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CLASP Radiology > Acute Abdomen > Flashcards

Acute Abdomen Flashcards

1
Q

What

A

5%

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2
Q

diffuse

A

mesenteric

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3
Q

RUQ

A

…

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4
Q

LUQ

A

…

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5
Q

llq

A

…

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6
Q

rlq

A

…

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7
Q

Primary imaging

A

xray
ct
uss

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8
Q

secondary imaging

A

mri

fluoroscopy

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9
Q

xray cxr xray abdo why

A

xray cxr - to see for pneumoperitoneum erect

supine abdo - to see for

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10
Q

xray pros

A

..

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11
Q

xray cons

A

…

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12
Q

uss pros

A

easy
safe
good for seeing of solid organs, free fluid, aorta and female pelvic organs
bowel - occasionally helpful

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13
Q

uss cons

A

operator dependent

immobile/obese patients

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14
Q

ct pros

A

v sensitive

quick

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15
Q

ct cons

A

radiation exposure
contrast induced nephropathy
contrast allergy

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16
Q

CXR
full body contrast
full body PET/CT

A

0.1 mSV
full body contrast ct - 10mSv
Full body PET/CT - 30mSv

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17
Q

MRI pros

A

no radiation, good soft tissue delineation, staging esp. rectal cancer
long exam, not available, contraindicatu

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18
Q

What is it used

A

second line for hepato-biliary
small bowel known disesae
pelvis - perioneal and peri-anal & acute gynae problems

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19
Q

RIF pain

A

appendicitis
renal colic
tubo-ovarian pathology

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20
Q

appendicitis imaging?

A

CT and USS

USS first

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21
Q

US findings acute apendicitis

A

aperistaltitc, non-compressible, dilated (>6mm)

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22
Q

CT acute appendicitis appearance

A

apependiceal dilation >6mm
wall thickening >3mm
thickening of caecal apex
periappendiceal ….

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23
Q

Right utereric calculus

A

loin to groin - non-contrast CT gold standard

24
Q

Stones size visual

A

> 1mm

25
Q

Which stones not radioopaque

A

…

26
Q

LIF pain

A

diverticuluitis
colitis (ischaemic, pseudomembranous or IBD)
colorectal cancer
epiploic appendagitis (twisting of epiploic appendages)
tubo-ovarian pathology
renal colic

27
Q

Presentation acute diverticulitis?

A

LIF pain
unremitting pain with associated tenderness
..

28
Q

imaging for acute diverticulitis

A

CT with IV contrast - thickened abnormal segment of sigmoid colon with outpouching
maybe CXR for pneumoperiotneum for perforation

29
Q

role of imaging acute diverticulitis

A

…

30
Q

epigastric and RUQ pain

A

biliary colic
cholecystitis
pancreatitis
perforation

31
Q

acute cholecystitis almost always secondary to what

A

gallstones

32
Q

diagnosis acute cholecusttis diagnosis on .

A

…

33
Q

acute choleycytsitis imaging

A

US first line
CT can be false because density of stones may be same as adjacent bowels
mri if biliary tree dilatation
No role fo AXR

34
Q

USS acute cholecystitis

A

gallbladder thickening >3mm
pericholecystic fluid
also

35
Q

CT acute cholecystitis

A 
cholelithiasis 
gallbladder distension 
gallbladder wall thickening 
mural/mucosal 
....
36
Q

MRCP

A

MRI for biliary tree

37
Q

treatment options for cholelithiliasis

A

medical if patient unwell ..
inteventiona lradiolgy percutaneous
ercp if obstructed biliary tree
surgery

38
Q

pancreatitis symptoms for lots of patients

A

acute onset severe central epigastric pain 30-60mins
poorly localised tenderness and pain
exacerbated by supine positioning
radiaties to back in 50% patients
bloods: elevation of serum amylase 90-95% specific for diagnosis

39
Q

When imaging in pancreatitis & role in early days

A

diffusely unwell …

40
Q

Role in early days of iaging

A

see if its gallstones causing it

complications

41
Q

early imaging

A

US to see gallstones

42
Q

ct findings pancreatitis

A

focal/diffuse parenchymal enlargement
indistinct pancreatic margins
surrounding retoperitoneal fat stranding
liquefactive necrosis of pancreas (won’t enhance at all)
lots of free fluid due to necrosis
infected necrosis/abscess formation
vascular complications

43
Q

perforation of waht (2 common and 2 less common)

A

common: perforated ulcer
diverticular
less common: secondary to cancer, secondary to ischaemia

44
Q

perforation imaging

A

supine CXR - pneumoperitoneum

45
Q

ct for perforation

A 
shows free fluid 
localised inflammatory change - doesn't show where hole is but look for this 
distrubution gas (very black), defect in wall,, localised inflammatory change
46
Q

abdo pain & distension

A

bowel obstruction
masses
ascites

47
Q

small bowel obstruction

A

common - adhesion, canccer herniae and gallstone ileus

48
Q

symptoms small bowel

A

vomiting, pain, distension

49
Q

small bowel again

A

…

50
Q

small bowel

A

xray - valvulae coniventes are visible, loops central, dilatation >2.5cm - 3cm
pacuity of gas distally
US no role
CT transition point key!!!

51
Q

ct findings small bowel obstruction

A

dilated small bowel loops >2.5cm
normal or collapsed loops distally
may see mass
small bowel faeces sign

52
Q

gallstone ileus

A

rarer: gallstone ileus - large gallstone (2-3cm) , gallbladder wall
gets tuck at narrowest which is ileocaecal bowel
small bowel obstruction
air in biliary tree
density in RIF

53
Q

large bowel obstruction causes (60%, 15%, 10%)

A

colorectal cancer
volvulus
diverticulitis

54
Q

large bowel imaging

A

abdo xray:
distended bowel peripherally >5cm
haustra
lack of gas distally e.g. rectum has little or no air

55
Q

pseudo obstruction and obsturction

A

diffuse air

56
Q

large bowel obstruction imaging

A

ct

57
Q

sudden abdo pain and shcol

A 
bowel ischaemia
perforation
... 
aaa 
ruptured ectopic pregnancy

CLASP Radiology (4 decks)

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