GI - 1 Imaging Techniques Flashcards Preview

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Flashcards in GI - 1 Imaging Techniques Deck (41)
1

• Best method for examining UGI: Mouth -> esophagus ->stomach->duodenum

EGD

2

Flexible endoscope

EGD

3

Directed biopsy & therapeutic

EGD

4

• Gold Standard for diagnosing colonic mucosal disease

Colonoscopy

5

Flexible colonoscope

Colonoscopy

6

Anal canal ->rectum -> colon 95% reach cecum

Colonoscopy

7

Terminal ileum can be examined

Colonoscopy

8

• Sensitivity > barium enema or CT for colitis, polyps, cancer

Colonoscopy

9

Anus -> sigmoid colon

Flexible Sigmoidoscopy

10

Name 3 things Flexible Sigmoidoscopy is used to evaluate?

o Diarrhea
o Rectal bleeding
o Colon cancer screening with other modalities

11

swallow disposable capsule with camera

Capsule endoscopy (Small Bowel Endoscopy)

12

Visualization of jejunal & ileal mucosa: beyond conventional endoscope

Small Bowel Endoscopy

13

o Implanted electromagnetic devices
o Intestinal motility disorders
o Zenker’s diverticulum
o Swallowing disorders
o Small bowel diverticulosis
o Pregnancy
o Severe Crohn’s enteritis
o Small intestinal strictures
o Obstruction
All of these are contraindications for:

Small Bowel Endoscopy

14

Push down small bowl: Down mouth -> mid jejunum

Push enteroscopy

15

Biopsies or endoscopic therapy

Push enteroscopy

16

Used for bleeding

Push enteroscopy

17

Diagnosing a perforated ulcer
Free air: at little as 1-2 mL of air seen

Plain film

18

mall bowel obstruction

Plain film

19

Moderate-Severe abdominal tenderness

Plain film

20

Suspicion of bowl ischemia

Plain film

21

Ingestion of FB or penetrating FB

Plain film

22

• Drinks/swallows barium & x-ray or video taken

Barium Esophagram

23

• Evaluates: Swallowing, Peristalsis, Lesions, HH, Rings, Strictures, Cancer, , Ulcers, Reflex

Barium Esophagram

24

• Swallow barium, x-ray => visualize esophagus, stomach & duodenum

Upper GI series w/ Small Bowel Follow Through

25

• Evaluates
o Abdominal pain
o Weight loss
o Heme in stool
o Diarrhea

Upper GI series w/ Small Bowel Follow Through

26

evaluates entire SI w/ barium

Small Bowel Series

27

LARGE bowel: rectum -> cecum

Barium Enema

28

Can reflux into terminal ileum

Barium Enema

29

X-rays taken after barium inserted. • Evaluates
o Cancer
o Polyps
o Inflammation
o Structural abnormalities

Barium Enema

30

• Sound waves create image
• Differentiation of
 Cystic VS. Solid lesions of the liver and kidneys

Abdominal Ultra Sound

31

• Images of gut wall * adjacent organs vessel, & lymph nodes

Endoscopic Ultra Sound

32

• Most accurate preoperative local staging of esophageal, pancreatic & rectal malignancies
• Highly sensitive for diagnosing
o Bile duct stones
o Gall bladder disease
o Submucosal gastrointestinal lesions
o Chronic pancreatitis

Endoscopic Ultra Sound

33

• Gold standard for diagnosis of GERD
• Measures reflux of acid from the stomach to esophagus
• Catheter places 5cm above lower esophageal sphincter & kept in place for 24hr

Ambulatory 24hr pH monitoring

34

Endoscope mouth -> duodenum

Endoscopic Retrograde Cholangiopancreatography (ERCP)

35

• Ampulla of Vater identified & cannulated w/ plastic catheter

Endoscopic Retrograde Cholangiopancreatography (ERCP)

36

• Radiographic material injected into bile duct & pancreatic duct under fluoroscopic guidance

Endoscopic Retrograde Cholangiopancreatography (ERCP)

37

• Endoscopic sphincterotomy opens sphincter of Oddi to do one of the following
o Stones retrieved from ducts
o Biopsies can be obtained
o Strictures can be dilated & stented
o Therapeutic & diagnostic procedures esp for ductal strictures & CBD stones

Endoscopic Retrograde Cholangiopancreatography (ERCP)

38

• Checks function of gallbladder & bile ducts
• Given W/ CCK to check gallbladder emptying
• Used when presenting with RUQ pain, nausea, vomiting

Hepatobiliary Iminodiacetic Acid (HIDA) Scan

39

• Can be done with or without contrasting agent
• Most helpful in evaluating
o Retroperitoneum ( pancreas, kidney, nodes, aorta)
o Liver
o Appendicitis
o Diverticular disease

CT Scan

40

Better soft-tissue contrast than CT

MRI

41

• Evaluation of intra-and extra-hepatic biliary & pancreatic duct dilatation & cause of obstruction
• Evaluates
o Choledocholithiasis
o Retained gallstones
o Pancreatobiliary neoplasms
o Strictures
o Primary sclerosing cholangitis
o Chronic pancreatitis
• No contrast agents needed
• If stones - > ERCP

Magnetic Resonance Cholangiopancreatography (MRCP)