Session 10 - Part II

Question 1

What are the different ways of imaging the GIT?

Answer 1

CT & MRI
Ultrasound
X- Ray
Contrast studies
Angiography

Question 2

What are the types of Contrast studies?

Answer 2

Barium tests insoluble (Swallow. follow through & Enema)

Iodine based water soluble

Question 3

What is Angiography useful for?

Answer 3

Ischaemia blockages

Question 4

What is Lead pipe colon?

Answer 4

An appearance of the colon on x ray due to long term Inflammatory bowel disease eg Ulcerative colitis and Crohns disease

Question 5

What are the benefits of Ultrasound?

Answer 5

Cheap
No radiation
Portable

Question 6

How can you tell there has been a perforation on x ray?

Answer 6

There will be gas in the Peritoneal cavity (Needs to be an erect x ray to allow the air to settle)

Question 7

What can cause perforations?

Answer 7

Peptic ulcers
Trauma
Diverticulum

Question 8

What is a Diverticulum?

Answer 8

Outpouching of a hollow (or a fluid-filled) structure in the body

Question 9

What do calcifications look like on x ray?

Answer 9

White

Question 10

How would patients present with an Aortic aneurysm?

Answer 10

Pain that radiates fully to the back

Question 11

When would you x ray the abdomen?

Answer 11

If looking for something specific due to the radiation risks eg renal colic looking for stones
Exacerbation of IBS

Question 12

What markings on the large bowel would you see on an x ray?

Answer 12

The Haustra (Lines on the large bowel that do not pass all the way across)

Question 13

In what direction are x rays usually taken?

Answer 13

Anterior to Posterior

Except for when looking at the heart size due to shadowing

Question 14

What marking on the small bowel would you see on x ray?

Answer 14

Valvulae conniventes (mucosal folds that cross the full width of the bowel)

Question 15

What would you see in a Toxic megacolon gas pattern?

Answer 15

Pseupolyps due to oedema

Expansion of the bowel

Question 16

What would you see in a Volvulus gas pattern?

Answer 16

Necrosis due to lack of blood supply
Perforation peritonitis
Sigmoid colon most likely to twist on its mesentery –> coffee bean sign (Very dilated sigmoid colon)

Question 17

What size is the large bowel when it is obstructed?

Answer 17

> 6 cm dilated due to more gas in bowel

Question 18

What size is the small bowel when it is obstructed?

Answer 18

> 3 cm dilated due to more gas in bowl

Question 19

What are the symptoms of a small bowel obstruction?

Answer 19

Vomiting then constipation

Question 20

What are the symptoms of a large bowel obstruction?

Answer 20

Constipation

Motility issues, especially with peristalsis

Question 21

What colour is Barium on x ray?

Answer 21

White

Question 22

When would you use a Barium enema?

Answer 22

To see diverticular and out pouches

Question 23

Where is a Barium enema distributed?

Answer 23

Per rectum

Question 24

When is a Barium follow through used?

Answer 24

When you want to see the upper GIT past the Duodenum

Question 25

When is a Barium swallow used?

Answer 25

When you want to see the Oesophagus

Question 26

At what level does the Aorta biforcate?

Answer 26

L4

Question 27

What are the disadvantages of an MRI?

Answer 27

Time consuming
The patient must lie still for a long time
Not suitable for a patient with metallic things in them eg pacemaker, some tattoo inks