Abdominal X-Rays

Question 1

what does this x-ray show

Answer 1

thickening of most of the colonic wall consistent with mucosal oedema secondary to active UC

Question 2

define toxic megacolon

Answer 2

segmental or total colonic diameter of >6cm radiologically with signs of systemic upset

Question 3

what does this x-ray show

Answer 3

pan-colonic dilatation which is worst in the transverse bowel
- also mucosal oedema with some dilated small bowel

Question 4

what are the hallmark findings of intestinal obstruction

Answer 4

dilated loops of bowel and absence of gas distal to the obstruction (commonly seen as absence of gas in rectum)

Question 5

in LBO, what does the appearance of x-ray findings depend on (2)

Answer 5

• level of obstruction
• competence of ileo-caecal valve

Question 6

describe the differences in appearance of LBO with and without ileo-caecal valve competence

Answer 6

• competent - distension of large bowel and caecum with relatively normal looking small bowel
• incompetent: dilatation of both large and small bowel with colon distal to obstruction usually collapsed and free of gas

Question 7

what is there a high risk of in large bowel obstruction with a competent ileo-caecal valve

Answer 7

colonic perforation as the colon acts as a closed loop with no mechanism to decrease the luminal pressure

Question 8

what does this x-ray show

Answer 8

sigmoid volvulus

Question 9

what does this x-ray show

Answer 9

caecal volvulus

Question 10

what is an important investigation in assessing pt w abdo symptoms + signs of peritonism

Answer 10

erect CXR

Question 11

what does this x-ray show

Answer 11

free air below the diaphragm due to perforation of abdominal viscus