GI imaging Flashcards
X-RAY
- types
- often used when?
- what can all be seen on this image?
- indications
Types:
- flat plate, upright, lateral decubitus,
- contrast studies: upper and lower GI fluoroscopy
- often used for urgent investigation
- What can all be seen: shows gas in abnormal places, stones, metallic FB, solid organs.
- indications:
- -suspected bowel obstruction/perforation
- -suspected intussusception
- -FB
- -suspected abdominal mass
- blunt abdominal trauma
Gas In the Bowel:
- characteristics of small bowel
- characteristics of large bowel
- abnormal findings
Small bowel:
- intraluminal gas usually minimal
- centrally located
- numerous tight loops of small diameter 2.5-3.5cm
- valvulae connivents (stacks of coins)
Large Bowel:
- mixture of gas and feces
- loops are larger in diameter (3-5cm)
- haustra
Abnormal findings:
- dilated loops
- air-fluid levels on ERECT film
- intramural gas
- intraperitoneal gas
- extraperitoneal gas
Upper GI series:
- aka
- what type of imagining is this??
- what are the 2 types?
- reserved fro looking at which organs?
- indications
- CI
- what are some indications for small bowel follow through?
aka: barium swallow
Type of image: plain film x-ray and fluoroscopy. “real time xray”
2 types:
- standard barium upper GI series
- Double-contrast upper GI serioes (air & barium)
Reserved for looking at: esophagus, stomach, and duodenum.
Indications:
- dysphagia
- GERD
- Assessment of Hiatal hernia
- strictures
- persistent vomiting
CI:
- intestinal obstruction
- esophageal perforation or if rupture is suspected
- pregnant women
- individuals with poor swallowing reflex
Indications for small bowel follow through;
- crohns
- tumors
- unexplained abd pain
Lower G Series
- aka
- reserved for looking at what organs?
- what are the 2 types?
- indications
- risks
aka: Barium enema
reserved for looking at the colon
2 Types:
- barium enema
- double contrast enema (Air & Contrast)
Indications:
- colon cancer (apple core lesion)
- dx/monitor UC or Crohns
- risks:
- pregnant women
- colon perforation
Abdominal CT
- indications
- used to examine what?
indications:
- stage and follow CA
- pts w/ jaundice
- pancreatic dz
- hepatic metastases
Used to examine the abd wall, localizes hernias
Hepatobiliary Scintigraphy
- aka
- uses?
- how does this work?
- indications
aka: HIDA SCAN/Cholescintigraphy
Uses:
-used in dx of probs with liver, gallbladder, or bile ducts
How this works:
-radio-isotope is taken up in the liver and secreted into the bile.
Indications:
- cholecystitis
- bile duct obstruction
- assessment for liver trasnplant.
Abd US:
- aka
- perks and downfalls of US
- preferred imaging for which quadrant?
aka: transabdominal ultrasound
Perks: rapid, no radiation, inexpensive
downfalls:
- hampered by fat, air
- operator dependent
- limited sensitivity
Preferred imaging for RUQ pain.
Endoscopy:
- aka
- used to visualize which organs?
- indications
- CI
aka: EGD; esophagogastroduodenoscopy
Used to visualize the esophagus and duodenum.
Indications:
- signs and sx of upper GI dz
- surveillance of upper GI cancer
- bx
CI:
- possible perforation
- medically unstable/unwilling pts
- anticoagulation
Capsule Endoscopy
- indications
- CI
- how does this work?
- why might this be used over endoscopy?
Indications:
- obscure GI bleeding
- IBD
- small bowel polyps and tumors
- celiac dz
CI:
- swallowing disorders
- small bowel obstruction/stenosis
How this works:
-pt swallows pill containing a camera
Used over endoscopy:
-parts of small bowel not reachable by endoscopy
Flexible Sigmoidoscopy
- pros and cons
- indications
- CI
Pros:
- done in the office
- inexpensive and cost-effective
- easier bowel prep and rarely needs sedation
Cons:
- detects only half of polyps
- misses 40-50% of cancers located beyond the view of sigmoidoscope
- often limited by discomfort
Indications:
- screening
- blood in stool
- eval of colon
- medical management of colitis
CI:
- bowel perforation
- acute diverticulitis
- active peritonitis
Colonoscopy:
- used to examine which organs?
- Complications
- indications
- CI
used to examin the rectum, colon, and distal ileum.
Complications: rare but can have bleeding, perforation with polypectomy.
Indications:
- screening at age 50 YO
- evaluation
- follow up colorectal CA
CI:
- pregnancy
- relative CI:
- -colonic perforation
- -toxic megacolon
- -IBD w/ ulceration
Endoscopic Retrograde Cholangiopancreatography (ERCP)
- what type of imaging is this?
- how does this work?
- indications
- CI
Type of imaging:
-combo of luminal endoscopy and fluorscopic imaging
How this works:
-endoscope insserted through mouth into duodenum, dye injected through catheter into pancreatic or biliary ducts.
- Indications:
- -biliary dz: biliary obstruction, assessment and tx of duct strictures, choledocholithiasis (gallstone in common duct)
- -pancreatic dz; assess and tx acute pancreatitis, strictures, pancreatic stones, malignancies
CI
- refusal
- unstable cardiopulmonary, neurologic, or cardiovascular status
- existing bowel perforation
