abdominal imaging Flashcards
describe some common causes of abdominal pain
appendicitis bowel obstruction urinary system disorder diverticulitis cholecystitis pancreatitis malignancy gynaecological IBD ischaemia perforation
what might an x-ray be used for
bowel obstruction/ perforation
what are USS useful for
free fluid, solid organs, aorta, gynaecological
bowel
what are the advantages of CT
sensitivity
quick
planning of surgery and intervention
what are the risks of CT
radiation exposure
renal impairment due to the contrast is possible
what are the advantages of MRI
no radiation
good soft tissue delineation
what are the disadvantages of MRI
takes longer to do
contraindications e.g. claustrophobia, pacemaker,
may be used as a second line test
what are the symptoms of acute appendicitis
periumbilical pain, nausea, vomiting
localizes to the right iliac fossa
difficult to diagnose
how can imaging be used to diagnose appendicitis
xray cant be used
CT and USS can be
use USS first
may be able to determine alternative pathologies
distended/ fluid filled appendix may be visible
how can imaging be used in acute diverticulitis
diagnosis and complications e.g. abscess, obstruction, perforation, fistulae
what is a colovesical fistula
a communication between the lumen of the colon and the bladder
how is cholecystitis diagnosed
sign of inflammation, fever, pain, CRP
Imaging: gallstones, wall thickening, fluid
MR cholangiopancreatography if obstruction in the common bile duct
what is Emphysematous cholecystitis
air in gall bladder
usually associated with diabetes
usually very serious
what can cause a small bowel obstruction
adhesions, cancer, herniae and gallstones ileus
what are the stigmata of small bowel obstruction
vomiting, pain and distension
increased bowel sounds, tenderness, palpable loops
what are the causes of large bowel obstruction
colorectal cancer
volvulus(twisted bowel)
diverticulitis
need to know site, cause, metastasis
how can imaging be used in small bowel obstruction
detect site, causes, severity, and complications
basis of management
CT better than xray, more specific and better at seeing metastases
what are the possible causes of perforation
perf ulcer
diverticular disease
cancer
ischaemia
what features of perforation might be seen on imaging
free fluid and gas
defect in wall
inflammatory change
faeces in the peritoneum
what are the causes of bowel ischamia
arterial occlusion
venous occlusion
non occlusive hypoperfusion
what are the signs of bowel ischaemia
Severe abdominal pain • Vomiting, diarrhoea, distension inconsistent • Borderline amylase, raised WCC, acidotic • DDx includes perf, pancreatitis, obstruction, diverticulitis
what other problems can be seen with imaging
ureteric stone
tubo-ovarian abscess
what is the main role of USS
RUQ/RIF pain
what is the role of CT
primary imaging technique for acute pain in general
