r!de n%e&"on of

r!dop!'(e &on"r!" n"o "#e (re"#r! "o d!$noe (re"#r!l

p!"#olo$y ( ! "r!(m! or (re"#r!l "r&"(re* Mo"

&ommonly n m!le p!"en"*

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INDICATION+

TRAUMA , T#e mo" &ommon nd&!"on #en "#ere

preen" of .lood !" "#e (re"#r!l me!"( !f"er .l(n" or

pene"r!"n$ "r!(m!*

LO/ER URINAR0 TRACT +0MPTOM+ , +ymp"om of

(rn!ry (r$en&y1 (rn!ry fre'(en&y1 !nd poor .loodemp"yn$ 2r3 for (re"#r!l "r&"(re)

PO+T OPERATI4E E4ALUATION , Performed for "#e

m!$n$ !nd ev!l(!"on of "#e (re"#r!l !f"er ! (r$&!l

pro&ed(re ( ! (re"#ropl!"y*

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CONTRAINDICATION

Rel!"ve &on"r!nd&!"on ! p!"en" !ller$& "o

r!dop!'(e &on"r!"*

+#o(ld no" .e performed "# p!"en" #o #!ve !n !&"ve

(rn!ry "r!&" nfe&"on*

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COMPLICATION

Advere re!&"on !re r!re #en (n$ "#e &on"r!"

med(m*

D(e "o "en'(e ,

A&("e (rn!ry "r!&" nfe&"on

Ure"#r!l "r!(m!

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PATIENT PREPARATION

T#ere $ener!lly no pe&!l prep!r!"on for !

(re"#ro$r!m*

I" der!.le "o "re!" !ny (rn!ry "r!&" nfe&"on

.efore "#e pro&ed(re done*

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H+G 2 H0+TERO+ALPINGOGRAPH0 )

I" ! r!do$r!p#& d!$no"& "(dy of "#e ("er( !nd

f!llop!n "(.e mo" &ommonly (ed n "#e ev!l(!"on of

nfer"l"y*

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INDICATION

Infer"l"y

Re&(rren" m&!rr!$e

5ollon$ "(.!l (r$ery

Aemen" of "#e n"e$r"y of ! &!e!re!n ("erne &!r

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CONTRAINDICATION

6non &on"r!" !ller$y

Pre$n!n&y

A&"ve pelv& nfe&"on

He!vy ("erne .leedn$

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COMPLICATION

D(e "o &on"r!" med(m ,

ALLERGIC

D(e "o "en'(e ,

PAIN

7LEEDING

TRAN+IENT NAU+EA1 4OMITING AND HEADACHE

IN5ECTION

A7ORTION 2 oper!"or m(" en(re "#!" "#e p!"en" no"

pre$n!n")

INTRA4A+ATION 2p!!$e of &on"r!" med! n"o "#e ven

d(e "o lo&!l or y"em& !.norm!l"e)

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PATIENT PREPARATION

8* P!"en" #o(ld !."!n from n"er&o(re .e"een

.oo3n$ "#e !ppon"men" !nd "#e "me of e9!mn!"on

(nle #e rel!.le me"#od of &on"r!&ep"on1

or1

"#e e9!mn!"on &!n .e .oo3ed .e"een "#e :"# !nd

8;"#d!y n ! p!"en" "# re$(l!r

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AFTER CARE ,

Af"er H+G1 yo( &!n e9pe&" "o #!ve pelv& &r!mp !nd !

"&3y v!$n!l d!r$e ! ome of "#e fl(d dr!n o(" of

"#e ("er(* I" m!y .e "n$ed "# .lood*

A p!d &!n .e (ed for "#e v!$n!l d!r$e !nd "ylenolm!y .e "!3en ! nd&!"ed !f"er "#e pro&ed(re for p!n

relef*

If e9peren&e n&re!ed p!n1 fever1 or #e!vy .leedn$

!f"er "#e e9!m1 &on"!&" do&"or mmed!"ely*

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RE5ERENCE+ ,

#""p,@@emed&ne*med&!pe*&om@!r"&le@8=?:=-overve

#""p,@@*#e!l"#lne*&om@#e!l"#@#y"ero!lpn$o$r!p#yBo

verve8

+*CHAPMAN1 !nd R*NA6IELN0* A G(de "o

RADIOLOGICAL PROCEDURE+*:THEDITION*
http://emedicine.medscape.com/article/1893948-overviewhttp://www.healthline.com/health/hysterosalpingography%23overview1http://www.healthline.com/health/hysterosalpingography%23overview1http://www.healthline.com/health/hysterosalpingography%23overview1http://www.healthline.com/health/hysterosalpingography%23overview1http://emedicine.medscape.com/article/1893948-overview

