Abdominal Imaging

Question 1

In suspected acute appendicitis what imaging modalities are used?

Answer 1

USS first
then if inconclusive may use CT
(there is no role for X-ray)

Question 2

What is the main purpose of Ultrasound imaging in pancreatitis?

Answer 2

to look for the cause ie. are there gallstones

Question 3

What is the main purpose of CT in pancreatitis?

Answer 3

to look for complications

Question 4

Describe features of small bowel obstruction on AXR?

Answer 4

Valvulae conniventes are visible (the plicae circulaire- mucosal folds of the intestine)
Loops are central
Dilatation > 2.5 -3 cm
Paucity of gas distally

Question 5

Describe the features of small bowel obstruction on CT?

Answer 5

central small bowel loops
Dilated small bowel loops >2.5 cm up from outer wall to outer wall
Normal calibre or collapsed loops distally
Reliably demostrates site of transition from dilated to collapsed which is location of obstruction

Question 6

Describe the features of large bowel obstruction on AXR?

Answer 6

Peripheral >5cm 
Haustra visible
Colonic distension
Collapsed distal colon
Rectum has little or no air 
Caecum can reach up to 10cm before perforation