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Gastrointestinal > Imaging Of The GI System > Flashcards

Imaging Of The GI System Flashcards

1
Q

What is the ABDO X approach to an abdominal x ray?

A

ABDO X

  • Air
  • Bowel
  • Dense structures + calcifications
  • Organs + soft tissues
  • external objects, lines + tubes
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2
Q

How do you differentiate between the small + large bowel on an abdominal x ray?

A

small bowel: central | valvulae conniventes | contains air or fluid
large bowel: peripheral | haustral folds | contains air or faeces

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3
Q

Reasons for requesting abdominal x ray

A
  • position of iatrogenic items
  • forgein objects
  • confirm ureteric stone identified on CT
  • specialist cases

US or CT preferred as first line

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4
Q

Where should you see air in an abdominal x ray?

A
  • should only be within the bowel (intramural)
  • not within the perioneal space (extramural) | pneumoperitoneum
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5
Q

What is pneumoperitoneum?

A

Air within the peritoneal cavity
abnormal

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6
Q

What is Rigler’s sign?

A
  • Bowel wall crisply + clearly defined due to gas on both sides
  • Seen in pneumoperitoneum on AXR
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7
Q

What imaging is best to detect pneumoperitoneum?

A

CT

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8
Q

Features of small bowel on AXR

A
  • Central
  • Valvulae conniventes (lines across whole diameter)
  • Contains air or fluid
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9
Q

Features of large bowel on AXR

A
  • peripheral
  • haustral folds
  • contains air or faeces
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10
Q

What is seen in sigmoid volvulus on AXR?

A
  • coffee bean sign
  • large gas filled viscus from pelvis + epigastrium
  • normal positioned caecum
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11
Q

What is seen in caecal volvulus on AXR?

A
  • Reverse C shaped viscus on right side ‘fetal appearance’
  • Normal sigmoid
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12
Q

What does oedematous bowel wall indicate on AXR?
What sign shows this?

A

Inflammatory bowel disease
e.g. crohn’s, ulcerative colitis
Thumb printing

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13
Q

What is seen in inflammatory bowel disease on AXR?

A
  • thumb printing sign: mucosa thickening of haustra due to inflammation + oedema
  • lead pipe colon: loss of haustral markings
  • toxic megacolon: colonic dilation, oedema + pseudopolyps
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14
Q

What does a coffee bean sign on AXR indicate?

A

Sigmoid voluvus

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15
Q

What does thumb printing sign on AXR indicate?

A

Irritable bowel disease
Bowel wall oedema

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16
Q

What do you look for for A on ADBO X?

A

air

  • pneumoperitoneum
  • rigler sign: bowel wall crisply + cleared defined
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17
Q

What do you look for on B of ABDO X?

A

Bowel

  • sigmoid volvulus: coffee bean sign
  • caecal volvulus: fetal
18
Q

What is achalasia?

A

Impaired relaxation of lower oesophageal sphincter

19
Q

Symptoms of achalasia

A
  • weight loss
  • halitosis (bad breath)
20
Q

What is used to investigate + image achalasia?
What sign is seen?

A
  • X ray
  • Barium swallow + fluoroscopy
    .
  • Bird beak structure of distal oesophagus
21
Q

What are the upper limits for the normal diameter of:
- small bowel
- colon
- caecum

A
  • small bowel: 3cm
  • colon: 6cm
  • caecum 9cm

3/6/9 rule

22
Q

What is seen on a AXR in small bowel obstruction?

A
  • dilatation of small bowel >3cm
  • coiled spring appearance
  • inspect inguinal region for hernias
23
Q

Causes of pneumoperitoneum

A

Bowel perforation
Perforated duodenal ulcer
Recent abdominal surgery

24
Q

Standard imaging for colon cancer if patient has been diagnosed already

A

CT

25
Q

Standard diagnostic imaging for colon cancer

A

CT colonogram

26
Q

Imaging of rectal cancer

A

MRI
for staging + follow up

27
Q

Imaging for Crohn’s disease

A

CT for acute abdomen
MRI for diagnosis + follow up

28
Q

What does pneumoperitoneum look liked on erect chest X ray?

A

Free gas under diaphragm
Space between liver + diaphragm

29
Q

What is a barium swallow used to test?

A

Pharynx
Oesophagus
Proximal stomach

30
Q

Outline a barium enema

A
  • tube is inserted into rectum to visualise large intestines
  • barium administered
  • results are monitored using fluoroscopy
31
Q

How can you visualise the vasculature associated with the GI system?

A

Angiogram

32
Q

Methods of imaging the GI tract

A

X rays
Contrast studies
Ultrasound
CT
MRI
Angiography

33
Q

How can bowel perforation be determined using imaging?

A

Erect CXR
Free gas under diaphragm

34
Q

Features of toxic mega colon on AXR

A

colonic dilation
oedema
pseudopolyps

35
Q

Pros and cons of abdominal ultrasound

A

Cheap
Portable
No radiation
.
User dependant

36
Q

Pros and cons of abdominal MRI

A

Detailed
No radiation
High contrast image
.
Time consuming
Issue with claustrophobia

37
Q

GI features at T12 in CT scan

A

Liver
Stomach
Spleen
IVC
Aorta + coeliac trunk
T12 vertebra
(Kidneys?)

38
Q

GI features at L1 in CT scan

A

Liver
Stomach
Spleen
Pancreas
IVC
Aorta + SMA
Both kidneys
L1 vertebra

39
Q

GI features at L3 on CT scan

A

Liver
Aorta + IMA
IVC
Colon
Small intestines
Psoas major muscles
L3 vertebra

40
Q

GI features at L4 on CT scan

A

Iliac crest
Bifurcation of abdominal aorta

Gastrointestinal (28 decks)

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