Abdomen and Pelvis Radiography Flashcards
How do we determine what type of scan to do and diagnose?
Determine the quadrant the pain is coming from
What are the most common modalities used to image abdomen and pelvis?
- plain films or X-ray
- ultrasound
- CT
- MRI
- floro
Which imaging types do NOT give off radiation
MRI and Ultrsound
What type of scan gives off most radiation?
CT
-never take for granted a CT scan. Should NOT do several on one patient in short amount of time
What are the 5 primary quadrants?
- epicgastric
- RUQ
- LUQ
- RLQ
- LLQ
Epigastric quadrant pain
-esophagus, stomach, pancreas, aorta, biliary system
What is a good scan to do on someone with esophagus and stomach pain?
Floro such as upper GI
If someone has acute pain or severe epigastric pain..
CT with and without contrast
Some people allergic to contrast
- hives, nephrotoxicity, anaphylaxis
- Harvard Prep-24 hour prep to avoid allergic reaction
- no allergies to oral contrast
What is a good natural contrast in human body?
Adipose
What’s the most common pathology in epigastric relation?
- pancreatitis
- gastritis and ulcers
- aneurysms of Aorta
RUQ pain
-liver, gallbladder, biliary system, kidney, duodenum, colon
Most common pathology of RUQ
- cholycystitis
- hepatitis
- biliary obstruction
What is the best RUQ test to run and why?
ultrasound
- it is the best test for the gall bladder
- if ultrasound is negative or there is severe pain, then do CT with and without contrast
What are symptoms of cholycyctitis?
- gallbladder wall thickening
- gall stones
LUQ pain
-spleen, stomach, colon, kidney
Most common pathology of LUQ
- splenic injury
- Colitis
- pancreatitis
What test should you use for LUQ pain
Begin with CT with and without contrast
What is the key quadrant for pathology and boards?
RLQ
Anatomy of the RLQ
- colon (cecum and appendix)
- Small bowel
- distal ureter
- hernias
- femal-ovaries and uterus
- bladder
What are the two most common dx of females LRQ pain?
- Ovarian cysts
2. Constipation
What quadrant does constipation affect?
ANY
Best test for RLQ pain
Female with acute, severe pain
- ultrasound to exclude torsion
- if negative proceed to CT with and without
Why do you want to rule out torsion with an ultrasound first?
It is time sensitive. Blood supply is being cut off. Can cause necrosis or infertility
Cholycistitis
- gall stones
- Gall bladder wall thinning
RUQ
LUQ
-spleen, stomach, colon, kidney
Most common pathology in LUQ
- splenic injury
- colitis
- pancreatitis
What does blunt abdominal trauma effect the most?
Spleen
What is the best test to being with in LUQ?
CT with and without contrast
What is another key quadrant for pathology ad boards?
RLQ
Most common pathology in RLQ
- Appendicitis
- Colitis
- Ovarian torsion
- Ureteral stones
- Chron’s disease
Anatomy of the LLQ
- colon
- small bowel
- distal ureters
- bladder
- hernias
- ovaries
Best test for LLQ
CT with and without
-except for female acute severe pain, start with ultrasound first
Most common pathology for LLQ
- Diverticulitis (can form abcess and rupture)
- Ureteral stone
- Ovary torsion and cysts
- Hernias
- Cystitis
If there is profuse abdomen and pelvic pain…
Just go straight to CT with and without contrast
Aortic Aneurysm limits
-anything about 5cm is a risk of rupturing
Testicular torsion
- ultrasound
- inflammation
- heterogenous appearance
- swelling-larger
- Can use doppler flow to see where the blood is and is not flowing
- treated by surgery
Acute diverticulitis
- LLQ pain
- “ticks”
- if abscess forms, needs drained
- cannot go through the midline because you will it the epigastric vessels, use ultrasound probe to check for blood flow