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HEPATOBILIAR SSTEM

PROCEDURES

$I%IA&'INI)'%A*A+NAM

1,1,-.11

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LEARNING OUTLINE

ENDOSCOPIC RETROGRADECHOLANGIOPANCREATOGRAPH ERCP=

PERCUTANEOUS TRANSHEPATICCHOLANGIOGRAPH PTC=

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ENDOSCOPIC RETROGRADECHOLANGIOPANCRETOGRAPH

ERCP=

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CHOLANGIOPANCRETOGRAPHERCP=

Is" d"*no#t! "nd t)e$"&e.t! $"do'o*!"'

&$o!ed.$e t)"t !o%ne# .&&e$ *"#t$onte#tn"'

GI= endo#!o&( "nd 5 $"(#:.o$o#!o&(= +o$

e5"%n"ton "nd nte$enton o+ t)e '"$(

t$ee "nd &"n!$e"t! d.!t#;

Contrast material is directly injected into common bile duct

through which a catheter is inserted into ampulla of Vater via

endoscope positioned in duodenum.

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INDICATIONS OF ERCP

DIAGN!"IC

#valuation of e$trahepatic biliary obstruction %suspected or &nown

#valuation of 'ancreatic duct obstruction % suspected or &nown

#valuation of signs(symptoms suggesting pancreatic malignancy

Investigation of diffuse biliary disease) e.g. sclerosing cholangitis

'ost cholecystectomy syndrome.

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INDICATIONS OF ERCP

"*#+A'#,"IC!

!tent placement

-alloon dilatation of ductal strictures

"issue biopsy from biliary or pancreatic ducts

!phincterotomy

CONTRAINDICATIONS OF

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CONTRAINDICATIONS OFERCP

. *IV positive individual.

/. #sophageal obstruction % Varices) pyloric stenosis.

0. 'revious gastric surgery.

1. Acute pancreatitis.

2. 'ancreatic pseudocyst.

3. 4hen glucagon or -uscopan are contraindicated.

5. !evere cardiorespiratory disease.

PATIENT PREPARATION FOR

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PATIENT PREPARATION FORERCP

Nil by mouth 3 hours prior to the procedure 6 no bowel prep

needed 7.

're medication chec&list 8 'atient9s current medications) and

any allergies to medications.

-efore the procedure begins) you may give local anesthetic %

1: ;ylocaine spray to anaesthesi

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AFTERCARE FOR ERCP

7 Nil orally until sensation has returned to the pharyn$

6 =.280 *7.

/7 >onitor pulse) temperature and blood pressure

every 0= minutes for 3 hours.07 If there is biliary or pancreatic obstruction) then

maintain antibiotics.

17 Chec& serum ( urinary amylase if pancreatitis is

suspected.

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COMPLICATIONS OF ERCP

A. Due to the contrast medium

.?Allergic reactions? 8 rare.

.Acute pancreatitis 8 more li&ely with large volumes)

high pressure injections.

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COMPLICATIONS OF ERCP

B. Due to the technique

@ocal

Damage by the endoscope) e.g. rupture of the

oesophagus) damage to the ampulla) pro$imal pancreaticduct and distal common duct) duodenal perforation.

Distant

-acteremia) septicemia) aspiration pneumonitis)

hyperamylasemia65=:7) acute pancreatitis6=.585.1:7.

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PERCUTANEOUS

TRANSHEPATICCHOLANGIOGRAPH PTC=

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TRANSHEPATIC

CHOLANGIOGRAPH PTC= Is a radiologic techniue used to visuali

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INDICATIONS OF PTC

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INDICATIONS OF PTC

-iliary drainage procedure % therapeutic.

#valuation of biliary anatomy in presence of biliary obstruction

when endoscopic retrograde cholangiopancreatography 6#+C'7

is unsuccessful.

