GI Imaging

Question 1

what is abdominal distension

Answer 1

bowel gas or fluid accumulate in the abdomen

Question 2

tests for abdominal distension - bowel source suspected

Answer 2

AXR

CT - delineate cause

Question 3

findings on AXR for abdominal distension

Answer 3

small/large bowel obstruction or ileus

Question 4

tests for abdominal distension - fluid source suspected

Answer 4

ultrasound

Question 5

findings on ultrasound for abdominal distension

Answer 5

may determine underlying cause

Question 6

underlying causes for abdominal distension

Answer 6

liver disease
metastases
peritoneal masses
ascites

Question 7

tests for haematemesis

Answer 7

endoscopy - first line
CT with IV contrast
+/- angiography

Question 8

positives for endoscopy

Answer 8

allows intervention/biopsy

Question 9

negatives for endoscopy

Answer 9

invasive

Question 10

causes of haematemesis

Answer 10

tumour
inflammation
trauma
vascular changes (variceS)

Question 11

tests for acute lower GI bleeding

Answer 11

same as for upper GI bleeding;
endoscopy - first line
CT with IV contrast
+/- angiography

Question 12

causes of dysphagia

Answer 12

inflammation
tumour
extrinsic compression
bengin lesion

Question 13

tests for dysphagia

Answer 13

endoscopy

fluoroscopic studies

Question 14

findings of fluoroscopic studies in dysphagia

Answer 14

functional and anatomical/pathological information

Question 15

tests for change in bowel habit

Answer 15

barium enema

CT virtual colonography (alternative)

Question 16

positives for barium enema

Answer 16

quick
in-expensive
widely available

Question 17

negatives for barium enema

Answer 17

misses cancer

Question 18

negatives for CT virtual colonography

Answer 18

less available
more expensive
higher dose

Question 19

tests for suspected IBD

Answer 19

endoscopy

small bowel MRI (Crohn’s only)

Question 20

tests for suspected small bowel disease (IBD)

Answer 20

fluoroscopic contrast studies - particular investigation of terminal ileum !

Question 21

findings of fluoroscopic contract studies in small bowel disease (IBD)

Answer 21

strictures
wall thickening
fistulation

Question 22

tests to detect if IBD is active

Answer 22

radio-labelled white cell scan - abnormal uptake on early and late scans localised with SPECT-CT

Question 23

tests for jaundice

Answer 23

ultrasound - first line
MRCP +/- ERCP
CT
blood tests (virology and immunology)

Question 24

what do radiological tests determine in jaundice

Answer 24

hepatic causes

post-hepatic causes

Question 25

findings in ultrasound in jaundice

Answer 25

dilated inta and/or extra-hepatic biliary tree

less reliable at identifying cause