GI Radiology

Question 1

When can you sometimes see big pockets of air in the GIT?

Answer 1

If there is an obstruction then chyme and gases are going to accumulate proximal and then the air will rise

Question 2

Pathology?

Answer 2

Blockage in the intestine which shows that the patient is upright

Question 3

What does the orientation left lateral decubitus mean?

Answer 3

Left side of body on the table

Question 4

What does KUB mean?

Answer 4

Abdominal X-ray

Question 5

What is abdominal ultrasound used to see?

Answer 5

1. Gallbladder
2. Appendix

Question 6

What is this?

Answer 6

Gallbladder with gallstones

Question 7

What would MRI be used for?

Answer 7

Very expensive, but can be used for decreasing exposure to radiation when repeat abdominal imaging is required

Question 8

What 2 contrasts are using in CTs?

Answer 8

1. IV
2. Enteral

Question 9

What is this?

Answer 9

Contrast used to diagnose cancer in the liver

Question 10

Label.

Answer 10

Question 11

Answer 11

Question 12

Which is more superior: splenic artery or vein? Levels?

Answer 12

Splenic artery: T11

Question 13

Answer 13

Question 14

Which is more anterior: portal vein or IVC?

Answer 14

Portal vein

Question 15

Answer 15

Question 16

When I can see the spleen and the pancreas, but no kidneys, which aortic unpaired branch can I see?

Answer 16

Celiac trunk

Question 17

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?

Answer 17

SMA

Question 18

Can you see the portal vein at the level of the SMA?

Answer 18

Not really

Question 19

Answer 19

Question 20

Answer 20

Question 21

What 2 structures go between the aorta and SMA?

Answer 21

Left renal vein and 3rd duodenum

Question 22

Answer 22

Question 23

Which appear larger on CTs: arteries or veins?

Answer 23

Veins

Question 24

Answer 24

Question 25

Answer 25

Question 26

Do the colon haustra span the whole diamter?

Answer 26

NOPE

Question 27

If it has air in it…

Answer 27

It’s the intestine!

Question 28

List X-ray densities in order.

Answer 28

1. Metal or contrast
2. Bone
3. Soft tissue
4. Fat
5. Air

Question 29

Can loops of bowel that do not contain air be evaluated on plain film?

Answer 29

NOPE

Question 30

What does this show?

Answer 30

Plicae circularis of small intestine that span the whole diameter

Question 31

What does this show?

Answer 31

Haustra that do NOT span the whole diameter of the large intestine

Question 32

What can free air be due to in the abdomen?

Answer 32

1. Trauma (ie blunt force in a car accident leads to injury to the bowel wall à free air)
2. Chronic GI ulcer that eventually erodes through the entire bowel wall

Question 33

Answer 33

NORMAL

Question 34

Answer 34

Pneumoperitoneum

UPRIGHT

Question 35

Answer 35

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.

Question 36

Answer 36

Left lateral decubitus, easier to see free air if the patient is too sick to stand upright

Question 37

Answer 37

Pneumoperitoneum

Supine lateral

Question 38

Answer 38

Pneumoperitoneum

Question 39

Answer 39

Pneumoperitoneum

Question 40

How to recognize pneumoperitoneum?

Answer 40

When air accumulates around the liver