Surgical and GI radiology Flashcards
How do you approach the AXR
A - airway
B - bone
C - caclium
D - density
How much air should be in
- small bwoel
- large bowel
- caecum
- small bowel = 3cm for small bowel
- large bowel = 6cm for large bowel
- caecum = 9cm for caecum
3/6/9 rule
what other organ in the abdomen also contains air/fluid
stomach
describe a small bowel on an AXR
- centrally located
- jejnum contains valvulae connivertes
- ileum is normally featureless
- goes the whole way acorss the lumen of the bowel
Describe large bowel on an AXR
- large bowel is generally peripheral
- large bowel contains haustra
What are valvulae conniventes
The valvulae conniventes, also known as Kerckring folds/valves, plicae circulares or just small bowel folds, are the mucosal folds of the small intestine, starting from the second part of the duodenum, they are large and thick at the jejunum and considerably decrease in size distally in the ileum to disappear entirely
What are the causes of small bowel obstruction
- Adynamic ileus (post surgical, sepsis, drugs)
- post surgical adhesions (4-6 weeks)
- malignancy
- volvolus
- intussusception (Iipomas, polyps)
if you have an obstruction of the large bowel everything up to that point is ..
dialted including the small bowel
What are the causes of large bowel obstruction
- Malignancy
- volvolus (sigmoid and caecal)
- post operative adhesions
- ileus (usually also involves small bowel)
What are the radiographic sing of bowels perforation
- Rigler’s sign - looks like a coffee bean
- falciform sign - can now see the ligament
- football sign
- continous hemi-diaphragm sign
What is the first thing you do if you think that the patient has perforation
- erect chest x ray - this is to check for continous hemi-diaphragm sign
What is the thumbprinting sign
if someone was to put there thumbs on either side of the bowel this is thumb printing of the bowel
What are the causes of thumbprinting sign
- ischaemic/inflammatory bowel diease
- pseudomembranous colitis
- diverticulitis
- lymphoma
- amyloid
- typhoid
What does thumb printing represent
diffuse oedema of the bowel
Where should you not have gas
- Within the billary tree
