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In what order should the following examinations be performed?

  1. UGI, IVU, Barium enema

  2. IVU, Barium enema, UGI

  3. Barium enema, UGI, IVU

  4. IVU, UGI, Barium enema

The correct answer is: Barium enema, UGI, IVU

The correct order of examinations, starting with a Barium enema, then an Upper Gastrointestinal (UGI) series, followed by an Intravenous Urogram (IVU), follows the considerations of the exams’ impact on one another and their specific requirements. Performing a Barium enema first is advantageous because it primarily visualizes the lower digestive tract (colon) and uses a contrast material (barium) that can obscure findings in the upper GI tract if performed afterward. Completing the Barium enema before proceeding to UGI allows for clear imaging of all segments without overlap in contrast materials, ensuring that each examination can be interpreted accurately. After the Barium enema, conducting the UGI series, which examines the upper digestive tract (including the esophagus, stomach, and duodenum), makes sense. This procedure may also use barium as a contrast agent, and by completing the lower GI study first, the risk of residual barium affecting the upper GI interpretation is minimized. Finally, the IVU, or Intravenous Urogram, is performed last because it involves a different type of contrast medium (iodine-based), which is injected intravenously. Performing the IVU after the preceding examinations avoids any interference that might occur