{"id":8645,"date":"2019-08-08T10:10:29","date_gmt":"2019-08-08T08:10:29","guid":{"rendered":"https:\/\/medifactia.com\/?page_id=8645"},"modified":"2021-09-07T13:27:21","modified_gmt":"2021-09-07T12:27:21","slug":"pa-rontgen","status":"publish","type":"page","link":"https:\/\/new.medifactia.com\/sv\/pa-rontgen\/","title":{"rendered":"P\u00e5 r\u00f6ntgen"},"content":{"rendered":"<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-0  el_before_av_three_fifth  avia-builder-el-first  \" style='border-radius:0px; '><p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h1  blockquote modern-quote  avia-builder-el-1  el_before_av_textblock  avia-builder-el-first  '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >P\u00e5 r\u00f6ntgen<\/h1><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p>I regel \u00e4r det r\u00f6ntgenavdelningen som tillhandah\u00e5ller instruktioner och kapslarna (mark\u00f6rer) f\u00f6r patienterna. Instruktion\/information till patienten \u00e4r en mycket viktig del av handl\u00e4ggningen.<\/p>\n<p>Dag sju, 12 timmar efter den senast svalda kv\u00e4llsdosen (fem stavformade mark\u00f6rer), utf\u00f6res r\u00f6ntgen buk\u00f6versikt (alternativt genomlysning) en bild med vertikal str\u00e5lriktning, format 30\u00d740 alternativt 35\u00d743. Det \u00e4r viktigt att \u00f6versiktsbilden t\u00e4cker hela kolon inklusive rektum. Klaras ej detta p\u00e5 anvisat bildformat f\u00e5r kompletterande bilder till\u00e4ggas. R\u00f6ntgens uppgift vid denna transitunders\u00f6kning inskr\u00e4nker sig s\u00e5lunda till en enda \u00f6versiktsbild tagen dag sju vid en tidpunkt som skall \u00f6verensst\u00e4mma med tiden f\u00f6r tidigare mark\u00f6rintag.<\/p>\n<\/div><\/section><\/p><\/div>\n<div class=\"flex_column av_three_fifth  flex_column_div av-zero-column-padding first  avia-builder-el-3  el_after_av_one_full  el_before_av_two_fifth  column-top-margin\" style='border-radius:0px; '><p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2  blockquote modern-quote  avia-builder-el-4  el_before_av_textblock  avia-builder-el-first  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Bildbed\u00f6mning<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p>Transittiden i dygn \u00e4r ekvivalent med antalet dagsdoser som \u00e4r kvar i tarmen. Alla dagsdoser, dvs. 10 mark\u00f6rer per dag oavsett form, bidrar till slutv\u00e4rdet (se\u00a0<a href=\"https:\/\/new.medifactia.com\/sv\/manuell-berakning\/\">Manuell ber\u00e4kning<\/a>). I enstaka fall kan mark\u00f6rer noteras i ileum och d\u00e5 skall dessa ing\u00e5 i totalantalet mark\u00f6rer.<\/p>\n<p>I kliniska sammanhang \u00e4r det vanligast att titta p\u00e5 totalv\u00e4rdet f\u00f6rst. Om totalv\u00e4rdet \u00e4r h\u00f6gt \u00e4r det n\u00f6dv\u00e4ndigt att titta p\u00e5 varje segment f\u00f6r att f\u00e5 en uppfattning om\u00a0<i>var\u00a0<\/i>i kolon f\u00f6rdr\u00f6jningen ligger.<\/p>\n<ul>\n<li>Totala antalet mark\u00f6rer i tarmen visar om total transittid \u00e4r\u00a0<i>snabb<\/i>,\u00a0<i>normal\u00a0<\/i>eller\u00a0<i>l\u00e5ngsam<\/i><\/li>\n<li>Totala antalet mark\u00f6rer i respektive segment ger information om typen av f\u00f6rdr\u00f6jning, dvs.\u00a0<i>var\u00a0<\/i>i kolon transit \u00e4r abnorm<\/li>\n<\/ul>\n<\/div><\/section><\/p><\/div><div class=\"flex_column av_two_fifth  flex_column_div av-zero-column-padding   avia-builder-el-6  el_after_av_three_fifth  el_before_av_one_full  column-top-margin\" style='border-radius:0px; '><p><div  class='avia-image-container  av-styling-    avia-builder-el-7  el_before_av_textblock  avia-builder-el-first  avia-align-center '  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\"  ><div class='avia-image-container-inner'><div class='avia-image-overlay-wrap'><img class='avia_image' src='https:\/\/new.medifactia.com\/sv\/wp-content\/uploads\/sites\/4\/2018\/02\/Schematic-figure-engelskatransparent-e1629632767705.png' alt='' title='Schematic figure - engelska(transparent)' height=\"3891\" width=\"2240\"  itemprop=\"thumbnailUrl\"  \/><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '  style='font-size:12px; '  itemprop=\"text\" ><p style=\"text-align: center;\"><em>Schematisk figur: Kvinnlig patient med 27 mark\u00f6rer i kolon (10 stav-, 17 ringformade). Transit-tiden \u00e4r 2,7 dygn dvs. normal.