Flashcards in L17 Investig GI Sys Deck (10)
LO2: recog keys strucs in X sec images of abdo.
LO3: list comm reasons for req plain abdo radiograph.
-Why req AXR- acute abdo pain? If not see append or gyn pain. Small or LI obstruc. Acute exacerb IBD partic toxic megacolon. Renal colic?? Now low dose CT first tell if stone or hydronephrosis. NOT constip, only v occas in kids.
LO4: comp and contrast app of SI and LI on abdo radiograph and desc classic images of bowel obstruc.
-AXR SI cent, often don't see. valvulae conniventes cross ent wall, thin.
-AXR LI periph. Haustra not full X bowel wall. Faeces and gas, low transit time. T colon hang down to pelvis, fem longer so colonosc more fail. S colon can loop and be long, can move, trace from caecum.
LO5: expl role of erect chest radiograph in ass of acute abdo pain.
--CXR for perforation- pneumoperitoneum. Gas up to under diaph. Need able sit 10-20min.
Peptic ulcer, divert, tum, obstruc, trauma, iatrogenic eg laparoscopy.
Subtle signs on AXR. CT after CXR us.
LO6: recog use of CT and MRI in investig abdo and Id key anat strucs.
ABDO CT: comp axial tomog.
-high dose rad but use lot esp acute. Good spat resol, poor contrast resol vs MRI. Use IV or oral/rectal contrast not much now.
-abdo CT spinal levels and planes. Transverse. Sagittal. Coronal. Look up form bott so opp. L1 trans pyloric plane of Addison. CT reformatting of visc struc.
-virtual colonosc- repl barium enema. Gastrograph White liv drink paint stool. Gas in bum. Diff planes. Fly through- tol, less perfor. See eg polyp.
-thick bowel, mesenteric, retro perit strucs and aorta. Detec perfor viscus, subdiaph abcess, extra luminal in append and diverticulitis. Contrast extravasated from int lumen and free air detected.
ABDO MRI: mag reson
-no rad. Good spat and contrast resol. Time consuming and req still. Better soft tiss defin. SI diffic as move= fuzzy.
-MR cholangio pancreatogram (MRCP) of bill tree. See gallst.
-SI MR- fill fluid, look at wall eg crohns, no rad expos good for yng pt need rep imaging. Eg crohns structure, see peristalsis motil.
-MRI good for abcess, fistulae in peri anal reg. Comm in hepatobil and panc dis.
LO7: disc basic interven radiologic proceed used in managem GI dis.
-endo vasc treat of aneurism.
-demonstr GI vasc sys foll punc, Catheter, and infec of radio opaque contrast to BV.
-isotope studies- lim use now as CT and MRI. IV isotope dissip to tiss= faint backg on gamma cam. Active fast bleed prod pool bef isotope leaves blood=patch gamma activ.
LO1: AXR soft tiss
-soft tiss eg organs- liv, spleen, kidn, bladder, lung bases. Musc. Bone- pelvis, sacrum, coccyx, lumbar spine, lower thoracic spine, lower ribs.
See organs shadows.
-other abn- stones, organs/masses, calcif of panc, vasc, nodes. Bones. Artefact. For bod.
Renal calculi- eg in ureter, partial stag horn. Chronic pancreatitis= calcif panc. Vas calcif eg aorta and iliac veins, atheroscler- abdo pain, worry isch gut. AAA mass bleed. For bod eg NG tube, stent.
-used to define hollow viscera- barium heavy met or water sol If risk perfor or leak.
-Comm swall for dismotil/achalasia LOS not open corr, OGD init.
Swall barium in upright/prone posit. See oesoph. Motil and anat lesion.
-doub contacts barium meal for stom and duod rare now as OGD and cam, poor sensit CA, carbex in stom prod gas. Small amnt barium given with effervescent grans or tablets to prod CO2 so double contrast btw barium and air.
-SI foll through but now MRI us. Barium swall. For gross anat SI.
-SI enema- tube through duod LOT dilute barium intro. For obstruc and stricture.
-Barium enema rare but only ever water sol. Pt low fibre diet 3D and colon cleansed with oral laxative. Barium and air insufflated by rectal catheter and doub contrast views obt of ent colon.
-all perf after overnight fast.
-sound waves gen image, freq above audib (20KHz), us 2-18 MHz. Cheap vs CT and MRI. Portable. User dep. good for gallst, panc head CA, dilat CBD. Appendix. Liver and PV.
-US, CT and MRI used to define organs, thick bowel, messes, abcess, fistulae.
-US no rad, best for fluid filled lesions. Thick bowel no mucosal detail. Diag acute cholecystitis, AAA, appendicitis.