Acute Abdomen

Question 1

What consists of the “acute abdomen series”?

Answer 1

Erect posterior-anterior chest radiograph and supine and erect or decubitus radiographs of the abdomen.

Question 2

Air-fluid levels are seen in normal patients, commonly in the stomach, often in the small bowel, but never in what part of the colon?

Answer 2

Never in the colon distal to the hepatic flexure.

Question 3

Normal gas in the abdomen is predominantly what?

Answer 3

Swallowed air

Question 4

Normal air-fluid levels in the small bowel should not exceed how many cm in length?

Answer 4

2.5 cm in length

Question 5

The normal colon contains some gas and fecal material and varies in diameter from how many cm?

Answer 5

3 to 8 cm

Question 6

Small bowel is dilated when it exceeds how many cm in diameter?

Answer 6

2.5 to 3.0 cm

Question 7

The colon is dilated when it exceeds how many cm in diameter?

Answer 7

5 cm

Question 8

Cecum is dilated when it exceeds how many cm in diameter?

Answer 8

8 cm

Question 9

Adynamic ileus typically demonstrates what findings?

Answer 9

Diffuse symmetric , predominantly gaseous, distension of bowel.

The small bowel, stomach, and colon are proportionally dilated without abrupt transition.

More bowel loops are dilated than obstruction.

Question 10

Postoperative adynamic ileus usually resolves in how many days?

Answer 10

4 to 7 days

Question 11

This refers to a segment of intestine that becomes paralyzed and dilated as it lies next to an inflamed intraabdominal organ.

Answer 11

Sentinel loop

Question 12

It is a manifestation of fulminant colitis characterised by extreme dilation of all all or portion of the colon.

Im this state, peristalsis is absent and the large bowel loses all tone and contractility.

Answer 12

Toxic megacolon

Question 13

What is the most common cause of toxic megacolon?

Answer 13

Acute ulcerative colitis

Question 14

Most striking finding of a toxic megacolon?

Answer 14

Dilation of the transverse colon up to 15 cm diameter.

Question 15

When is the diagnosis of toxic megacolon suggested?

Answer 15

The diagnosis is suggested when the diameter of the colon exceeds 5 cm and the mucosa appears abnormal.

Question 16

Toxic megacolon mortality percent

Answer 16

20%.

The bowel wall becomes becomes a “wet blotting paper”, and risk of perforation is extreme.

Question 17

This means stasis of bowel contents above a focal lesion.

Answer 17

Mechanical bowel obstruction

Question 18

Mechanical bowel obstruction may be due to what processes?

Answer 18

May be due to obturation (occlusion of mass in the lumen), stenosis due to intrinsic bowel disease, or compression of the lumen by extrinsic disease.

Question 19

What is the goal of imaging in mechanical bowel obstruction?

Answer 19

To confirm the presence of obstruction, identify its level, and demonstrate its cause.

Question 20

Radiographs can confirm the presence of bowel obstruction how many hours before the diagnosis can usually be made clinically?

Answer 20

6 to 12 hours

Question 21

Most strangulation obstructions are closed-loop obstructions, which means what?

Answer 21

Blockage of a bowel loop segment at both ends. This occurs with incarcerated hernias and volvulus.

Question 22

Gas within the parenchyma of solid organs or within the wall of hollow viscera may represent what disease processes?

Answer 22

Infection, fistula, infarction, or recent surgery or instrumentation.

Question 23

Term applied to necrotising fasciitis of the perinuem, perianal and genital regions.

Answer 23

Fournier gangrene

Question 24

Radiographs and CT findings of Fournier gamgrene are:

Answer 24

Bubbles and streaks of gas in affected soft tissues.