X-Rays In General Surgery Flashcards
Non-contrast radiography
CXR
AXR
Contrast radiographs for general surgery
Gastrograffin
Barium
Erect CXR
… = free air under the diaphragm
Concerning for perforation of viscus e.g. bowel
Can also be non-pathological immediately post-laparoscopy
Pneumoperitoneum = free air under the diaphragm
Concerning for perforation of viscus e.g. bowel
Can also be non-pathological immediately post-laparoscopy
PICC placement - advantages?
Can be in for up to 6 months
CVC placement
Rigler’s sign =
Coffee-bean sign - means what?
Sigmoid volvulus, often lacks haustral folds
What is this
Large bowel obstruction - dilated bowel loops more peripherally located
Relatively wide - normal = <6cm
Haustral folds. Do not cross the entire width of the bowel
What is this?
Small bowel obstruction
Dilated bowel loops more centrally located
Relatively narrow - normal = <3cm (3-6-9 rule)
Valvular conniventes - mucosal folds which cross the entire width of the bowel
What is this showing?
No abnormality
What is this?
What is this
Barium enema
61 YO with abdo pain, vomiting and cramping abdominal pain, extensive past surgical history with previous bowel resection (and anastomosis), appendicectomy and cholecystectomy - what is shown? What are causes?
Small bowel obstruction
Dilated bowel
Adhesions from previous surgeries!
NG tube inserted - patient nil by mouth, unable to aspirate any stomach content, why is the tube in this location?
Gone into trachea, right lung because its wider and more vertical
54 year old presents with abdominal pain - recent intra-abdominal surgery
Bowel perf
89 year old, distress
Not his usual self from his nursing home
Unable to give a history but appears distressed
Nursing home uncertain when he last opened his bowels
What is this showing?
Sigmoid volvulus - coffee bean sign,
64 year old man with abdo pain, not had bowels open in 3 days and is complaining of increasing abdo pain
Of note, has had a change in bowel habit over the last few months and has lost 10kg of weight over the last 2 months
Large bowel obstruction - potential malignancy
70yo man with newly inserted NG tube for feeding - unable to aspirate gastric contents
Inserted down enough to suck out of bottom of stomach
78 yo male with abdominal pain, sudden onset abdominal pain today with large distended abdomen - FINISH SLIDE
Caecum volvulus
