GI Imaging Flashcards
Right upper quadrant pain, often exacerbated by eating +/- deranged LFTs suggests what?
Cholecystitis/ Biliary colic
What is the first line investigation for cholecystitis/biliary colic?
Ultrasound
Following ultrasound, what test would give you further clarification about cholecystitis/gallstones?
MRCP +/or ERCP
What is epigastric/diffuse abdominal pain with an elevated serum amylase likely to be?
Acute pancreatitis
What test can be used first line in acute pancreatitis and why?
Ultrasound- to look for gallstones and or biliary obstruction
What is the main purpose of imaging in pancreatitis?
Evaluate complications
When are investigations for pancreatitis complications best done?
Around 1 week following onset of symptoms
What is the first line investigation for a suspected perforation?
Erect CXR
What would you be looking for in an erect CXR of suspected perforation?
Free subphrenic gas
What is the send test you would do for perforation?
CT
What is central abdominal pain, later associated with localised RIF pain, with slight fever and raised inflammatory markers suggestive of?
Appendicitis
What should be a differential diagnosis of appendicitis in women?
Gynaecological pathology
What is the first line investigation for suspected appendicitis?
Ultrasound
What is lower abdominal pain, classically LIF with associated diarrhoea and maybe PR bleeding with elevated inflammatory markers suggestive of?
Diverticulitis
What is the initial investigation of diverticulitis?
CT
What is a sudden onset back pain and associated hypotension likely to be?
Ruptured AAA
What is the first line investigation for a distended abdomen with a suspected bowel source?
AXR
What will a small bowel obstruction show on AXR?
Dilated small bowel loops
What will a large bowel obstruction show on AXR?
Dilated large bowel loops and no gas in rectum
What is the second test to do for a distended abdomen after AXR?
CT
What test should be done if it is fluid that is suggested to be causing distension i.e. ascites?
Ultrasound
Where can haematemesis arise from?
Oesophagus, stomach or duodenum
What are possible cause of haematemesis?
Tumour, inflammation, trauma, vascular cause i.e. varices
What is the first line test for haematemesis?
Endoscopy
What are the advantages of using an endoscopy for haematemesis?
Allows intervention or biopsy
What test should be done after endoscopy for acute GI bleeding and when?
CT while still bleeding
Should the CT for acute upper GI bleed be done with contrast? If so, what kind?
Yes, IV- not oral
What is a third line test/management which can be used for acute upper GI bleed?
Angiography and intervention
Is the protocol the same for an upper and lower acute GI bleed with regards to radiological tests?
Yes
What is the first line investigation for dysphagia?
Endoscopy
What less common tests can be used to assess the oesophagus?
Fluoroscopic studies- barium or water soluble contrast
What are radiological investigations for change in bowel habit?
Barium enema or CT virtual colonography
What further test is used to assess the right colon?
Flexible sigmoidoscopy
What is the first line investigation for inflammatory bowel disease?
Endoscopy
What test is used is a small bowel disease is suspected to have caused a change in bowel habit?
Fluoroscopic contrast studies
What is a useful test for Crohn’s with known or suspected small bowel involvement?
Small bowel MRI
What can a radio-labelled white cell scan do?
Localise active inflammation
What is the purpose of investigations for jaundice?
Too determine if intra or post hepatic
What is the first line investigation for jaundice?
Ultrasound
What is the second line test for jaundice?
MRCP or ERCP
What can be done at the time of ERCP?
Removal or stents
If there is suspected mets on ultrasound of liver, what should be the next test?
CT
