What are the primary imaging tools in acute abdomen?
X-ray CT USS
What is the secondary imaging tool in acute abdomen?
What are the drawbacks of using CT?
Increases cancer risk Contrast – renal impairment
USS allows for clear visualisation of...
solid organs, free fluid, aorta, pelvis
MRI is good for...
soft tissue imaging, especially in pelvis
MRI is used as a second-line test for...
hepato-biliary (MRCP), small bowel, pelvis
Which imaging should be used in acute appendicitis?
USS then CT if inconclusive
Diverticulitis may be misdiagnosed as...
appendicitis, colorectal Ca
What do you need to be able to do when doing imaging for suspected diverticulitis?
o Make diagnosis o Look for complications – abscess, obstruction, perforation, fistulae
Give complications of diverticulitis.
abscess, obstruction, perforation, fistulae
Which imaging modalities may be used in diverticulitis?
How is acute cholecystitis diagnosed?
RUQ pain + fever/raised CRP/WCC + confirmatory imaging
Which imaging modalities are used in Acute cholecystitis?
What would usually be seen on USS of acute cholecystitis?
Gallstones GB wall thickening
What is emphysematous cholecystitis?
Air in gallbladder wall
Who gets emphysematous cholecystitis?
Give common causes of small bowel obstruction.
adhesions, cancer, herniae & gallstone ileus
What are the main symptoms of small bowel obstruction?
vomiting, pain & distension
What are the main signs of small bowel obstruction?
increased bowel sound, tenderness, palpable loops
Which imaging modalities can be used for small bowel obstruction?
What is the drawback of x-ray in small bowel obstruction?
may not detect fluid-filled loops
What is gallstone ileus?
Obstruction of the small intestine due to gallstone impaction, usually at the iliocaecal valve
What are the main causes of large bowel obstruction?
colorectal cancer, volvulus, diverticulitis
How can you identify large bowel on x-ray?
Haustra go all the way across
Which imaging modality is best for large bowel obstruction?
CT - can identify cause too
What should you look for in bowel obstruction to assess risk of perforation?
dilation of the caecum suggests high risk of perforation.
What are the common causes of perforation in the GI tract?
Perforated ulcer Diverticulum
Which imaging modalities are useful in perforation?
What % of CO does the GI tract usually receive?
What % of CO does the GI tract receive in ischaemia?