Dykstra's abdominal lecture Flashcards
What is often used in the initial workup in patients complaining of abdominal pain?
Abdominal Radiographs
What is the rule of thumb for air in the abdominal cavity?
it rises to the superior portion
Where is air under the diaphragm best seen?
on the right side because the liver makes it obvious
What is Rigler’s sign and what does it mean?
both sides of bowel wall become outlined by air… means that there is a lot of air in the abdomen
-when supine, air can surround the falciform ligament on the liver
Where is it normal to see air?
in the stomach, 1-2 loops of small intestine, and in the rectum and sigmoid
Where is there normally NOT air?
in the large bowel
When looking at a radiograph, where is the small vs. the large bowel?
small is central, large is peripheral
What is an ileus?
air in the ileum, it’s a bowel dilation without mechanical obstruction
What is a mechanical SBO
Mechanical small bowel obstruction; different air-fluid levels in a single loop of bowel, little gas in colon, absent in rectum
disproportionate air in the smal bowel
What is Mechanical LBO?
Air seen to the point of obstruction, no air in rectum or sigmoid colon, no gas in small bowel
What is fluoroscopy normally used for?
to evaluate specific complaints localized to the esophagus
What is ultrasound used for
to evalutate patients with ab pain, especially to evaluate for cholelithiasis
no radiation
What is CT used for
used a lot in the acute setting but also in the workup of nonspecific abdominal pain
RADIATION
What is MRI often used for
to evaluate a specific issue seen on prior imaging studies
ex: indeterminate liver mass or renal mas
* **no radiation*
