gastrointestinal, abdomen Flashcards
abnormal channels to abscesses
sinuses
- Evaluation of abdominal stab wounds
- positive contrast technique – water iodinated CM
▪ AP - cross table lateral
▪ erect lateral ( if possible)
Bowerman & Smithwick technique
- Sign of splenic injury
- Done if it is not manifested on conventional supine & erect films
- CA – 200ml barium sulfate by mouth
▪ AP
▪ LLD of LUQ
Schoor & Danon technique
RLD w/ gas in stomach
Leigh technique
- Positive Contrast Peritoneography
- For selected cases of abdominal abdnormalities
- CM – 25% sodium diatrizoate solution (75g of hypaque+300ml sterile water)
Gelfand Technique
PP: supine; MSP centered approx. 1 inch of the iliac bone is included on the lower border of film
CR – perpendicular
RP – Xiphoid
Instruction – exhalation suspended
SS – Size & shape of liver, spleen and kidneys
LIVER AND SPLEEN AP PROJECTION
PP: prone; MSP centered; elbows flexed
CR:
1st exposure - 25° caudad
2nd exposure - 10° cephalad
Perpendicular - general survey
RP: xiphoid
Instruction – suspended exhalation
SS: greater surface of liver
LIVER
PA Axial Position or PA Projection
Benassi Method - two 34cmx43cm
PP: supine; right side elevated about 40-45°; center left side; cassette at or just below level of xiphoid
CR: Perpendicular
RP: approx. 2” left of midline at level of xiphoid
SS: greater surface of spleen
SPLEEN
LPO – Benassi method
found in individual that is short & stocky (overweight)
stomach:
▪ high
▪ lumen: largest above
- tapering toward pylorus
▪ extends more towards left
▪ horizontal position
▪ incissura angularis above level of
pylorus
- 1cm
▪ occasionally pylorus is the lowermost part of the stomach
steer horn
found in sthenic individual
stomach :
▪ J-shaped
▪ Body tend to be vertical in AP projection & uniform in size
▪ found at level of IC in erect position
Eutonic
found in asthenic individuals
(underweight)
stomach:
▪ fishhook-shaped
▪ greater curvature tends to sag down into the pelvis
▪ greatest diameter between the incissura angularis &
▪ Adjoining greater curvature
hypotonic
Variant type of stomach:
cascade and infantile
esophogastric junction is higher than pylorus
cascade
normal stomach but pylorus is hidden at back of anthrum
infantile
▪ Barium sulfate
▪ Water soluble, iodinated CM
- Move through GIT quicker than barium sulfate suspension
- Normally clears the stomach 1 to 2 hrs
- Entire iodinated CM reaches & outlines the colon in about 4 hrs
CONTRAST AGENT
✓ Outlines the esophagus – does not adhere to mucosa
✓ Satisfactory examination of stomach & duodenum including mucosal delineation
✓ Permits rapid survey of entire small intestine
- Fails to provide clear anatomic detail of the small intestine due to dilution of CM & decrease all opacification
✓ Densely concentrated in the large intestine
- Due to rapid water absorption through colonic mucosa
Iodinated CM
✓ Easily removed by aspiration either before or during surgery
✓ No ill effects
- preexisting perforation of stomach or intestine
- if medium escapes into the peritoneum, medium is readily absorbed from peritoneal cavity & excreted by the kidneys.
✓ Strongly bitter taste
✓ Not evacuated completely to permit a double contrast study of the colon mucosa – rectally administered iodinated medium.
water-soluble CM
- mass of undigested material that gets trapped in the stomach
BEZOAR