abdomen Flashcards
achalasia
ZENKERS DIVERTICULUM
diverticulum may contain air, fluid, or ingested materials,
- patchy food
Esophagram indication
Evaluates just esophagus
achalasia
- dilated esophagus
- fluid line level
sx:
- nausea/vomit
- inability to tolerate lots of food
esophageal web
- plummer vincent syndrome
- small cell carcinoma in future
esophageal varices
- portal hypertension,
-drinkers
- cirrhosis
ESOPHAGEAL VARICES
- portal hypertension, - drinkers
- cirrhosis
In a CT scan, esophageal varices can appear as rounded or tubular structures within the esophageal wall that are enhanced after the administration of intravenous contrast material. They might be seen as a series of beaded enlargements along the normally smooth outline of the esophagus. The appearance can vary based on the severity and the stage of the liver disease causing the portal hypertension.
visualization of a thin, circumferential filling defect in the
distal esophagus called a Schatzki Ring
Schatzki ring:
- narrowing of the lower part of the esophagus
-causes dysphagia
- located just above the junction with the stomach, at the level of the lower esophageal sphincter.
On a barium swallow X-ray, which is what this image seems to be, a Schatzki ring appears as a thin ring of constriction and can cause a characteristic “ring” shadow. Below this ring, the esophagus may appear dilated if there is significant obstruction to the flow of food and liquid.
Upper GI series indication
Evaluate the anatomy and function of the esophagus, stomach, and duodenum
duodenal ulcer
- highly attenuated area
- 1st: UPPER GI SERIES NOT ENDOSCOPY
duodenal ulcer
- jagged ulcer
- ulceration area not filled with contrast in duodenum
duodenal ulcer
gastric ulcer
- Outpouching
gastric polyp
- SMOOTH not jagged
- not filled with contrast
- usually cystic or air filled
- need to bx
can see feeding tube
gastric polyp
Gastric polypoid mass
- bubbly
-jagged
pt presentation + fam hx important
barium enema indication
evaluate the anatomy and function of the large intestine (colon and rectum)
involves the introduction of barium sulfate into the rectum via a catheter
colon polyp
- Polyps are smooth and symmetric
colon polyp
- Polyps are smooth and symmetric
colon polyp
Colonic tumor
- apple core sign: core is the tumor tissue
- need a CT scan with IV contrast to see if lesion is growing its own vasculature
Colonic tumor
- different gray scale suggest tumor
lead pipe sign in UC
- Loss of haustra marking - lead pipe deformities
Diverticulosis
- outpouching
Diverticulitis: infection with outpouching
- Different presentation: hx of diverticulosis or never screened before; fever, abdominal pain, leukocytosis
Diverticulosis
- outpouching
Diverticulitis: infection with outpouching
- Different presentation: hx of diverticulosis or never screened before; fever, abdominal pain, leukocytosis
baby ribs: small ribs + smooth bones
- generalized air
- air in the bowel wall
- concern: NECROTIZING Enterocolitis
good abdominal xray
can see diaphragm to pubic symphysis
alignment:
- can see straight pelvic rami
- straight spine orientation
air in biliary tree
- Sign of Gram negative infection: should never be free air in the biliary system
normal air in small bowel
Cut off sign - looks like air fluid level; not normal
generalized free air:
- sepsis
- post surgery
- infection
left lateral decubitus
- can see extraluminal air that has escaped
-distended bowel with generalized free air
Calcified outline of the gall bladder
Older pts = normal
Concern for obstruction with air fluid level
localized air in splenic flexure
fecal impaction
air outlining pancreas
gallstone: mostly fat + calcium
- indication for surgery
cholecystitis -> inflammation -> ileus
pheboliths in bladder: calcifications that happen with ag
localized to small bowel
- SBO:
- step ladder air fluid levels
free air under diaphragm
1- Right 11th Rib,
2- T12 spinous process/T12 vertebral body,
3- Left 11th Rib/gastric bubble
4- Splenic flexure
5- Transverse Colon
6- Descending Colon
7- Sacrum/S1
8- L SI joint,
9- L femoral head,
10- Ascending Colon/R Ilium
11- R Iliac Crest,
12- Hepatic flexure
13- R psoas muscle.
cecal volvulus
Young pt classic presentation - sx of obstruction; 20s-30s, no past medical/surgical hx
LBO
- stool all over
-80yrs old
- pencil thin stool
Coffee bean sign
SIGMOID VOLVULUS: older, pencil thin stools
