GI Anatomical Imaging Flashcards
Search Strategy for Abdomen
- what structures are you looking for in this area ( think organs, regions, ligaments)
Solid Organs: liver, spleen, pancreas, adrenal glands, kidneys
gallbladder/ bilary system
stomach, duodenum, rest of small bowel, colon
Fat planes abdominal wall, bone
lymph node chains: hepatogastric ligament, periportal region, mesentery
CT characteristics (8)
- pros
- cons
- uses Radiation
- Fast ( less than 5 min)
- Good overall look at SOLID organs, FAT PLANES
- Best spatial resolution
- Excellent for calcification
- Good for overall look of pelvic organs
- Iodine-based (IV) contrast
- limited detail
MRI characteristics
- Pros
- Cons
- No radiation
- not so fast ( > 20 mins)
- best tissue resolution
- not good for calcification
- excellent for pelvic organs (uterus, ovaries, prostate, seminal vesicles)
- Gadolinium -based IV contrast
Biliary Tree imaging
- diagnose problems of bile and pancreatic ducts
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)
- modality of choice
- Xray is performed after visualization
Abdominal Aortic Vasculature (6)
- what imaging is best to view
- cons
- R & L gastric artery
- Proper hepatic artery
- Gastroduodenal artery
- Common hepatic artery
- Splenic artery
- Celiac trunk
- use Digital Subtraction arteriography
cons: invasive procedure
Ascites
- definition
- causes
- symptoms
- treatment
- accumulation of fluid in abdomen
most common cause: - liver cirrhosis
- salt and water retention
- heart failure
- cancer
Symptoms:
pain, discomfort, bloating
Tx: diuretics, therapeutic paracentesis
Mid-sagittal View
- Normal View
- useful in assessing SMA and nutcracker syndromes
Superior Mesenteric Artery Syndrome
- definition
- causes
- symptoms
- treatment
- digestive condition when 3rd part of duodenum is compressed between aorta and SMA
- short ligament of Treitz
Causes:
-partial or complete blockage of duodenum
Symptoms:
abdominal pain, fullness, nausea, vomiting, weight loss
TX: Sx may be needed if other treatment strategies do not work
Nutcracker Syndrome
- definition
- effects
compression of LEFT RENAL VEIN between SMA and aorta
- can lead to renal venous hypertension and disruption of thin veins in collecting system leading to hematuria
- SX may help to relieve compression
Hiatal Hernia
- describe
- symptoms
- bulge of stomach through esophageal hiatus into thorax
- due to age related changes to stomach and/or diaphragm
Symptoms:
- reflux
- sense of shortness of breath
Zenker’s Diverticulum
- describe/ location
- symptoms
- what imaging do you use?
- false diverticular formation in the esophageal wall adjacent to inferior pharyngeal constrictor and cricopharyngeus muscles
- due to uncoordinated swallowing and failure of cricpharyngeus m.
- in Killian’s triangle
- notorious for trapping food and causing severe halitosis
Symptoms
- dysphagia
- feelings of food being stuck in throat
- aspiration
- regurgitation hours after eating
- rarely a fluctuant mass is found in PE
Imaging
- use Fluoroscopic barium esophagography
- DO NOT use endoscopy
Ulcerative Colitis
- “lead” pipe appearance of long standing ulcerative colitis due to spasm of longitudinal muscles and/or irreversible fibrosis
- loss of haustral markings throughout the entire colon
Cholithiasis
- describe
- location/ tests
- gallbladder imaging
- formed by high concentrations of cholesterol or bilirubin in bile and/or inefficient emptying of gallbladder
- gallbladder is not typically well-visualized on plain films (X ray) of the abdomen without use of a contrast media
Symptoms:
- gallstones
- RUQ pain=> radiate to shoulder
- Positive Murphy’s sign
- Procedure of choice for suspected cholithiasis is ultrasonography
Beak Sign of Arterial Dissection
- luminal dissection of vessel
- can be seen as wedge of hematoma at distal end of false lumen ( false lumen propagation is occuring)
- manifest as acute angle between dissection flap and outer wall
- may be filled with contrast-enhanced blood (high attenuation) or thrombus ( low attenuation)
Shatzki Ring
- narrowing of esophagus caused by a RING of mucosal tissue (which lines the esophagus) or muscular tissue
- can cause difficulty in passing liquids and food