*istory of anatomy8 altering surgical procedures 6 -illroth II

procedure) +ou$8en8B gastric bypass surgery) and the 4hipple

procedure7.

#+C' not feasible 6e.g. patients with gastro8jejunostomy7.

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INDICATIONS OF PTC

Assessment of high biliary obstruction especially at

hilar region 6'orta hepatic7.

"o identify causes of obstructive jaundice anddifferentiate from medically treatable cause.

Introducing stents across the obstruction.

Inaccessible papilla 6eg) in ampullary carcinoma or

duodenal obstruction from malignancy7.

CONTRAINDICATIONS OF

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CONTRAINDICATIONS OFPTC

. -leeding tendency

.'latelets E == === .

.'rothrombin time is /sec greater than control .

/. -iliary tract sepsis .

0. Non8availability of prompt surgical facilities

or unfit patient for surgery.

1. *ydatid disease.

PATIENT PREPARATION FOR

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PATIENT PREPARATION FORPTC

. *aemoglobin) prothrombin time and platelets are

chec&ed and corrected if necessary.

/. 'rophylactic antibiotics % ". Ampicillin 2== mg .d.s.% to commence /1 h before and continue for 0 days

after the e$amination.

0. Nil by mouth for 2 hours prior to the procedure.

1. 'remedication.

COMPLICATIONS OF PTC

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>orbidity is appro$imately 0: while mortality is E

=.:.

A. Due to the contrast mediumAllergic(idiosyncratic reactions 8 very uncommon.


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B; Due to the techniue

Local :

. 'uncture of e$trahepatic structures.

/. Intrathoracic injection.

0. Cholangitis.

1. -ile lea&age 8 may lead to biliary peritonitis 6incidence =.2:7.

2. !ubphrenic abscess.

3. *aemorrhage .

5. !hoc& 8 owing to injection into the region of the coeliac ple$us.


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Generalized:

. -acteraemia.

/. !epticaemia.

0. #ndoto$ic shoc&.

"he li&elihood of sepsis is greatest in the presence of

choledocholithiasis because of the higher incidence ofpre8e$isting infected bile.

REFERENCES

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REFERENCES

7 Chapman !) Na&ielny +) A Guide to +adiological

'rocedures) 3th edition) !aunders @td. ,!A) /=0

/7http((patient.info(doctor(endoscopic8retrograde8ch

olangiopancreatography

07 http((radiopaedia.org(articles(percutaneous8transhe

patic8cholangiography
http://patient.info/doctor/endoscopic-retrograde-cholangiopancreatographyhttp://patient.info/doctor/endoscopic-retrograde-cholangiopancreatographyhttp://radiopaedia.org/articles/percutaneous-transhepatic-cholangiographyhttp://radiopaedia.org/articles/percutaneous-transhepatic-cholangiographyhttp://radiopaedia.org/articles/percutaneous-transhepatic-cholangiographyhttp://radiopaedia.org/articles/percutaneous-transhepatic-cholangiographyhttp://patient.info/doctor/endoscopic-retrograde-cholangiopancreatographyhttp://patient.info/doctor/endoscopic-retrograde-cholangiopancreatography

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An*o*$"&)(

I%"*e *.dedo(N"#($") I#"nd"$

01201210022

A )

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An*o*$"&)(

An*o*$"&)( # "n %"*n* te!)n

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P"tent &$e&"$"ton

Before/

P"tent )#to$(

- A''e$*( )#to$(- Med!"ton# "nt!o"*.'"nt# !".#e e5!e##e

'eedn*=

Det"'ed e5&'"n"ton o+ &$o!ed.$e, &o##'e $## "nd

!o%&'!"ton#; Ot"n n+o$%ed !on#ent;

No #o'd +ood 8) e+o$e &$o!ed.$e $ed.!e $# o+"#&$"ton=; Note t)e )(d$"ton #t"t.# o+ &"tent$ed.!e $# o+ !ont$"#t nd.!ed $en"' d"%"*e=

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t"' #*n# $e!o$ded; P.'#e n t)e e5t$e%t( d#t"'to #e'e!ted &.n!t.$e #te !)e!ed;

