GI Diagnostics- Coplan Flashcards
What are the 3-way views you can see on an abdominal x-ray
Ant/posterior view
Upright
PA Chest x-ray
What does the upright view best used to assess
What does a PA chest x-ray best used to assess?
Upright: better visualization of air-fluid levels (small bowel obstruction)
PA Chest x-ray: free air underneath hemidiaphragms & check chest pathology
What are dark areas on x-ray considered? What is an example
What are white areas on x-ray considered? What is an example?
Dark = radiolucent, permits penetration of x-ray
Air
White= radioopaque, blocks penetration of x-rays
Organ, bone tissue
Obstruction seen on xrays indicated what?
Dilated bowel PROXIMAL to obstruction with collapsed bowel DISTALLY
Air fluid levels
Small bowel obstructions have?
Large bowel obstructions have?
Small = conniventes
Large= haustrations
What would a paralytic ileus indicate on x-ray?
Dilated bowel
Gas in both small & large intestines
What would perforation look like on x-ray?
Free air outside the bowel
What is drank on a UGI series?
What views are seen after drinking this?
Patient drinks barium sulfate contrast & fluoroscopy
Visualizes:
- esophagus,
- stomach,
- 1st part of duodenum
What does a fluoscopy view considered? How does it work?
Fluoroscopy = “xray moview”
Continuous x-ray is passed through the body part, & the image is transferred to a monitor
What does an Esophogram show?
Throat & esophagus only
What does a Small bowel follow through look at?
Follows barium throughout the small bowel
A large filling defect is also known as what bizzare thing on x-ray?
Bezoar
What are contraindications for abdominal x-rays?
Pregnancy unless risk out weight benefits
What are contraindications towards using an Upper GI series (UGI)
Pregnancy (unless benefits outweigh risks) Complete bowel obstruction Suspected upper GI perforation Unstable vitals Potential complications
How is a Barium enema performed?
What body parts is it trying to view
Patient receives a “barium enema,” then fluroscopy used to visualize colon, distal small bowel (occasionally appendix)
What diseases can be found with a Barium enema?
Inflammatory Bowel Disease
Cancer
Ulcers
Diverticula
What does an apple core finding during barium enema indicate?
Adenocarcinoma
What are contraindications of a Barium Enema?
Pregnancy (unless benefits outweigh risks)
Megacolon
Suspected perforation (use Gastrografin NOT barium)
Unstable vitals
What contrast is ordered in suspect Perforation in a UGI series?
Use water-soluble Gastrografin
aka Leakage of barium outside of the UGI tract
What kind of ultrasound is ordered to assess blood flow?
DOPPLER U/S
What do dark areas vs light areas on Ultrasound?
Dark areas are echo free = hypoechoic
Eg. aorta, bile ducts, cysts
White areas are echogenic = solid
Eg. tumors
How is a HIDA scan performed?
Patient receives radionuclide injection
Radionuclide extracted by liver & excreted in to bile
Provides visualization of biliary tree
What is a suspected finding that would prompt you to order a HIDA scan?
Primary: indication is to diagnose suspected acalculous cholecystitis
Which type of imaging is ordered first, U/S or HIDA?
US generally ordered 1st,
HIDA scan done if US negative & clinical suspicion for cholecystitis persists
