Use of water in the examination of the upper gastrointestinal tract

Described is an original technic in which water is used in conjunction with the barium examination of the upper gastrointestinal tract. After the routine barium examination, the ingestion of water through a straw with a hole in it, while the patient is upright, results in a triple-contrast study of the stomach. The technic has proven useful in: (1) demonstrating all types of benign and malignant lesions in the stomach, pyloric valve, and duodenum; (2) showing benign and malignant lesions, inaccessible to palpation, in the fundus and upper portions of the stomach body; (3) demonstrating "occult" ulcers when the water washes away all of the barium except that which for some unknown reason remains within the ulcer crater; (4) examining the postoperative stomach, particularly when marginal ulceration is suspected after subtotal gastrectomy; and (5) demonstrating hiatal hernias and gastroesophageal reflux. A modified technic is used for patients who can only be examined in the recumbent position.