ch 5 GI system Flashcards by Sydney Luella

imaging appearance of congenital tracheoesophageal fistula

blind pouch filled with contrast agent or NG tube, fistula track (if one exists), NG tube injection

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imaging appearance of tracheoesophageal fistula (acquired)

demonstration of connection between esophagus and tracheobronchial tree

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imaging appearance of reflux esophagitis

streaks or dots superimposed on flat mucosa

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imaging appearance of Barrett esophagus

smooth tapered stricture

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imaging appearance of Candida (fungal) and herpesvirus esophagitis

Cobblestone pattern, shaggy marginal contour, small mucosal ulcers or plaques

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imaging appearance of ingestion of corrosive agents

alkaline ingestion = deeper ulceration, stricture formation

acidic ingestion = superficial minimal ulceration, stricture formation

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imaging appearance of esophageal cancer

flat plaque like lesion, infiltrating lesion (irregular wall), polypoid mass (deep ulceration)

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imaging appearance of esophageal diverticula

an outpouching or pocket filing with barium

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imaging appearance of esophageal varices

serpiginous thickening of folds (resembling rosary beads)

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imaging appearance of hiatal hernia

in a GI series, numerous thicker folds of the stomach above the diaphragm

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imaging appearance of achalasia (functional obstruction)

in chest XR, dilated esophagus
in GI series: narrowing of distal esophageal segment

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imaging appearance of esophageal perforation

perforation through entire wall: air in mediastinum, extravasation of contrast material through perforation

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imaging appearance of pyloric stenosis

in GI series, demonstrating shouldering caused by a filling defect at the antrum

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imaging appearance of peptic ulcers

small shadow erosions to perforations

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what are esophageal diverticula?

esophageal outpouchings

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dilated veins in the wall of the esophagus are called _______. what are they most commonly the result of?

esophageal varies, increased pressure in the portal venous system (usually from liver cirrhosis)

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________ is the most common abnormality detected in upper GI exams

hiatal hernias

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functional obstruction of the distal section of the esophagus with proximal dilation caused by incomplete relaxation of the lower esophageal sphincter

achalasia

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imaging appearance of alcohol related gastritis

thickened gastric folds

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imaging appearance of corrosive gastritis

severe narrowing of antrum and by cause obstruction of the gastric outlet

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imaging appearance of bacterial or infectious gastritis

thickened gastric wall causing narrowing of stomach and gas in the stomach wall

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imaging appearance of chronic atrophic gastritis

thinning and absence( of mucosal folds (“bald”)

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is chronic atrophic gastritis corrosive or noncorrosive?

noncorrosive

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this condition occurs when the two muscular layers of the pylorus become hyperplastic and hypertrophic; this condition is seen at birth

pyloric stenosis

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imaging appearance of pyloric stenosis on UGI series

demonstrating shouldering caused by a filling detect at the antrum

imaging appearance of inflammatory process of peptic ulcers

small shallow erosions to perforations - bleeding ulcer

imaging appearance of duodenal ulcers

rounded or linear collection of contrast material surrounded by lucent folds that often radiate toward the crater

imaging appearance of benign gastric ulcers

mucosal folds are smooth and slender and appear to extend into the edge of the crater

imaging appearance of metastatic gastric ulcers

irregular folds merge into a mound of polypoid tissue around the crater

imaging appearance of superficial gastric erosions

fleck of barium with radiolucent halo

imaging appearance of gastric cancer

broad spectrum, irregularity and ulceration suggest malignancy, linitis plastica appearance

linitis plastica appearance refers to...

diffuse thickening, narrowing, and fixation of the stomach wall

order of the small intestine

duodenum, jejunum, ilieum

chronic inflammatory disorder of unknown cause that most often involves the terminal area of the ileum but can affect any part of the GI tract

Crohn disease

imaging appearance of Crohn disease

small bowel series shows... -irregular thickened mucosal folds -cobblestone appearance -string sign and skip lesion

imaging appearance of small bowel obstruction

-caliber of air filled bowel appears as a dilated proximal bowel and a collapsed distal bowel -stepladder appearance

common disorder of intestinal motor activity in which fluid and gas do not progress normally through a non-obstructed small and large bowel

adynamic ileus

the telescoping of one part of the intestinal tract into another because of peristalsis which forces the proximal segment of bowel to move distally within the ensheathing outer portion

intussusception

imaging appearance of adynamic ileus

large amounts of gas and fluid in small and large bowel

imaging appearance of intussusception

coiled spring apperance on contrast enema

imaging appearance of malabsorption disorders

dilation within normal folds, irregular distorted folds

it is estimated that 20% of patients with (diverticulitis/diverticulosis) will eventually develop (diverticulitis/diverticulosis)

