Imaging Studies for GI Disorders Flashcards
Mild or transient heartburn
Medical therapy, no imaging required
Esophageal obstruction
Barium swallow
Esophageal tear
Gastrografin swallow
Hematemesis
Endoscopy
Bowel perforation
• Upright chest and supine abdominal plain film
• If patient unable to stand; supine and left
lateral decubitus
Gastric or duodenal ulcer
- Test for H. pylori; medical therapy
* If no improvement, endoscopy
Trauma; blunt or penetrating
Supine/upright abdomen and CT with contrast
Pancreatitis
Ultrasound, nuclear medicine hepatobiliary
scan
Jaundice
- Painful
- Ultrasound, ERCP
- Painless; suspect biliary obstruction
- MRCP or ERCP
- Painless; suspect liver
- Ultrasound
Intestinal obstruction
Supine and upright film of abdomen
Esophagus or stomach obstruction
Upper GI and small bowel series or endoscopy
Small bowel obstruction
CT w/ oral contrast
Distal small bowel or colon obstruction
Barium enema
RLQ Pain
- Supine and upright film of abdomen
* CT with oral and IV contrast
Appendicitis
- Ultrasound
* CT with IV contrast (consider oral contrast)
Abdominal tumor
MRI
Ischemic colitis (without peritonitis)
- Plain radiograph, three-way view of abdomen
* Then colonoscopy or contrast enema
Abdominal abscess
- Supine and upright film of abdomen
* CT with oral and IV contrast
Colon cancer
Colonoscopy
Abdominal trauma
CT w/ IV contrast
Acute diverticulitis
Plain film, CT with oral, rectal, and IV contrast
Positive FOBT
> 40yo: colonoscopy/barium enema
<40yo w/ GI sx: H. pylori test, therapeutic trial; if fails, endoscopy or
UGI series
