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Gastrointestinal Tract > 17) Imaging of GIT > Flashcards

17) Imaging of GIT Flashcards

1
Q

What types of imaging can be used for the GIT?

A 
X-ray - abdominal and erect chest
Contrast studies
Ultrasound
CT/MRI
Angiography
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2
Q

What types of contrast studies are there?

A

Barium swallow, enema and meal

Water soluble studies

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3
Q

What imaging types are low dose radiation?

A

Ultrasound, MRI

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4
Q

What imaging types are high dose radiation?

A

Barium enema, CT

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5
Q

What are the risks of radiation in imaging?

A

Carcinogenesis
Genetic
Developmental risk to foetus

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6
Q

Why would an abdominal X-ray be requested?

A

Acute abdominal pain (sometimes)
Small or large bowel obstruction (used as triage)
Acute exacerbation of IBD

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7
Q

How is an abdominal X-ray taken?

A

Patient on back, X-ray from above

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8
Q

What features can be seen on an AXR?

A

Bowel gas pattern
Soft tissue structures
Bones

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9
Q

When can hollow tube be seen on X-ray?

A

If gas filled of gas and fluid filled

Slow transit time in colon and stomach so will be gas filled

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10
Q

When it can be seen, what are the features of the small bowel on AXR?

A

Central position

Valvulae conniventes - lines across entire bowel lumen

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11
Q

What are the features of the large bowel on AXR?

A

Peripheral position
Haustra
Faeces and gas
Transverse colon hangs down into pelvis

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12
Q

What is the rule of 3/6/9 in abnormal gas patterns?

A

Small bowel obstruction if dilated >3cm
Large bowel obstruction if dilated >6cm
Caecum (if ileocaecal valve working) obstruction if dilated >9cm

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13
Q

What causes small bowel obstruction?

A

Adhesions, hernias, tumours, inflammation

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14
Q

How does small bowel obstruction present?

A

Vomiting (early)
Distension
Absolute constipation (late)
Colicky pain

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15
Q

What causes large bowel obstruction?

A

Colorectal carcinoma (unless proven otherwise)
Diverticular stricture
Hernia
Volvulus

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16
Q

How does large bowel obstruction present?

A

Distension
Pain
Absolute constipation
Vomiting (late)

17
Q

What is a volvulus?

A

Loop of intestine twisting around itself or around its mesentery

18
Q

What is the most common volvulus?

A

Sigmoid volvulus

19
Q

What can be the outcome of a volvulus?

A

Bowel loop dilates and can cut off its blood supply (in mesentery) or perforate

20
Q

What can be the treatment for a sigmoid volvulus?

A

Sigmoidoscopy - passed through twist

21
Q

What inflammation can be seen on AXR?

A

Mucosal thickening
Featureless colon (UC)
Bowel wall oedema

22
Q

Describe the features of toxic megacolon:

A 
Microvascular ischaemia 
Mucosa sloughs off 
Colonic dilatation
Oedema 
Pseudopolyps
23
Q

What is thumb printing?

A

Oedematous thickened haustra due to active inflammation (UC)

24
Q

What other organs may be seen on an AXR?

A

Liver, spleen, kidneys, bladder

25
Q

What other abnormalities may be see on an AXR?

A

Stones
Masses
Calcification - chronic pancreatitis, vascular
Foreign bodies

26
Q

What condition can a chest X-ray be used to diagnose?

A

Perforated bowel

27
Q

Why does a chest X-ray need to be used in perforated bowel?

A

To see diaphragm being elevated from viscera, with air/gas in the peritoneal cavity

28
Q

What can cause a perforated bowel?

A 
Peptic ulcer 
Diverticular 
Tumour 
Obstruction 
Trauma
29
Q

When is barium contrast study used and when is water soluble contrast study used?

A

Barium if healthy

Water soluble if going into surgery

30
Q

What can a barium swallow be used for?

A

Visualise aspiration, used in elderly

31
Q

What can a barium enema be used for?

A

Injected rectally, check if anastomoses have healed in removed rectum where ileostomy has been used

32
Q

What is the L1 plane of a CT called?

A

Trans-pyloric plane

33
Q

What are the advantages of MRI scans?

A

No radiation

Good spatial and contrast resolution - differentiating between different tissues

34
Q

What can be visualised using ultrasound?

A

Gall stones
Common bile duct dilation
Liver, portal vein and appendix

35
Q

How is a GI angiography carried out?

A

Inject radio opaque contrast IV, then use imaging to visualise blood supply

36
Q

What can a GI angiography be used to see?

A

Bleeding

Ischaemia

37
Q

What can GI stenting be used for?

A

Removing blockages

Gastrointestinal Tract (11 decks)

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