abdomen, pelvis and GI system

Question 1

imaging

Answer 1

advantages
- cheap compared to CT / fluoro
- non invasive / lose risk
- reasonable assessment of acute abdominal pain in hospital setting if correctly requested
disadvantages
- limited yield
- limited sensitivity and specificity
should be avoided for:
? constipation
? renal stones
non acute abdominal pain

Question 2

gastrogafin

Answer 2

• oral contrast administered in the cases of adhesions bowel obstruction / ileus
• effective tool for demonstrating whether surgical intervention is necessary or not
• adhesion obstruction - due to previous surgery - preventing more surgery = good thing
• if there is passage of contrast though to the right colon in 24hrs, the obstruction does not require surgical intervention
• it acts as a dental laxative and anti-inflammatory

Question 3

sigmoid volvulus

Answer 3

• twisting of the bowel causing obstruction
• tend to appear dilated
• coffee bean sign

Question 4

large bowel obstruction

Answer 4

• large dilated bowel loops
• haustral folds not well visualised
• smooth bowel walls

Question 5

small bowel obstruction

Answer 5

• dilated bowel loops but not as big as large bowel obstruction
• haustral folds more prominent
• usually more centrally located

Question 6

fluoroscopy

Answer 6

advantages
- relatively cheap compared to CT / MRI
- relatively non invasive compared to surgery
- dynamic
- high temporal and spatial resolution
disadvantages
- less sensitive than CT / MRI for most conditions
- poorly tolerated by patients
- poor contrast resolution unless contrast is administered

Question 7

barium swallow

Answer 7

• a dedicated examination of the pharynx, oesophagus and stomach and duodenum
• used for gastro-oesophageal reflux disease, difficulty swallowing and hiatus hernia

Question 8

polyp

Answer 8

• small growths on the inner lining of the large intestine or rectum
• common, 1 in 4 affected
• more common in men than women aged 60+
• some develop into cancer
• risks include family history, colitis, crohns, overweight, smoking

Question 9

gastrostomy

Answer 9

• tube inserted directly into the stomach through the abdominal wall
• for patients that cannot eat or drink and often have issues passing a NG tube down
  2 main types:
  1. percutaneous endoscopic gastronomy - a feeding tube inserted into the stomach using an endoscopy to identify the position
  2. radiologically inserted gastrostomy - a feeing tube inserted using fluoroscopy to identify the position of the stomach