Ticker

6/recent/ticker-posts

Advertisement

Responsive Advertisement

What Is Intravenous pyelogram Test

Intravenous pyelogram (IVP) test is the radiographic examination is used to detect the problems, obstruction, strictures, renal calculi etc in kidney ureters and urinary bladder.

The use of Intravenous pyelogram test is been decline past over 10 years this is because several new techniques coming in these days like:

  • Development of newer imaging modalities like CT scan, ultrasound etc.
  • The cost of  Intravenous pyelogram is much high
  • Adverse effect of contrast media.

Intravenous pyelogram Test

Indication

  • Screening of entire urinary tract in cases of hematuria or pyuria
  • Disease of renal collecting system and renal pelvis 
  • Differentiation of functioning of both kidneys
  • Abnormalities of the ureter
  • strictures in ureters
  • obstruction in bladder or ureter 
  • check of renal calculi in kidney ureter or urinary bladder
  • suspected renal injury

Contraindications

  • Iodine sensitivity
  • Pregnancy
  • Severe history of anaphylaxis previously 30% risk of similar reaction on subsequent occasion. the risk is lower with low osmolar contrast media

Risk Factor in Intravenous pyelogram Test 

  1. Cardiac Failure: For patient in cardiac decomposition hyperosmolar contrast should not be used as the contrast media intensify the congestive cardiac failure.
  2. Dehydration: Renal shutdown may be precepted especially in infants, diabetics and in multiple myeloma patient as it causes protein precipitation in renal tubules results in anuria.
  3. Previous allergic reaction: in these cases, non ionic agents should be used and injectable steroids should be given in 12 and 4 hours before procedure.

Contrast Media

Generally 50ml Omnipaque is given to the patient. Contrast is given through the I.V which is injected in arterial vein in hand through which contrast is pushed. Omnipaque id thick liquid which consist iodine. 

Preparation

  1. Ask for any history for diabetes mellitus, renal disease or allergy to drug or any specific food.
  2. Fasting for 4 hrs.
  3. Do not dehydrate the patient.
  4. Bowl preparation: Low residue diet and plenty of oral food, the bowl should be clear there should be no gas present in the bowl. Dulcolax is the tablet 2 days before the procedure to cleansing the bowel.

Procedure Of Intravenous pyelogram Test

  • Explain the procedure to the patient.
  • A scout film is taken including the kidneys, ureters, bladder and urethral regions on a large size films. take a K.U.B x ray in supine position to see the all the region in x ray films clearly and see whether gas is present or not if gas is present then procedure should not be done and given another date to the patient.
  • Inject the I.V in the arterial vein of patient.
  • A test dose of omnipaque is given to the patient to check the allergic reaction or not
  • Then 50ml contrast is push through I.V. 
  • Then several x ray images is taken in a fixed time interval i.e x ray is taken in 2min, 5min,  10min, 15min, 20min, pre-void, post-void. and if required the delayed is also been taken.

 Scout Film

What Is Intravenous pyelogram Test

2 Min Film

At 2 min we see patient is comfortable or getting any kind of allergy. this is considered as a test dose.

What Is Intravenous pyelogram Test

5 Min Film

At 5 min the contrast is reaching up to kidney or we can say to nephrons.

What Is Intravenous pyelogram Test

10 Min Film

At 10 min the contrast i reaching up to the kidney an half ureters. 
At this point compression paddle is given.

What Is Intravenous pyelogram Test

15 Min Film

At 15 min the compression paddle is release and ask patient to lay down on prone position.
and the main focus is on ureters.
What Is Intravenous pyelogram Test

20 Min Prone Film

At 20 min the main focus on urinary bladder 

What Is Intravenous pyelogram Test

Pre Void Film

After that ask patient to wait till micturating. before micturition a film is taken to see urinary bladder.
the urinary bladder must fully filled.
  
What Is Intravenous pyelogram Test

Post Void Film

After Micturition a film is taken of whole KUB to see weather there is contrast is remaining or not. 
What Is Intravenous pyelogram Test


Post a Comment

0 Comments