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GI > Week 10 - GI Imaging > Flashcards

Week 10 - GI Imaging Flashcards

1
Q

When do you request an AXR

A 
Acute abdominal pain 
Small/large bowel obstruction
Acute exacerbation of IBD
Renal colic (1st line is CT)
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2
Q

ABC approach of an AXR

A

Air - bowel gas pattern
Bowel - and other soft tissue
Calcification - bones and stones

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3
Q

Describe the bowel gas pattern

A

Colon - slow transit as faeces and gas
Small bowel - fast transit as fluid
Stomach - medium transit as fluid and lots of gas

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4
Q

Dilation in obstruction of different parts of the GI tract

A

Small bowel obstruction if small bowel dilated >3cm

Large bowel obstruction if large bowel dilated >6cm or if caecum >9cm (competent ileoceacal valve)

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5
Q

AXR appearance of small bowel

A

Central
Valvulae conniventes across whole lumen
Often not visible

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6
Q

AXR appearance of large bowel

A

Peripheral
Haustra across part of lumen
‘Clouds’ of faeces and gas visible
Transverse colon hangs down to pelvis (longer in women)

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7
Q

Symptoms of small bowel obstruction

A

Early - vomiting, mild abdominal distension
Late - absolute constipation
Colicky pain every 2-3 mins

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8
Q

Causes of small bowel obstruction

A

Post op adhesions
Inguinal, femoral and incisional hernias
Tumours
Inflammation

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9
Q

Symptoms of large bowel obstruction

A

Early - absolute constipation, significant abdominal distension
Late - faeculant vomiting
Colicky pain every 10-15 mins

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10
Q

Causes of large bowel obstruction

A

Colorectal carcinoma (assume until disproven)
Hernias
Volvulus
Strictures

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11
Q

Types of volvulus

A

Sigmoid (common)

Caecal - if anatomical defect reducing caecum’s attachment to abdominal wall

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12
Q

Abnormalities that can be visualised with AXR

A 
Obstruction
Inflammation
Toxic megocolon
Lead pipe colon
Thumb printing 
Calcification
Foreign bodies e.g nasojejunal tube, colonic stent, ingested objects
Gall/Kidney stones
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13
Q

Appearance of inflammation on AXR

A

Mucosal thickening
Lead pipe colon
Bowel wall oedema

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14
Q

What is toxic mega colon and give some causes

A 
Colonic distension with no obstruction
Causes:
Oedema
Pseudopolyps 
Acute deterioration of colitis
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15
Q

Describe thumb printing

A

Oedematous thickened haustra often seen in active inflammation

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16
Q

When might you see calcification on a AXR

A

Chronic pancreatitis (fat necrosis)
Atherosclerosis
Calcified lymph nodes
Gall/renal stones

17
Q

Diagnosis of bowel perforation

A

Erect CXR (need to be sat upright for at least 10 mins)

18
Q

Causes of bowel perforation

A 
Peptic ulcer
Diverticular disease
Tumour
Bowel obstruction
Iatrogenic
19
Q

What are contrast studies

A

Used to define hollow viscera

May use barium or iodine

20
Q

Give examples of contrast studies and what they are used for

A

Barium swallow - achalasia, check aspiration
Barium enema - check anastomoses before reversing ileostomy
Barium meal
Water soluble (iodine)

21
Q

Compare abdominal CT, MRI and USS

A

CT - high dose radiation, better spacial resolution, quick
MRI - no radiation, better contrast resolution , time consuming
USS - no radiation, cheaper, portable, highly user dependent

22
Q

What does the transpyloric plane cross

A 
L1 vertebra
Liver (and round ligament)
Gall bladder
Kidneys
Pylorus 
Superior duodenum
Spleen
Pancreas
Transverse colon
Jejunum
23
Q

What is an MRCP

A

Magnetic resonance cholangiopancreatogram - MRI to visualise gall bladder and biliary tree

24
Q

What can you view with an abdominal USS

A 
Liver
Portal vein
Appendix
Gallstones 
Dilated common bile duct
25
Q

What is a GI angiography

A

IV radio opaque contrast injected to visualise GI blood supply in bleeding and ischaemia

26
Q

Which blood vessels can be seen in a GI angiogram

A

Aorta
Coeliac trunk
SMA
Iliac vessels

GI (19 decks)

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