Imaging the GI tract and GI diseases Flashcards
What is required to complement radiological investigations
Blood Tests
What is the first line investigation for cholecystitis
Ultrasound
What exacerbates cholecystitis
Eating
What are the risks of having an ERCP
Pancreatitis
How do patients normally present with pancreatitis
Epigastric / diffuse abdominal pain
What is raised in pancreatitis
Amylase
Why might an ultrasound be useful in pancreatitis
To investigate whether gall stones have caused it
What are complications of pancreatitis
Necrosis
Pseudocysts
Intra-abdominal collections
Vascular complications
What is the purpose of imaging in pancreatits
To evaluate the complications
When is imaging best performed following the onset of symptoms?
1 week
What is the first line investigation for a perforation
Erect chest Xray
Why do we need an erect chest x ray
To allow us to see if there is air under the diaphragm
What do we need to rule out in females with suspected appendicitis
Gynaecological pathology
What are the first line investigations for appendicitis
Ulstrasound - confirms the diagnosis and allows us to find an alternative cause
Where is diverticulitis classically
In the LIF
Where is diverticulitis classically
In the LIF
What are 2 associations with diverticulitis
Diarrhoea
PR bleeding
What is diverticulitis
Inflammation associated with diverticular disease
What is a main investigation for diverticulitis
CT - shows inflammatory change and associated complications
What are 2 non GI causes
Urological or vascular
Where does vascular pain radiate to
The back
What are 2 causes of distended abdomen
Bowel gas and fluid
What is the first line investigation for a suspected bowel source
AXR
What is an Ileus?
Like an obstruction - the bowels are really irritated and there is a lot more gas than there should be.
Often occurs after surgery
What other investigations for an obstruction
CT
What are 4 causes of haematemesis
Tumour
Inflammation
Trauma
Vascular causes (varices)
What is the first line investigation for haematemesis
Endoscopy
What is the first line investigation for haematemesis
Endoscopy
When do we do a CT contrast for a patient with haematemesis
When they are still bleeding
What is the first line investigation for dysphagia
Endoscopy
What is the radiological investigation for a change in bowel habit?
Barium enema or CT virtual colonography
What are the benefits of a barium enema
Quick
Inexpensive
Widely available
What is the main disadvantage of a barium enema
You can miss up to 1 in 5 cancers
What are the two investigations for suspected Inflammatory Bowel disease
Endoscopy or a barium meal
What is the most important part to look at
The terminal ileum
When is a small bowel MRI used?
In known cases of small bowel Crohn’s or Large bowel Crohn’s with suspected small bowel involvement
What can a radio-labelled white cell scan localise
Active inflammation
What is a type of hepatic jaundice
Hepatitis
What is a cause of post hepatic jaundice
Gall stones
What is the purpose of radiological investigations in jaundice?
To determine whether it is hepatic or post hepatic causes
What is the first line investigation for jaundice
Ultrasound
What further investigations for jaundice may be required
MRCP or ERCP
What is typically seen on an Ultrasound of liver metastases
Darker circles
