Imaging of the GI tract Flashcards
What is the first line investigation in cholecystitis/biliary colic?
What can further clarification be gained with?
USS
MRCP/ERCP
What is the main purpose of imaging in pancreatitis?
Which imaging techniques are useful for this?
To evaluate complications
CT
What is the first line investigation when perforation is suspected?
What scan may help find the source of the perforation?
What else might it help find?
Erect CXR
CT might help find the source and show further features such as intra-peritoneal collections
What other pathology should be considered in females who present with appendicitis like symptoms?
Gynaecological pathology
What is the first line investigation for appendicitis?
USS
What investigation should be used for diverticulitis?
What does this scan show?
CT scan
It shows inflammatory change and associated complications
What is the first line investigation if the bowel is the suspected cause of a distended abdomen?
What investigation may help delineate the cause of an obstruction?
AXR to determine where the obstruction is.
CT may help delineate the cause
What is the first line investigation if fluid is suspected as the cause of a distended abdomen?
USS
What is the main investigation for haematemesis?
How can imaging be used to complement this?
What is the protocol for lower GI bleeding?
Endoscopy.
image WHEN bleeding
- CT with IV contrast, NO oral contrast
- +/- angiography & intervention
Same protocol for lower GI bleeding
How is dysphagia investigated?
Endoscopy
Fluoroscopic studies also assess oesophagus
Barium or water soluble contrast
FUNCTIONAL as well as ANATOMICAL / PATHOLOGICAL information
What radiological investigations can be used to investigate change in bowel habit?
Barium enema or CT virtual Colonography
Often to complete visualisation of RIGHT colon further to Flexible Sigmoidoscopy
Why is Barium enema a dying art?
It can miss 1 in 5 cancers
How is suspected IBD investigated?
Endoscopy Fluoroscopic contrast studies if small bowel disease suspected: Strictures Wall thickening Fistulation
How might known IBD be investigated?
Small Bowel MRI for use in known cases of small bowel Crohn’s or Large bowel Crohn’s with suspected small bowel involvement
Radio-labelled White Cell Scan can localise active inflammation to see if the disease is active
What is the purpose of radiological investigation in jaundice?
to determine HEPATIC vs POST-HEPATIC causes
