GI Imaging Flashcards
What are the advanatages of abdominal xrays?
5
- Plain abdominal x-rays are readily available
- Often used for urgent investigation
- Does show gas in abnormal places or abnormal amounts
- Can show stones and metallic foreign bodies well
—Kidney and gall bladder stones
- Solid organs can be seen but not well
What kind of xrays may you need for abdominal views?
2
What do you get better imaging with?
2
May need upright and lateral decubitus films as well as flat plates
Better imaging with CT or ultrasound
Abdominal xray
Indications 5
Not indicated for 3
Indications
- Suspected bowel obstruction/Perforation
- Suspected intussusception
- Foreign bodies
- Suspected abdominal mass
- Blunt abdominal trauma
Not indicated
- Vague central abdominal pain
- Gastroenteritis
- Haematemesis
Interpretation
Determine ownership, adequacy, and technical quality of the film
THEN?
3
- Gases
- Abdominal findings
- Solid organs (liver, kidneys, spleen, psoas muscles, bladder)
What are we looking for with gases in general?
Normal and abnormal gas distribution
What are we looking for with gas in the small bowel?
(normal findings 4)
- Intraluminal gas usually minimal
- Centrally located
- Numerous tight loops of small diameter (2.5-3.5cm)
- Valvulae conniventes (Stack of coins)
What are we looking for with gases in the large bowel?
(normal findings 3)
- Mixture of gas and feces
- Loops are larger in diameter (3-5cm)
- Haustra
What are abnormal findings in gas patterns?
5
- Dilated loops
- Air-fluid levels on erect film
- Intramural gas
- Intraperitoneal gas
- Extraperitoneal gas
- What is the large area in the RUQ of the xray?
- Its bulk prevents what in this area?
- liver
- any bowel occupying this area
What is the soft tissue in the LUQ, size of a fist?
spleen
Can be seen, obscured, or not at all
Kidney shape?
Which is higher than the other?
What size?
Bean shaped
Left higher than right
About 3 vertebrae in size
Explain where you will find the psoas muscles on the xray?
Forms straight lines extending inferolaterally from lumbar spine to lesser trochanter of femur
Bladder appears how on the xray?
If full appears as soft tissue density in pelvis
Normal Gas Pattern
See picture
What is these xrays showing?
What symtpoms does he have from this pathology? 3
SMALL BOWEL OBSTRUCTION
TWO PATIENTS WITH
- ABDOMINAL DISTENSION,
- CRAMPY MID-ABDOMINAL PAIN
- VOMITING
What are these two xrays showing?
What symptoms come with this pathology? 3
LARGE BOWEL OBSTRUCTION
TWO PATIENTS WITH
- ABDOMINAL DISTENSION.
- LOWER ABDOMINAL PAIN, AND
- CONSTIPATION
What are these two xrays showing?
Often occurs when?
Ileus
After surgery
What are these xrays showing?
Constipation (full of stuff/stool)
What are these xrays showing
1?
2?
- Calcified gallbladder
- Kidney stones
Abdominal organs
Find the Foreign Body!
- Upper GI series aka?
- Uses what tools?
- What are the two types?
- What does it look at? 3
- Also called a barium swallow
- Uses plain film x-ray and fluoroscopy
- 2 types
- Standard barium upper GI series
- Double-contrast upper GI series - Looks at the
- esophagus,
- stomach, and
- duodenum