<\/em><\/p>\n<\/div><\/section><\/p><\/div><\/p>\n<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-9  el_after_av_two_fifth  el_before_av_one_full  \" style='border-radius:0px; '><p><div  style='height:20px' class='hr hr-invisible   avia-builder-el-10  el_before_av_heading  avia-builder-el-first '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div><br \/>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2  blockquote modern-quote  avia-builder-el-11  el_after_av_hr  el_before_av_textblock  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Vid segmentell transittid delas kolon upp i:<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><ul>\n<li>Cekum-ascendens (inkluderar h\u00f6ger flexur)<\/li>\n<li>Transversum<\/li>\n<li>Descendens<\/li>\n<li>Sigmoideum-rektum (inkluderar v\u00e4nster flexur)<\/li>\n<\/ul>\n<\/div><\/section><\/p><\/div>\n<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-13  el_after_av_one_full  el_before_av_one_full  column-top-margin\" style='border-radius:0px; '><p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2  blockquote modern-quote  avia-builder-el-14  el_before_av_textblock  avia-builder-el-first  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Varf\u00f6r stavformade mark\u00f6rer 24 respektive 12 timmar innan r\u00f6ntgen dag sju?<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><ul>\n<li>\u00c5terspeglar vad som skett under det sista dygnet och ger bra precision p\u00e5 snabb transit<\/li>\n<li>Kan verifiera att kapslarna (mark\u00f6rerna) tagits enligt f\u00f6reskrift<\/li>\n<li>Vid l\u00e5ngsam passage ligger dag sex-mark\u00f6rerna i cekum-ascendens och underl\u00e4ttar avgr\u00e4nsningen av cekum<\/li>\n<li>Kan bekr\u00e4fta l\u00e5ngsam passage i proximala kolon vid t.ex. \u2018colonic inertia\u2019<\/li>\n<\/ul>\n<p>Vid tolkning av r\u00f6ntgenbild \u00e4r det i regel enkelt att exakt best\u00e4mma totalantalet mark\u00f6rer i kolon. D\u00e4remot kan i vissa fall cekum vara n\u00e5got medialslagen och sv\u00e5r att avgr\u00e4nsa mot t.ex. sigmoideum. Om en s\u00e5dan patient har l\u00e5ngsam passagetid kan f\u00f6rdelningen av de stavformade mark\u00f6rerna som d\u00e5 ligger i proximala kolon hj\u00e4lpa till att avgr\u00e4nsa h\u00f6gerkolon fr\u00e5n sigmoideum. Hos enstaka patienter d\u00e4r avgr\u00e4nsningen av mark\u00f6rernas l\u00e4ge i t.ex. sigmoideum gentemot cekum eller transversum \u00e4r sv\u00e5r, kan insufflation av viss m\u00e4ngd luft via rektalsond i samband med bildtagningen underl\u00e4tta best\u00e4mningen av mark\u00f6rernas position.<\/p>\n<\/div><\/section><\/p><\/div>\n<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-16  el_after_av_one_full  el_before_av_one_full  column-top-margin\" style='border-radius:0px; '><p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2  blockquote modern-quote  avia-builder-el-17  el_before_av_textblock  avia-builder-el-first  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Colonic inertia och outlet obstruction<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p>Patienter med en sv\u00e5r variant av \u2018slow-transit constipation\u2019, sk. \u2018colonic inertia\u2019, har ut\u00f6ver f\u00f6rl\u00e4ngd total transittid \u00e4ven h\u00f6gt antal mark\u00f6rer i