Abodomen

Question 1

indications for abdomen x-ray

Answer 1

• Acute abdomen pain
• ? obstruction
• localisation of FB
• calcification
• ? renal colic
• mass

Question 2

areas to review on AXR

Answer 2

areas of interest

abdominal structures and their location

soft tissue

calcifications

gas pattern

Question 3

Distention

Answer 3

sufficient air within the bowel

Question 4

Dilation

Answer 4

abnormal

bowel is distended above normal limits

Question 5

mechanical obstruction

Answer 5

physical/organic obstructing lesion that prevents the passage of bowel contents

Question 6

latrogenic

Answer 6

caused/paused by the treatment of physician

Question 7

gas pattern for small bowel

Answer 7

1-2 loops of bowel

normal diameter is less than 2.5cm

Valvulae conniventes

Question 8

Gas pattern- large bowel

Answer 8

see air in rectum and sigmoid

normal measurements 6cm and 9cm for caecum

Question 9

radiographic appearances small bowel

Answer 9

multiple dilated loops of gas (centrally located)

The valvulae conniventes can be seen across
the entire lumen (stack of coin appearance)

Question 10

clinical indications small bowel

Answer 10

distended abdomen and vomiting

Question 11

clinical indications for large bowel

Answer 11

Abdo pain with failure to pass stools

Question 12

radiographic appearances for large bowel

Answer 12

dilated loops of the bowel greater than 5cm

marked distension of the caecum

Generally peripheral in location

haustra does not cross fully along lumen

Question 13

what is a volvulus

Answer 13

twisting if the bowel its mesenteric
attachment to abdominal wall

Question 14

What is a complication of a volvulus?

Answer 14

Obstruction and
Ischaemia

Question 15

which bowel is involved in volvulus

Answer 15

large bowel

Question 16

common sites for volvulus

Answer 16

caecum and sigmoid

Question 17

clinical indications for volvulus

Answer 17

Patient suffering with constipation
Abdominal pain

Question 18

radiographic appearances for volulus

Answer 18

Dilated loop of bowel with a coffee bean shape

Bowel loop points to the right upper quadrant
therefore more likely to be sigmoid volvulus

loss of haustra

Question 19

caecal volvulus Radiographic appearances

Answer 19

Caecum is dilated

embryo sign

not located within RLQ

Question 20

clinical indications for caecal volvulus

Answer 20

nausea, vomiting, abdominal distention

Question 21

Inflammatory bowel disease

Answer 21

thickening of the bowel wall

Question 22

radiographic appearances of colitis

Answer 22

Loss of bowel wall shape

thumbprinting pattern within large bowel

Question 23

what is colitis

Answer 23

thickening of the fold of haustra

both sides of the folds are outlined by gas

Question 24

what is colitis

Answer 24

thickening of the fold of haustra

both sides of the folds are outlined by gas

Question 25

colitis is caused by

Answer 25

Infection
- Ischaemia
- Inflammation

Question 26

clinical indications of toxic megacolon

Answer 26

Acute abdominal pain
- Sepsis
- Known history of ulcerative colitis

Question 27

radiographic appearances of toxic megacolon

Answer 27

Gross dilatation of the large bowel
- Bowel wall oedema (thumbprinting)
- mottled appearance

Question 28

what is extraluminal air

Answer 28

air within the abdominal cavity, where it shouldn’t be

Question 29

extraluminal air causes

Answer 29

significant dilation of the bowel

Question 30

extraluminal air common sites

Answer 30

within the large bowel, sigmoid, duodenum

Question 31

extraluminal air plain film projections

Answer 31

Erect CXR - pt sits up 10 mins for air topresent under diaphragm
horizontal beam ray, straight tube

Question 32

clinical indications for pneumoperitoneum

Answer 32

abdominal pain post colonoscopy

Question 33

radiographic appearances of pneumoperitoneum

Answer 33

dilation of large bowel

rigler’s sign- double walled sign - air seen on both sides of intestine

dark crescents of gas seen under hemidiaphragms

football sign - abdominal cavity outlined by gas

Question 34

calcifications