P.n!t.$e #te / #)"ed, !'e"ned, d$"&ed

D$" 'ood e+o$e #t"$tn* t)e &$o!ed.$e "##e##!o"*.'"ton &$o-'e dne( +.n!ton=

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$uring:

Se'dn*e$ te!)n

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Se'e!ton '' e %"de "#ed on t)e #t$on* &$e#en!eo+ " &.'#e "nd t)e "#en!e o+ e##e' d#e"#e;

T)e +e%o$"' "$te$( # t)e &$e+e$$ed #te +o$ "n "$te$"'&.n!t.$e e!".#e o+ t# #e "nd t)e 'o!"ton e"#("!!e##= ; It # &.n!t.$ed K.#t n+e$o$ to t)e n*.n"''*"%ent;

I+ " +e%o$"' "$te$( &.n!t.$e # !ont$"nd!"ted

e!".#e o+ &$eo.# #.$*!"' *$"+t#, t)e &$e#en!e o+"n "ne.$(#%, o$ o!!'.#e "#!.'"$ d#e"#e, ot)e$"$te$e# %( e .#ed n#te"d;

T)e +e%o$"' en o.'d e t)e e##e' o+ !)o!e +o$

eno.# "!!e##;

Se'dn*e$ te!)n

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Se'dn*e$ te!)n

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After care/- Bed $e#t 4 on " d"(!"#e "##, "t 'e"#t ? );

- L"$*e$ !"t)ete$# $e

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Co%&'!"ton o+ !"t)ete$ te!)n

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I%"*e *.ded o(

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I%"*e *.ded o(

Bo( A &$o!ed.$e to $e%oe " &e!e o+ t)e

t##.e#"%&'e o+ !e''# +$o% od( #o t)"t t !"n e"n"'(ed !'o#e'(;

I%"*e *.ded o( Co%ne# %"*n* &$o!ed.$e t) need'e o(;

T)e o( !"n e done .nde$ .'t$"#o.nd,

%"%%o*$"&)!MRI *.d"n!e, de&endn* on)!) %od"'t( t)e -ndn*# "$e e#t #een;

U#n* $e"'t%e %"*e# !"n %"e #.$e t)e need'e$e"!)e# t)e !o$$e!t #&ot;

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T(&e# Ste$eo#t"t!*.ded o(

U't$"#o.nd*.ded o(

MRI*.ded o(

Fne need'e "#&$"ton FNA= o( I%"*e*.ded need'e 'o!"'"ton

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P"tent &$e&"$"tonBefore:

- Med!"' )#to$( "''e$*(, %ed!"ton=, %en#t$."')#to$(+e%"'e=

- We"$ !o%+o$t"'e !'ot)e# t) #e&"$"te to& "ndotto%;

- Re%oe "'' Kee'$(;

- Need to )"e &$e&$o!ed.$e e5"%#/ 'ood te#t#,.'t$"#o.nd, CT #!"nMRI;

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$uring:- I%"*e *.ded oe# "$( de&endn* on t)e

t(&e;

- R"do'o*#t '' .#e .'t$"#o.nd to 'o!"te t)e

"no$%"' t##.e;- T)e "$e" '' e !'e"n#ed "nd "ne#t)eted;

1= Fne need'e "#&$"ton FNA= o(

- W)'e "t!)n* t)e .'t$"#o.nd %onto$, t)e$"do'o*#t '' !"$e+.''( n#e$t e$( #%"'' o(nto t)e "no$%"' t##.e;

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2= Need'e !o$e o(- R"do'o*#t %"e# " #%"'' n!#on, "o.t 18 o+ "n

n!) 'on*, n t)e #n "oe t)e "$e to e oed;

- W)'e "t!)n* t)e .'t$"#o.nd %onto$, t)e

$"do'o*#t '' !"$e+.''( n#e$t t)e #&$n* 'o"dedo( need'e nto t)e "$e" o+ t)e "no$%"'t##.e;

- T)e need'e '' e "!t"ted, %"n* " !'!n*no#e, "nd " #%"'' #"%&'e o+ t##.e '' e

$e%oed;

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After care:- In!#on '' e !'e"ned "nd !'o#ed t) t"&e "nd

" &$e##.$e d$e##n* "&&'ed;

Co%&'!"ton#T)e +o''on* #e$o.# !o%&'!"ton# o!!.$ n 'e##t)"n 1 &e$!ent o+ oe#/

- He%o$$)"*e

- Se#

- Pne.%ot)o$"5, )e%ot)o$"5, o$ e%&)(#e%"

- De"t)

THAN OU

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THAN OU

Re+e$en!e

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Re+e$en!e

A *.de to $"do'o*!"' &$o!ed.$e#, !)"&%"n ?t)edton=

;.)#;n)#;.

