168b - Imaging of the GI System

Question 1

What are the indications for an “abdominal series”?

Answer 1

Free air or bowel obstruction

Question 2

Which imaging modality is recommended to assess bowel motility?

Answer 2

Barium + serial x rays until barium reaches the cecum

(Fluoro for bowel motility, esophagram for esophagus)

Question 3

What is the recommendation around CTs for pregnant women?

Answer 3

Avoid ionizing radiation in pregnant women (esp first trimester) if possible

Consider US or MRI over CT

Question 4

Why not use ultrasound to evaluate the pancreas?

Answer 4

Bowel gas makes it difficult to seee

Question 5

What is the best imaging modality for the gallbladder?

Answer 5

Ultrasound

Best for seeing gallstones, cholecystitis, biliary dilation

(followed by MR if necessary to see stones in the distal bile duct or malignancy)

Question 6

Which imaging modality is best for evaluating hepatic parenchyma?

Answer 6

MRI

• But only used after increased suspicion after ultrasound or CT

Question 7

Which imaging modality is recommended to evaluate bowel obsruction, perforation, inflammation, tumor, or abscess?

Answer 7

CT abdomen/pelvis with IV and oral contrast

(For anything with motility, use barium study)

Question 8

Which imaging modality is best for the pancreas?

Answer 8

Triphasic CT or pancreas MRI