h\u00f6gerkolon. I princip brukar anges att vid \u2018colonic inertia\u2019 f\u00f6religger l\u00e5ngsam passage b\u00e5de i h\u00f6ger- och v\u00e4nsterkolon och med mer \u00e4n 1,5 dagsdos (&gt;15 mark\u00f6rer) i cekum-ascendens. M\u00e5nga patienter med f\u00f6rstoppning och l\u00e5ngsam kolontransit har f\u00f6rdr\u00f6jningen huvudsakligen i v\u00e4nsterkolon. Om man har normalt eller l\u00e5gt antal mark\u00f6rer i proximala och mellersta kolon men en stor ansamling av mark\u00f6rer i rekto-sigmoideum \u00e4r bilden f\u00f6renlig med \u2018outlet obstruction\u2019.<\/p>\n<\/div><\/section><\/p><\/div>\n<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-19  el_after_av_one_full  el_before_av_one_full  column-top-margin\" style='border-radius:0px; '><p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h2  blockquote modern-quote  avia-builder-el-20  el_before_av_textblock  avia-builder-el-first  '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Svaret p\u00e5 unders\u00f6kningen<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p>Svaret p\u00e5 unders\u00f6kningen skickas till inremitterande l\u00e4kare varvid man angivit:<\/p>\n<ul>\n<li>Totalantalet mark\u00f6rer i kolon och d\u00e4rmed om transit \u00e4r\u00a0<em>snabb<\/em>,\u00a0<em>normal<\/em>\u00a0eller\u00a0<em>l\u00e5ngsam<\/em><\/li>\n<li>\u00c4ven f\u00f6rdelning av mark\u00f6rerna\u00a0i de olika segmenten anges och utifr\u00e5n dessa v\u00e4rden kan segmentell transittid ber\u00e4knas<\/li>\n<\/ul>\n<\/div><\/section><\/p><\/div>\n<div class=\"flex_column av_one_full  flex_column_div av-zero-column-padding first  avia-builder-el-22  el_after_av_one_full  avia-builder-el-last  column-top-margin\" style='border-radius:0px; '><p><section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p>F\u00f6r mer information, var god se <a href=\"https:\/\/new.medifactia.com\/sv\/wp-content\/uploads\/sites\/4\/2021\/09\/0099SE1-Clinical-Instruction-for-Use.pdf\" target=\"_blank\" rel=\"noopener\">Clinical Instruction for Use<\/a>.<\/p>\n<\/div><\/section><br \/>\n<div   class='hr hr-default   avia-builder-el-24  el_after_av_textblock  el_before_av_button '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div><br \/>\n<div  class='avia-button-wrap avia-button-left  avia-builder-el-25  el_after_av_hr  el_before_av_button ' ><a href='https:\/\/new.medifactia.com\/sv\/avsedd-anvandning\/'  class='avia-button   avia-icon_select-yes-left-icon avia-color-theme-color avia-size-large avia-position-left '   ><span class='avia_button_icon avia_button_icon_left ' aria-hidden='true' data-av_icon='\ue87c' data-av_iconfont='entypo-fontello'><\/span><span class='avia_iconbox_title' > Avsedd anv\u00e4ndning<\/span><\/a><\/div><br \/>\n<div  class='avia-button-wrap avia-button-right  avia-builder-el-26  el_after_av_button  avia-builder-el-last ' ><a href='https:\/\/new.medifactia.com\/sv\/manuell-berakning\/'  class='avia-button   avia-icon_select-yes-right-icon avia-color-theme-color avia-size-large avia-position-right '   ><span class='avia_iconbox_title' >Manuell ber\u00e4kning <\/span><span class='avia_button_icon avia_button_icon_right' aria-hidden='true' data-av_icon='\ue87d' data-av_iconfont='entypo-fontello'><\/span><\/a><\/div><\/p><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/pages\/8645"}],"collection":[{"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/comments?post=8645"}],"version-history":[{"count":9,"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/pages\/8645\/revisions"}],"predecessor-version":[{"id":14490,"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/pages\/8645\/revisions\/14490"}],"wp:attachment":[{"href":"https:\/\/new.medifactia.com\/sv\/wp-json\/wp\/v2\/media?parent=8645"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}