;e%d;!o%
http://www.uhs.nhs.uk/http://www.webmd.com/http://www.webmd.com/http://www.uhs.nhs.uk/

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P*)PA*A+I/N/0

*A$I/'/ICA'

P*/C)$2*)A"#n! N!#r!# .n" A.d(ll!#;8

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Content#

U+G H7+ !nd 6U7

CT &!n

MRI

U't$"#o.nd o+ t)e )e&"to'"$(

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#(#te%

Indicai!n"+(pe&"ed $!ll"one

R$#" (pper '(!dr!n" p!n

!(nd&e

5ever of (n3non or$n

A&("e p!n&re!""

To !e $!ll.l!dder f(n&"on

G(ded per&("!neo( pro&ed(re*

C!n#aindicai!n"

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C!n#aindicai!n"T#ere !re no &on"r!nd&!"on*

Pai$n %#$%a#ai!n5!" for !" le!" #o(r .efore "#e

(l"r!o(nd1 prefer!.ly overn$#"*

E!" ! f!"-free me!l "#e evenn$ .efore

"#e (l"r!o(nd !nd "#en "o f!" (n"l "#e

pro&ed(re*

U't$"#o.nd o+ dne(#, U$ete$#

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"nd B'"dde$

Indicai!n"+(pe&"ed ren!l m! leon

+(pe&"ed ren!l p!renym!l de!e

Po.le ren!l o."r(&"onH!em!"(r!

Ren!l &y"& de!e

Ren!l >e me!(remen"

To f!&l"!"e !&&(r!"e needle pl!&emen" nn"erven"on!l pro&ed(re

7l!dder "(mo(r*

C!n#aindicai!n"

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No &on"r!nd&!"on

Pai$n %#$%a#ai!n *M(" #!ve f(ll .l!dder

If "#e .l!dder very (n&omfor"!.ly f(ll1

ome (rne voded "o releve "#e pre(re

.(" "ry no" "o emp"y "#e .l!dder*

Co%&.ted To%o*$"&)(

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CT= #!"n

Indicai!n

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Indicai!nD!$noe m(&le !nd .one dorder1 ( !

.one "(mor !nd fr!&"(rePnpon" "#e lo&!"on of ! "(mor1 nfe&"on or

.lood &lo"

G(de pro&ed(re ( ! (r$ery1 .opy !nd

r!d!"on "#er!pyDe"e&" !nd mon"or de!e !nd &ond"on

( ! &!n&er1 #e!r" de!e1 l(n$ nod(le

!nd lver m!e

Mon"or "#e effe&"vene of &er"!n "re!"men"1( ! &!n&er "re!"men"

De"e&" n"ern!l n%(re !nd n"ern!l .leedn$

C i di i

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C!n#aindicai!nPre$n!n"

P!"en" !ller$& "o I4 &on"r!" med! 2I4CM)

Ren!l mp!rmen"

Pai$n P#$%a#ai!nP!"en" e9pl!ned of "#e pro&ed(re1 "#e

"me " l3ely "o "!3e1 "#e ne&e"y for

mmo.l"y !nd "#e ne&e"y for .re!"#-

#oldn$ #l" &!nnn$ e" !nd !.domen*

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T#e p!"en" #o(ld .e ! p!n-free !

pr!&"&!l .(" "oo #e!vy ed!"on or !n!l$e!m!y .e &o(n"er-prod(&"ve

- p!"en" &ooper!"on of"en re'(red*

C#ldren (nder "#e !$e of : ye!r ll

((!lly need ed!"on

C#ldren #o(ld !lo #!ve !n I4 &!nn(l!

