Abdomen XR Flashcards
if there is no air in the stomach, what does this mean
- recently vomited
- NG tube is in stomach and tube is attached to suction
scout film?
supine AP film for abdomen
dep on the amount of fat in a patient, which muscle can you see on film
psoas
KUB define
kidney
ureter
bladder
films
supine abdomen film shows us?
- overall bowel gas pattern
- calcifications
- masses
prone abdomen films hsow us?
gas in rectosigmoid
upright abdomen shows us?
free air
air-fluid levels in bowel
valvulae conniventens
small bowel mucosal folds
-traverse entire sm bowel lumen
haustral folds
do not go all the way across the colon lumen
indications for barium swallow
- high or lowdysphagia.
- gastro-esophageal reflux disease(GERD/GERD)
- assessment of a hiatus hernia.
- generalized epigastric pain.
- persistent vomiting.
- assessment of fistula or diverticulum
- inability to pass the endoscope during UGIE.
small bowel diameter vs large
S=2.5
L=6 cm
areas of large bowel that can increase in size?
sigmoid colon
ileocecal
aerophagia
all bowel gas comes from swallowed air
- prod numerous irregularly shaped air-containing loops of bowel
- loops of bowel are distended and overlapping but NOT dilated
are the loops of bowel dilated in aerophagia
no
they are distended
s.s of sbo
n/v coffee ground emesis diffuse abd pain abd distention inability to pass stool or gas
PE findings for SBO
abd distention
high pitched bowel sounds
tympanic bowel sounds to percussion
on an AP film with SBO suspicion, where does air and fluid line up
air will appear above the fluid line
**fluid is radio opaque
step ladder apperance
- seen with what pathophysiology
- what position does patient need to be in
SBO
upright abdominal film
components of LBO
distal portion of colon and rectum
MCC of LBO
tumor
other causes of LBO
-diverticulitis
-intussusception
0hernia
-volvulus
cecal volvulus vs sigmoid volvulous
sigmoid volvulus=COFFEE BEAN SHAPE and more common
Cecal–more serious and dangerous bc mesenteric arteries involved–ischemia
RF for cecal volvulus
- air travel in low cabin pressure
- colon muscle weakness (atonia)
- enlargement of the colon
- Hirschsprung’s disease(where the large intestine becomes inflamed and leads to constipation and obstruction)
- infections
- overexertion
- pelvic tumors
- pregnancy (especially in the third trimester)
- previous abdominal surgeries that caused adhesions
- violent coughing fits
sigmoid volvulus can lead to?
LBO
RF for sigmoid volvulus
-Chronic constipation
-Excessive or prolonged use of laxatives
-A diet that is too rich in fiber (commonly occurring in Africa)
-Chagas disease (commonly occurring in Africa)
>50
-megacolon
- M > F
Rigler’s sign
outline of intestine from outside and inside
- usually only the inner walls of bowel are seen on XR
- when air is in peritoneal space— can cause both sides of bowel wall to be visible—– causes Pneumoperitoneum
**get CXR if you suspect pnempperitoneum for air under the dia an on erect
thumb printing
mucosal thickening of the haustra due to IBD
-edema causes them to appear like thumb prints projecting into the lumen
Lead pipe
featureless colon
–loss of haustral markings secondary to UC
toxic megacolon
-what dz
C. Diff
> 6cm of the bowel
pneumoperitoneum?
free air under diaphgram
which parts of the bowel (sm and lrg) have mesentery
Jejunum
Ileum
Transverse colon
sigmoid
