Clinical questions - abdomen

Question 1

Sialectasis

Answer 1

ducts of glands like submandibular gland get dialated due to calculus

Question 2

Oesphageal Atresia:

Answer 2

smooth blunt termination of the oesophagus in the thorax, contrast may be seen to spill over into the trachea,

There is usually absence of gas in the stomach and bowel.

Question 3

Barrett’s oesophagus

Answer 3

oesophageal sphincter doesn’t hold acid in stomach therefore it burns the oesophagus. Oesophagal cell lining is destroyed.

Question 4

Hiatal Hernia

Answer 4

See gastric bubble in lungs and bowel looks like it is in the lungs

Question 5

Congenital Diaphragmatic Eventration /Hernia

Answer 5

Bowel sits in thoracic cavity

Question 6

Duodenal Ulcers

Answer 6

usually in first part of duodenum

Question 7

Hepatic Metastasis

Answer 7

Multiple hypoattenuating lesions of varying sizes are seenin both the left and right lobes of the liver, some with indistinct margins

Question 8

Crohn’s disease

Answer 8

In earliest stages, narrowing of the terminal ileum appears with a “string sign”. Later, we may see fistulae between loops of bowel, bladder and/or vagina. There may be “skip lesions” present (normal segments of bowel between abnormal segments of bowel)

Question 9

SBO

Answer 9

Dialated small bowel
Increased and enlarged plicae circularis
string of pearls in decubitus xray
air fluid lines

Question 10

Duodenal Volvulus

Answer 10

Dilated, air-filled duodenal bulb and paucity of gas distally
“Double bubble sign” = air-fluid levels in stomach and duodenum
Isolated collection of gas-containing bowel loops distal to obstructed duodenum = gas-filled volvulus = closed-loop obstruction

Question 11

Diffuse Small Bowel Disease Scleroderma

Answer 11

Atrophy of the muscular layers and replacement with fibrous tissue

• malabsorption
• not in stomach

Question 12

Meconium Ileus in new born *

Answer 12

meconium, creating a blockage in a part of the small intestine called the ileum. Most infants with meconium ileus have a disease called cystic fibrosis

Question 13

Malabsorption

Answer 13

Flocculation (clumping)of BaSO4
·Delayed progress of BaSO4 thru small bowel
·Dilution of the barium in the distal small bowel
·Coarse mucosal pattern

Question 14

Imperforate Anus

Answer 14

no rectum and anus developed at all

Question 15

Hirschsprung’s Disease

Answer 15

Congenital absence of neurons in the rectum, preventing peristalsis and passage of the colon contents
Then radiographically seen as an enlarged colon proximal to the area of interest

Question 16

Ulcerative Colitis

Answer 16

Starts as oedamtous mucosa with psuedopolyps at later stage moving to irregular/ LOSS of haustral folds due to the fibrotic nature of the affected colon wall

Question 17

Ascites

Answer 17

Uniform grayness to abdomen
Central placement of bowel loops
Separation of adjacent loops
Loss of definition of the liver and/or spleen edge

Question 18

Pneumoperitoneum:

Answer 18

• A large amount of free air will give double-wall sign

- crescents of air seen beneath each hemidiaphragm

Question 19

splenic haematoma

Answer 19

loss of the splenic flexure due to ruptured spleen