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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

25
Which stones not radioopaque
...
26
LIF pain
diverticuluitis colitis (ischaemic, pseudomembranous or IBD) colorectal cancer epiploic appendagitis (twisting of epiploic appendages) tubo-ovarian pathology renal colic
27
Presentation acute diverticulitis?
LIF pain unremitting pain with associated tenderness ..
28
imaging for acute diverticulitis
CT with IV contrast - thickened abnormal segment of sigmoid colon with outpouching maybe CXR for pneumoperiotneum for perforation
29
role of imaging acute diverticulitis
...
30
epigastric and RUQ pain
biliary colic cholecystitis pancreatitis perforation
31
acute cholecystitis almost always secondary to what
gallstones
32
diagnosis acute cholecusttis diagnosis on .
...
33
acute choleycytsitis imaging
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
USS acute cholecystitis
gallbladder thickening >3mm pericholecystic fluid also
35
CT acute cholecystitis
``` cholelithiasis gallbladder distension gallbladder wall thickening mural/mucosal .... ```
36
MRCP
MRI for biliary tree
37
treatment options for cholelithiliasis
medical if patient unwell .. inteventiona lradiolgy percutaneous ercp if obstructed biliary tree surgery
38
pancreatitis symptoms for lots of patients
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
When imaging in pancreatitis & role in early days
diffusely unwell ...
40
Role in early days of iaging
see if its gallstones causing it | complications
41
early imaging
US to see gallstones
42
ct findings pancreatitis
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
perforation of waht (2 common and 2 less common)
common: perforated ulcer diverticular less common: secondary to cancer, secondary to ischaemia
44
perforation imaging
supine CXR - pneumoperitoneum
45
ct for perforation
``` 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
abdo pain & distension
bowel obstruction masses ascites
47
small bowel obstruction
common - adhesion, canccer herniae and gallstone ileus
48
symptoms small bowel
vomiting, pain, distension
49
small bowel again
...
50
small bowel
xray - valvulae coniventes are visible, loops central, dilatation >2.5cm - 3cm pacuity of gas distally US no role CT transition point key!!!
51
ct findings small bowel obstruction
dilated small bowel loops >2.5cm normal or collapsed loops distally may see mass small bowel faeces sign
52
gallstone ileus
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
large bowel obstruction causes (60%, 15%, 10%)
colorectal cancer volvulus diverticulitis
54
large bowel imaging
abdo xray: distended bowel peripherally >5cm haustra lack of gas distally e.g. rectum has little or no air
55
pseudo obstruction and obsturction
diffuse air
56
large bowel obstruction imaging
ct
57
sudden abdo pain and shcol
``` bowel ischaemia perforation ... aaa ruptured ectopic pregnancy ```

CLASP Radiology (4 decks)

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