diverticulosis, diverticulitis

one of two major inflammatory bowel diseases in which the main symptoms are bloody diarrhea, abdominal pain, fever, and weight loss with alternating periods of relapse and remission

ulcerative colitis

affected areas ulcerative colitis = ______________ Crohn colitis = __________________

ulcerative colitis = sigmoid colon/rectum Crohn colitis = proximal portion of colon

imaging appearance of colitis ulcerative = _________ Crohn = ________

ulcerative = continuous Crohn = patchy

layers involved ulcerative = _________ Crohn = ________

ulcerative = mucosal layer only Crohn = all layers (mucosal through serosal)

condition characterized by abrupt onset of lower abdominal pain and rectal bleeding

ischemic colitis

this term comprises several conditions that have an alteration in intestinal motility as the underlying pathophysiologic abnormality

irritable bowel syndrome

imaging appearance of appendicitis

appendicolith

imaging appearance of diverticulosis

round or oval outpouching projecting beyond lumen; usually multiple

imaging appearance of diverticulitis

diverticular perforation with possible abscess

a tracheoesophageal fistula is _____________________

an abnormal connection between the trachea and esophagus

imaging appearance of ulcerative colitis

deep ulcers with intraluminal gas or polypoid changes, loss of haustral markings

imaging appearance of Crohn disease

in a BE, patchy distribution, noncontinuous segments (skip lesions)

imaging appearance of ischemic colitis

fine superficial ulceration, characteristics "thumbprinting," tubular narrowing and a smooth stricture

imaging appearance of IBS

no specific finds, rule out other disorders

imaging appearance of colon cancer in BE

sessile lesion, irregular, lobulated surface larger than 2cm, "apple core" or "napkin ring"

imaging appearance of large bowel obstruction ileocecal valve competent vs incompetent

ileocecal valve competent = large dilated colon, thin walled cecum, little small bowel gas ileocecal valve incompetent: gas filled loops of colon and of small bowel

imaging appearance of volvulus

distended cecum, displaced upward and to the left distended rectum, devoid of haustral markings, and a sausage or balloon shape bird's beak appearance

imaging appearance of hemorrhoids

single or multiple rectal filing defects simulating polyps

stones in the gallbladder

Cholelithiasis

inflammation of the gallbladder

cholecystitis

varicose veins of the lower end of the rectum that cause pain, itching, and bleeding

hemorrhoids

most gallstones (are/are not) visible on radiographs

are not

rare condition in which the growth of gas forming organisms in the gallbladder is facilitated by stasis and ischemia

emphysematous cholecystitis

rare condition in which calcification occurs in the wall of the gallbladder

porcelain gallbladder

infection of the liver caused by a virus

hepatitis

fibrotic change in response to liver damage

cirrhosis

hepatitis A is transmitted via

digestive tract (oral or fecal)

hepatitis B is transmitted via

blood or sexual contact

hepatitis C is transmitted by

blood transfusion or sexual contact

hepatitis E is transmitted by

food or water contaminated with fecal matter

in the US and western Europe, hepatitis (B/C) cirrhosis is the principal cause of liver transplations

hep C

90% of patients with hepatitis (B/C) recover without incident

hep B

do vaccines exist for each of the following types of hepatitis? A B C

A = yes B = yes C = no

imaging appearance of hepatitis

macronodules >5mm (US), hepatocellular necrosis (CT)

imaging appearance of cirrhosis in XR

haziness in ascites

imaging appearance of hepatocellular carcinoma

diffuse infiltrate, solitary multinodular mass (CT)

what is acute pancreatitis?

inflammatory process in which protein and lipid digesting enzymes become activated within the pancreas and begin to digest the organ

what is chronic pancreatitis?

condition in which frequent intermittent injury to the pancreas causes increasing damage that produces scar tissue

3 symptoms that help identify chronic pancreatitis

pain malabsorption causing weight loss diabetes

loculated fluid collections arising from inflammation, necrosis, or hemorrhage associated with acute pancreatitis or trauma

pancreatic pseudocyst

60% of pancreatic adenocarcinoma malignancies occur in the ________ of the pancreas

head

in regards to pneumoperitoneum, as little as _____ of free intraperitoneal gas can be identified

1 mL

where does free intraperitoneal air appear when the patient is upright?

beneath the domes of the diaphragm, appearing as a sickle shaped lucency

on what side is free intraperitoneal air easiest to identify?

right side

to identify free intraperitoneal air, if the patient is unable to sit or stand, what side should they ideally lay on?

left

imaging appearance of splenomegaly on XR

elevated left diaphragm, stomach displacement

imaging appearance of splenic rupture

various appearances depending on cause, seen on CT