Imaging Studies for GI Disorders

Question 1

Mild or transient heartburn

Answer 1

Medical therapy, no imaging required

Question 2

Esophageal obstruction

Answer 2

Barium swallow

Question 3

Esophageal tear

Answer 3

Gastrografin swallow

Question 4

Hematemesis

Answer 4

Endoscopy

Question 5

Bowel perforation

Answer 5

• Upright chest and supine abdominal plain film
• If patient unable to stand; supine and left
lateral decubitus

Question 6

Gastric or duodenal ulcer

Answer 6

• Test for H. pylori; medical therapy

* If no improvement, endoscopy

Question 7

Trauma; blunt or penetrating

Answer 7

Supine/upright abdomen and CT with contrast

Question 8

Pancreatitis

Answer 8

Ultrasound, nuclear medicine hepatobiliary

scan

Question 9

Jaundice

Answer 9

• Painful
• Ultrasound, ERCP
• Painless; suspect biliary obstruction
• MRCP or ERCP
• Painless; suspect liver
• Ultrasound

Question 10

Intestinal obstruction

Answer 10

Supine and upright film of abdomen

Question 11

Esophagus or stomach obstruction

Answer 11

Upper GI and small bowel series or endoscopy

Question 12

Small bowel obstruction

Answer 12

CT w/ oral contrast

Question 13

Distal small bowel or colon obstruction

Answer 13

Barium enema

Question 14

RLQ Pain

Answer 14

• Supine and upright film of abdomen

* CT with oral and IV contrast

Question 15

Appendicitis

Answer 15

• Ultrasound

* CT with IV contrast (consider oral contrast)

Question 16

Abdominal tumor

Answer 16

MRI

Question 17

Ischemic colitis (without peritonitis)

Answer 17

• Plain radiograph, three-way view of abdomen

* Then colonoscopy or contrast enema

Question 18

Abdominal abscess

Answer 18

• Supine and upright film of abdomen

* CT with oral and IV contrast

Question 19

Colon cancer

Answer 19

Colonoscopy

Question 20

Abdominal trauma

Answer 20

CT w/ IV contrast

Question 21

Acute diverticulitis

Answer 21

Plain film, CT with oral, rectal, and IV contrast

Question 22

Positive FOBT

Answer 22

> 40yo: colonoscopy/barium enema

<40yo w/ GI sx: H. pylori test, therapeutic trial; if fails, endoscopy or
UGI series