GI week: abdominal xrays

Question 1

What 2 signs on chest or abdominal X-ray indicate perforated bowel

Answer 1

Football sign (pneumoperitoneum)

Air under diaphragm

Question 2

What non-dangerous condition may mimic pneumoperitoneum on a CXR?

Describe it.

Which patients does this phenomenon occur in

Answer 2

Chilaiditi’s sign

Interposition of colon/ small bowel between liver and diaphragm

Occurs in pts with small livers (cirrhosis) or hyperexpanded lungs (COPD)

Question 3

What does a sigmoid volvulus look like on AXR

Answer 3

Coffee bean sign at LIF

Question 4

2 most common types of volvulus

Answer 4

Sigmoid and Caecum

Question 5

What does a caecal volvulus look like on AXR

Answer 5

Small bowel in RIF while caecum has moved upwards

Question 6

Signs of inflammation on AXR (eg in UC)

Answer 6

• thumbprinting (thick haustral folds)

- lead pipe colon (loss of haustral markings)