S11) Investigating the GI Tract Flashcards Preview

Y2 SEM 3: Gastro-intestinal System > S11) Investigating the GI Tract > Flashcards

Flashcards in S11) Investigating the GI Tract Deck (26)
Loading flashcards...
1

What are the 5 different imaging modalities of the GI tract?

- Plain X-rays – AXR, CXR

- Contrast studies – Barium swallow, enema, meal/follow through, water soluble contrast studies 

Ultrasound

- Cross-sectional imaging – CT, MRI

- Angiography 

2

Why request an abdominal X-ray?

- Acute abdominal pain

- Small/large bowel obstruction

- Acute exacerbation of IBD

- Renal colic

3

What are the features of an AXR?

Air/gas

- Bowel

- Calcification (bone and stones)

4

In terms of bowel gas patterns, what kind of structures are visible in an AXR?

- Visible if gas filled / gas and fluid filled

- Not visible is fully fluid filled

5

The bowel gas patterns in an AXR varies according to transit time. 

Describe this

- Slow transit = colon (faeces ± gas)

- Medium transit = stomach (fluid + lots of gas)

- Fast transit = small bowel (fluid) 

6

Identify 5 conditions which produce abnormal bowel gas patterns in an AXR

- Small bowel obstruction (>3 cm)

- Large bowel obstruction (>6 cm)

- Paralytic Ileus

- Volvulus

- Toxic Megacolon 

7

How does small bowel obstruction present?

- Vomiting (early)

- Distension (mild)

- Absolute constipation (late)

- Colicky pain 

8

What are the causes of small bowel obstruction?

- Adhesions

- Hernias (inguinal, femoral, incisional)

- Tumours

- Inflammation 

9

How does large bowel obstruction present?

- Vomiting (late, faeculant)

- Distension (significant)

- Pain

- Absolute constipation 

10

What are the causes of large bowel obstruction?

- Colorectal carcinoma

- Diverticular stricture

- Hernia

- Volvulus

- Pseudo-obstruction 

11

What is a volvulus?

A volvulus is when the colon twists around mesentery

12

In 3 steps, describe how a volvulus occurs

⇒ Enclosed bowel loop

⇒ Dilates

⇒ Perforation / ischaemia 

13

What is the most common volvulus and how does it occur?

Sigmoid volvulus:

- Starts in LIF

- Coffee bean sign towards RUQ

- Dilatation of proximal bowel 

14

AXR is not the gold standard for infection and inflammation. However, one might see acute or chronic changes. 

Identify some

- Mucosal thickening

- Featureless colon

- Bowel wall oedema 

15

Which soft tissue structures can be seen in an AXR?

- Organs 

- Musculature

16

Specifically, identify some organs which can be observed in an AXR

- Liver

- Spleen

- Kidneys

- Bladder

- Lung bases

17

Identify some bones which can be seen in an AXR

- Pelvis

- Sacrum

- Coccyx

- Lumbar spine

- Lower thoracic spine

- Lower ribs 

18

Identify 5 other abnormalities which can be observed in an AXR

- Stones

- Organs/masses

- Calcification (pancreatitis, vascular, nodes)

- Artefact

-  Foreign body 

19

Describe the use of an erect chest X ray

- Erect CXR is a specific examination performed for the assessment of subdiaphragmatic free gas (pneumoperitoneum)

- It is used to assess patients with acute abdominal pain

20

Perforation leads to pneumoperitoneum. 

Identiy 6 possible causes of this

- Peptic ulcer

- Diverticular

- Tumour

- Obstruction

- Trauma

- Iatrogenic (laparoscopy)

21

What is the purpose of contrast studies?

Contrast is used to define hollow viscera (Barium, water soluble)

22

Identify 4 common GI contrast studies

- Swallow

- Meal

- Small bowel enema/follow through

- Enema

23

Identify the visible abdominal structures in the cross-sectional abdominal CT at T12 below:

24

Identify the visible abdominal structures in the cross-sectional abdominal CT at L1 below:

25

Identify the visible abdominal structures in the cross-sectional abdominal CT at L3 below:

26

Identify the visible abdominal structures in the cross-sectional abdominal CT at L4 below: