GI Radiology Flashcards
When can you sometimes see big pockets of air in the GIT?
If there is an obstruction then chyme and gases are going to accumulate proximal and then the air will rise
Pathology?
Blockage in the intestine which shows that the patient is upright
What does the orientation left lateral decubitus mean?
Left side of body on the table
What does KUB mean?
Abdominal X-ray
What is abdominal ultrasound used to see?
- Gallbladder
- Appendix
What is this?
Gallbladder with gallstones
What would MRI be used for?
Very expensive, but can be used for decreasing exposure to radiation when repeat abdominal imaging is required
What 2 contrasts are using in CTs?
- IV
- Enteral
What is this?
Contrast used to diagnose cancer in the liver
Label.
Which is more superior: splenic artery or vein? Levels?
Splenic artery: T11
Which is more anterior: portal vein or IVC?
Portal vein
When I can see the spleen and the pancreas, but no kidneys, which aortic unpaired branch can I see?
Celiac trunk
When I can see both kidneys, no pancreas, and a think slice of the spleen, what unpaired branch of the aorta am I looking at?
SMA
Can you see the portal vein at the level of the SMA?
Not really
What 2 structures go between the aorta and SMA?
Left renal vein and 3rd duodenum
Which appear larger on CTs: arteries or veins?
Veins
Do the colon haustra span the whole diamter?
NOPE
If it has air in it…
It’s the intestine!
List X-ray densities in order.
- Metal or contrast
- Bone
- Soft tissue
- Fat
- Air
Can loops of bowel that do not contain air be evaluated on plain film?
NOPE
What does this show?
Plicae circularis of small intestine that span the whole diameter
What does this show?
Haustra that do NOT span the whole diameter of the large intestine
What can free air be due to in the abdomen?
- Trauma (ie blunt force in a car accident leads to injury to the bowel wall à free air)
- Chronic GI ulcer that eventually erodes through the entire bowel wall
NORMAL
Pneumoperitoneum
UPRIGHT
Pneumoperitoneum
SUPINE: air rises to the center of the abdomen
Here, there is hyper-lucency around the bowel in the center of the image. There is easy visibility of the outside wall of some bowel loops, and this indicates that outside wall is outlined by air. Remember, the reason we can make out different structures on XR is because of different densities adjacent to each other.
Left lateral decubitus, easier to see free air if the patient is too sick to stand upright
Pneumoperitoneum
Supine lateral
Pneumoperitoneum
Pneumoperitoneum
How to recognize pneumoperitoneum?
When air accumulates around the liver
