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Block 7 - GI > Radiology > Flashcards

Flashcards in Radiology Deck (28)
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What radiographic abdominal series variation is indicated given a clinical exam?

KUB - for specific question (tube placement, stone)
KUB supine/upright series - for small or large bowel obstruction
Acute abdominal series - if bowel perf suspected


What is the normal size of the small bowel?

<3 cm


What are the four common indications for a KUB?

abdominal pain
suspected bowel obstruction
suspected renal stone
suspected swallowed foreign body


What is pneumoperitoneum a sign of?

bowel perf


What is the test of first choice for suspected pneumoperitoneum?

actute abdominal series
CXR most useful film


What are radiographic findings of mechanical small bowel obstruction?

small bowel dilatation (>3cm)
paucity of distal small bowel and colon gas
air-fluid levels on upright view
CT if diagnosis still uncertain


What are radiographic findings of paralytic ileus?

mild dilatation of small bowel and colon without paucity of colon gas or with prominent colon gas
gas in rectum


What is a difference between the appearance of gallstones and renal stones on KUB?

gallstones are faceted


What are three common indications for a barium swallow?

chest pain, non-cardiac
GERD symptoms


What are four common diagnoses made by barium swallow?

esophageal carcinoma - irregular stricture w sharp overhanging edges
esophagitis - multiple ulcerations
hiatal hernia - stomach above diaphragm
achalasia - LES dysfunction, dilation of esophagus and narrowing at LES


What are four common indications for a UGI?

abdominal pain
suspected duodenal or gastric ulcer
suspected hiatal hernia
suspected gastric mass


What UGI findings suggest a duodenal ulcer?

persistent contrast collection, smooth mound of surrounding edema and thickened folds radiating to edge of ulcer crater


What UGI findings suggest a benign gastric ulcer?

smooth craters, smooth folds radiating to edge, smooth mounds of surrounding edema


What UGI findings suggest a malignant gastric ulcer?

irregular crater and mass around it, irregular edges and folds not radiating to edge


What are the five common indications for a small bowel follow through (SBFT)?

small bowel obstruction - intermittent or partial (not acute)
small bowel mass suspected
chronic GI bleed without source
malabsorption syndromes/diarrhea
IBD suspected


What are six common indications for a barium enema?

chronic GI bleed/hemoccult positive stools
suspected large bowel obstruction
left lower quadrant pain
suspected diverticulosis/diverticulitis
constipation or diarrhea
suspected IBD


What barium enema patterns suggest colon cancer?

polypoid mass or irregular stricture
apple core lesion


What barium enema patterns suggest colonic polyp?

filling defect, mass protruding into colon
need laxative prep first


What barium enema patterns suggest diverticulosis and what suggest diverticulitis?

osis - smooth round contrast collections protruding from colon
itis - intramural or pericolonic abscesses, bowel wall thickening
most common in sigmoid


What barium enema patterns suggest ulcerative colitis?

shallow ulcerations, loss of haustral markings, granular mucosa, collar-button ulcers


What are the common indications for an abdominal ultrasound?

RUQ pain (suspected gallstone)
increased LFTs
screen for liver masses
evaluate for hepato and splenomegaly


What are the two indications for a tagged RBC study?

acute GI bleeding
liver hemangioma


When are tagged RBC studies useful with GI bleeding?

only when ACTIVE


When are HIDA or DISIDA scans done?

acute cholecystitis - esp if acalculous
biliary leak or biloma


How can nuclear imaging confirm ACUTE cholecystitis as opposed to chronic?

cystic duct completely obstructed in acute but not chronic


If you see the gallbladder, it is not...

acute cholecystitis


What are some common indications for MRI?

other imaging studies done and questions persist
contraindications like IV contrast
liver mass characterization, esp confirmation of hemangiomas
adrenal mass characterization


What are four common indications for abdominal angiography?

mesenteric ischemia
acute or chronic GI bleed - active, brisker than nuclear RBC
abdominal vascular trauma