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303 Radiology > Abdominal > Flashcards

Abdominal Flashcards

0
Q

What does hepatomegaly look like

A

Rounded inferior angle, liver extends over psoas muscle/spine
Absent bowel gas in right upper quadrant
Or does not cross midline- ptotic liver

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1
Q

What causes hepatomegaly

A

Hepatitis

Alcoholism

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2
Q

Splenomegaly

A

Spleen extends below 12th rib

Gastric air bubble displaced anteromedially

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3
Q

What is the normal location but abnormal pattern in the bowel lumen

A

Normal:
Air in large bowel and stomach
Abnormal:
Not see more then a few cm of small bowel gas or 2-3 air fluid levels
Small bowel should not measure more than 3cm in diameter

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4
Q

What is the abnormal location but normal pattern in bowel lumen

A

Abnormal:

Hiatal hernias displace a portion of the GI tract

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5
Q

What is Chilaiditis’s sign/ syndrome

A

Sign: interposition of large bowel between the liver and diaphragm, asymptomatic
Syndrome: abdominal pain, constipation, vomiting, respiratory distress

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6
Q

Abnormal air patterns

A

Abnormal to see air in the abdominal cavity outside the GI tract
Pneumotosis intestinalis: air in the wall of the bowel
Pneomoperitoneum: air in the peritoneal cavity
Air in the abdominal vasculature, hepatic/portal

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7
Q

Rigler’s sign

A

See air on both sides of the lumen

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8
Q

Concretion calcification

A

Within a lumen

Well marginated, laminated, faceted, solid, moveable

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9
Q

Conduit wall calcification

A

Within the wall of a tube

Linear, parallel lines, may be continuous or discontinuous

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10
Q

Cyst wall calcification

A

Within the wall of a cyst or cyst like structure

Oval-round, thin walled calcification

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11
Q

Solid calcification

A

Within the substance of a mass

Irregular, fragmented, solid, lobulated (mulberry, popcorn)

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12
Q

How do gallstones calcify and what do they contain

A

Pattern- Concretion
Contain cholesterol (unlikely to calcify), bile pigments (likely to calcify), and or calcium carbonate
Requires ultrasound or contrast study

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13
Q

Renal stones

A

Pattern- Concretion
Mc calcium oxalate
Staghorn calculus- stone filling a calyx and or the pelvis
Asymptomatic unless moves into the ureter
Check lateral view if anterior calcification (abdomen), posterior (kidney)

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14
Q

Aortic aneurysm

A

Assoc with hypertension
Pattern- conduit/ cystic
May saccular or fusiform
Diameter over 3cm=aneurysm, over 5cm= surgical consult

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15
Q

Vas deferens calcification

A

Pattern- conduit wall

High assoc diabetes mellitus

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16
Q

Fibroids

A

Pattern- solid

Leiomyoma- Benign smooth muscle tumour

17
Q

What is Achalasia

A

Failure of relaxation of the gastroesophageal sphincter due to a decrease or absence of the myenteric plexus
Results in dilation of the esophagus

18
Q

Radiographic findings of Achalasia

A

Dilated oesophagus may present as widened mediastinum, distal end tapered/narrowed
On lateral view may see fluid level
Absent gastric air bubble

19
Q

What are the two types of hiatal hernia

A

Sliding (99%)

Paraeophageal

20
Q

What happens with a sliding hernia

A

The cardia of the stomach passes above the diaphragm due to laxity of the phreno-esophageal membrane
Esophagus should be seen above the herniated portion of the stomach
Asymptomatic or signs of GORD

21
Q

What happens in a paraesophageal hernia

A

The cardia of the stomach stays below the diaphragm and a portion of the body or funds passes through the membrane
Esophagus will extend below the herniated stomach

22
Q

Peptic ulcers

A

A tear in the mucosal layer >3mm
Gastric 1/3 >40yo, duodenal 2/3 adults of any age, cloverleaf pattern
Best assessed by endoscopy

23
Q

What are some radiographic signs that suggest a benign ulcer

A

Lesser curvature location
Ulcer crater extends beyond edge of lumen profile
Crater margins are smooth and well defined
Mucosal folds are smooth and extend to edge of ulcer crater
Ulcer crater located centrally within an edematous mound
*malignancy- findings not present, or opposite findings

24
Q

What is the typical appearance of an ulcer crater

A

Round-oval collection of barium, extends beyond the normal confines of the lumen
<5mm easily missed with contrast

25
Q

What are the three main types of gastric carcinoma

A

Polypoid (fungating, mass-like)
Infiltrative (scirrhosis, linitus plastica)
Ulcerating

26
Q

Polypoid (fungating, mass-like) gastric carcinomas

A

Large, irregular mass extends into the lumen

May contain ulcerations

27
Q

Infiltrative (scirrhosis, linitus plastica) gastric carcinomas

A

Causes narrowing of long segments of the stomach

Stiffening of the wall and shrinking of the stomach

28
Q

Ulceration gastric carcinomas

A

Demonstrates characteristics of aggressive ulceration

29
Q

What are the two types of inflammatory bowel disease

A

Ulcerative colitis

Crohn’s disease

30
Q

Ulcerative colitis

A

Starts at rectum and progresses retrograde
Imaging: small surface ulcers, continuous circumferential involvement of the bowel wall, loss of haustration, and shortening of the bowel
Lead-pipe or stove-pipe colon

31
Q

Chron’s disease

A

Findings usually start at the ileocecal region and progresses towards rectum
Imaging: deep ulcers, may have cobblestone mucosal pattern, discontinuous, non-circumferential involvement, fistulas (tracts), strictures (deep constrictions)

32
Q

Adenomas are classified by their gross appraise as either (2)

A

Sessile- flat or broad-based

Pedunculated- having a stalk

33
Q

What do polyps/adenomas look like

A

Appear as focal filling defects- areas of absence if contrast

34
Q

Are adenomas benign

A

Yes but they can degenerate into adenocarcinoma

Rare in 4cm more common (40-50%)

35
Q

What sequence does colorectal carcinoma follow

A

Dysplasia- adenoma- carcinoma

36
Q

What does carcinoma look like

A

Apple core lesion- over time, lesion spreads circumferentially and produces constricting annular lesions in the mucosa

37
Q

What are diverticuli

A

Mucosa studded with small <2mm openings

38
Q

What is diverticulitis

A

Inflammation of diverticuli, can result in abscess formation

Left lower quadrant pain, fever and tenderness

39
Q

What does diverticulosis look like

A

Outpouchings along the wall of the colon, fill with contrast
Smooth, rounded contours (distinguish from ulcers)

40
Q

What does diverticulitis look like

A

May be seen as thinned, irregular diverticuli

Possibly have strictures and or fistulas

303 Radiology (11 decks)

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