Imaging

Question 1

Abdominal radiograph

Answer 1

• First line modality
• Distension, pain, vomiting & diarrhea
• PA chest supine & upright abd: most sensitive, free air, exclude thoracic etiology
• Left lat decubitus: bowel gas, free air, bowel perforation
• Supine: bowel gas, limited mobility

Question 2

Pearl sign

Answer 2

• Gas trapped in folds of bowel loops- air fluid level

- Sm bowel obstruction

Question 3

Oral cholecystography

Answer 3

• Ingestion of radioopaque compound to evaluate gallstones

Question 4

CT of abdomen

Answer 4

• Cross sectional images of abdomen
• Solid organs
• Acute & chronic pain
• Guide for biopsy
• Liver, renal, colonic, enteric, pancreatic
• Great detail of soft tissue and BV

Question 5

Double contrast study

Answer 5

• Air & barium used to delineate mucosa

- visualization of mucosa, not good for small lesions

Question 6

Upper GI/ barium swallow

Answer 6

• Ingestion of barium + x-rays

- Imaging of esophagus for lesions, swallowing, hiatal hernias, strictures

Question 7

Apple core sign

Answer 7

• Indication of cancer- mass in bowel

- Visualized with barium and x-ray

Question 8

Lower GI barium enema

Answer 8

• Enema into rectum to examine colon & rectum
• Abd pain, diarrhea, bloody stool, wt loss & change in bowel habits
• Diverticular disease

Question 9

Endoscopy

Answer 9

Visualization of GI tract- most common method of examining upper GI
- Gold standard for most upper GI dx

Question 10

Colonoscopy

Answer 10

• Colon cancer

- Obtain biopsy of polyps

Question 11

Abd US

Answer 11

• Detection of gall stones, appendicitis, kidney, bladder, gall, kidney & spleen pancreatic masses
• Used in acute abdominal pain

Question 12

String sign

Answer 12

String appearance in contrast X-ray

- Chron, pyloric stenosis- sever narrowing

Question 13

Stairstep pattern

Answer 13

• Asynchronous air-fluid levels in same bowel loop

- Small bowel obstruction

Question 14

Sub diaphragmatic free air-

Answer 14

Intraperitoneal air under diaphragm

• CXR
• Enlarged gastric bubble

Question 15

Cut off sign

Answer 15

Gaseous distention of proximal colon

- Acute pancreatitis

Question 16

Volvulus

Answer 16

• Twisting causing bowel obstruction
• Sigmoid most common
• Coffee bean sign

Question 17

Thumbprinting

Answer 17

Thickened large bowel mucosa

- infection or inflammation- Colitis

Question 18

Sentinal loop

Answer 18

• Dilation of inflamed organ

- Appendicitis, pancreatitis, cholecystitis

Question 19

Bowel obstruction

Answer 19

Multiple gas fluid levels indicates blockage

- Lg or Sm bowel