ner"ed !" "#e "me ed!"on !dmn"ered

f I4 &on"r!" med(m needed*

Cont$"#t

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Cont$"#t

In"r!veno( &on"r!" med(mM!ny CT e9!mn!"on ll re'(re I4 &on"r!" med(m*

Aller$y !nd !"opy #o(ld .e e9&l(ded*

If preen"1 follo "#e relev!n" $(delne re$!rdn$ "#e (e of

"erod prop#yl!9 !nd (e LOCM*

An e9pl!n"!"on of "#e need for &on"r!" en#!n&emen"

#o(ld .e $ven "o "#e p!"en"*

T#e doe ll depend on "#e !re! e9!mned,

#e!d - F; ml

!.domen - 8;; ml1 $ven n"!lly ! ! .ol( of

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MRI=

Indicai!n

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Iem!@nf!r&"

4!&(l!r !nom!le

Hemorr#!$e

Infe&"on

T(mor !nd m!e

Tr!(m! !nd dff(e !9on!l n%(re

Ne(rode$ener!"ve dorder !nd demen"!

Infl!mm!"ory &ond"on

Con$en"!l !.norm!l"e

+e>(reHe!d!e

Cr!n!l ne(rop!"#e

C!n#aindicai!n"

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No me"!l or ele&"ron& dev&e*

T#e follon$ !re ome "em "#!" m$#" .e

&on"r!nd&!"ed,

5ore$n .ode from "r!(m!1 me!n&!l #e!r" v!lve1

(r$&!l mpl!n"1 pl!"e1 &re1 "!ple !nd &lp1 !nd

pro"#e"& "#!" &on"!n me"!l

P!&em!3er1 &ole!r mpl!n"1 dr($ nf(on por"1

n(ln p(mp1 deep-.r!n "m(l!"or1 !nd o"#er

ele&"r&!l dev&e

Me"!l "oo"# mpl!n" !nd flln$

A&&eore ( ! 3ey1 $l!e1 per&n$1 %eelry1

#!rpn1 p!$er1 !"e1 !lle"1 den"f&!"on .!d$e1!nd pen

O9y$en "!n31 &!r"1 !r1 I4 pole1 !nd o"#er med&!l

e'(pmen"

P!"en" #o !re (n!.le "o le "ll ( ! m!ny

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P!"en" #o !re (n!.le "o le "ll1 ( ! m!ny

ldren1p!"en" "# movemen" dorder1 or p!"en"

n evere p!n1 !lo m$#" .e (n("!.le for !n MRI !nd

&!n re'(re ed!"on or $ener!l !ne"#e!* +ml!rly1

"#oe "# evere !n9e"y or &l!("rop#o.! m$#"

re'(re mld ed!"on or !n9oly"&*

/#le pre$n!n&y no" ! &on"r!nd&!"on on$ "o !l!&3 of on>n$ r!d!"on1 mnm(m (e of MRI "ll

re&ommended* G!doln(m-.!ed &on"r!" !$en" !re

!.le "o &ro "#e pl!&en"! !nd #o(ld no" .e

!dmn"ered1 p!r"&(l!rly d(rn$ "#e fr" "rme"er*

T#e (e of &on"r!" m!"er!l no" re&ommended n

p!"en" "# !dv!n&ed ren!l n(ff&en&y

Cont$"#t

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Cont$"#t

G!doln(m +de effe&",-

/!rm"#

P!n !" n%e&"on "eN!(e!

He!d!e

Pai$n P#$%a#ai!n

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Pai$n P#$%a#ai!nMRI &reenn$ form need "o .e &omple"ed

P!"en" ll .e !3ed "o !n$e n"o ! $on!nd "o remove,

-eelry1 H!rpn1 Eye$l!e1 /!"e1 /$1

Den"(re1 He!rn$ !d1 Underre .r!

If MRI &on"r!" nd&!"ed1 I4 &!nn(l! ll

need "o .e ner"ed

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Re+e$en!e

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Re+e$en!e

C#!pm!n +1 N!3elny R1 A G(de "oR!dolo$&!l Pro&ed(re1 :"#ed"on

#""p,@@*#e!l"#lne*&om@#e!l"#@(l"r!

o(ndBPrep!r!"on? #""p,@@*r!dolo$y*(&f*ed(@p!"en"-&!

re@prep!re@mr #""p,@@*m!yo&ln&*or$@"e"-

pro&ed(re@&"-&!n@.!&@#y-"-done@pr&-

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