GI Diagnostics—1 Flashcards
Dark areas on an x-ray are _______ as they permit the penetrations of x-rays.
Dark areas on an x-ray are radiolucent as they permit the penetrations of x-rays.
Lighter areas are _________ and they block the penetration of x-rays.
Lighter areas are radiopaque and they block the penetration of x-rays.
What makes up dark areas on an x-ray?
air
What makes up light areas on an x-ray?
bone
organ tissue
What do each of the following represent in an x-ray?
Black
White
Grey
Darker grey
Intense white
Black: air
White: calcification
Grey: soft tissue
Darker grey: fat
Intense white: metallic objects
You will see the following on an abdominal x-ray in which 2 dz?
Dilated bowel proximal to obstruction with collapsed bowel distally
Air fluid levels
Obstruction & Intussesception
You will see the following abdominal x-ray findings in which dz?
Dilated bowel
Gas in both small & large intestines
Paralytic ileus: non-mechanical bowel obstruction
You will see the following abdominal x-ray findings in which dz?
Free air outside of the bowel
Perforation (ruptured viscus)
Which one is small v. latge bowel obstruction?
top: small bowel w/valvulae conniventes
bottom: large bowel w/haustrations
What type of bowel gas pattern?
Small Bowel Obstruction
What type of bowel gas pattern?
Large Bowel Obstruction
What type of bowel gas pattern?
Normal
What does this show?
complete small bowel obstruction showing multiple air-fluid levels of varying size arranged in inverted U’s.
What does this show?
distended small bowel loops
bowel wall b/w loops is thickened and edematous (large white arrow)
No air is seen in the colon or rectum
What does this show?
complete colonic obstrucion
obstructing carcinoma in descending left colon = proximal air-fluid levels
absence of air distally in the rectum or sigmoid = complete obstruction
ileocecal valve is competent so there is no small bowel air
What does the following show?
ileus: air throughout: small and large bowel look “the same”
What does the following show?
Label A-D
Post-operative ileus
A: massive gastric distention
B: distended small bowel loops
C: air in colon & mild dilatation of sigmoid colon
D: Haustral fold in apex of sigmoid colon
What does this show?
sickle-shaped free air on both sides under the diaphragm
What do you see?
free air of large quantity
supine view
white arrows: crescents of air seen beneath each hemidiaphragm
blue arrows: both sides of the bowel wall are visible
What is this showing?
Intussusception
A loop of bowel has slipped into another section of bowel = swelling, decreased blood flow, obstruction & tissue damage.
Requires emergency treatment (barium enema or surgery).
What are the risks/complications of abdominal x-rays?
contraindicated in pregnancy
Describe fluoroscopy
“x-ray movie”
Continuous x-ray is passed through the body part, & the image is transferred to a monitor
What parts of the GI tract is the esophagram used for?
aka barium swallow
throat & esophagus only
What are the 3 components of the UGI series?
Fluoroscopy
Esophagram
small bowel follow-through
UGI series is indicated for…
–Dysphagia, Dyspepsia
–GERD symptoms
–Early satiety
–Suspected PUD
–Suspected obstruction / inflammation
What 7 things could the UGI series detect?
- Hiatal Hernia
- Cancer
- Ulcers
- Diverticula
- Benign Tumors
- Extrinsic compression
- perforation
What would the UGI series show that would indicate possible cancer?
filing defect
What is a filling defect?
displacement of contrast medium by a space-occupying lesion in a radiographic study of a contrast-filled hollow viscus
What do you use specifically for a perforation?
water-soluble gastrografin
Which test is being done here?
esophagram
What is this showing?
small hiatal hernia
What does this show?
gastric ulcer
red arrow: neck of ulcer
blue arrow: ulcer mound
What does this show?
LARGE FILLING DEFECT
Bezoar in mentally disturbed 14 yo girl who ate her own hair.
large filling defect in most of stomach with barium mixed in within the interstices of the mass. A delayed film would show the barium remaining in the bezoar while exiting the rest of the stomach
4 Contraindications of UGI series
- pregnancy
- complete bowel obstruction
- suspected upper GI perforation (use water-solublegastrografin (meglumine diatrizoate- NOT BARIUM))
- unstable vitals
Potential complications of UGI series
aspiration
constipation or partial obstruction
When is a Barium enema indicated?
alternative to colonscopy
when pt cannot do a colonoscopy
May be therapeutic to reduce a non-strangulated ileocolic intussusception
What will a barium enema show in the case of IBD?
Narrowing of the barium column due to inflammation surrounding colon
What are the 7 main findings you can see through a barium enema?
IBD
Cancer
Ulcers
Diverticula
Benign Tumors
Extrinsic Compression
Perforation
What is this showing?
Barium Enema
What type of diagnostic tool is being used here and to show what?
Barium enema
“apple core” adenocarcinoma
Barium enema Contraindications
Pregnancy (unless benefits outweigh risks)
Megacolon
Suspected perforation (use Gastrografin NOT barium)
Unstable vitals
Complications of Barium enema
perforation
barium fecal impaction
