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I.
Large bowel
Almost always with gas in rectum and sigmoid
Plain Films
A. Gas Pattern
B. Extraluminal Air
C. Calcification and Foreign Bodies
D. Masses/Densities and fluid collections
II.
Contrast Studies
A. Esophagus
B. Stomach
C. Small Intestine
III. Cholangiogram
IV. Barium Enema
Small
bowe
l
Two to
three levels
possible
Large
bowe
l
None
normally
A. GAS PATTERN
dont
extend
Small bowel
Central
Valvulae extend across the lumen
Location will tell you (large
bowel is outer box)
NORMAL BOWEL GAS PATTERN
Stomach
Always with gas
Small bowel
2-3 loops of non-distended bowel
Karen, Andrew
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RAD 250
Key features:
o 1-2 persistently dilated loops
o Gas in rectum or sigmoid
Pitfalls:
o May resemble mechanical small bowel obstruction
o Clinical course
o Follow-up 6 hours to 8 hours
KAREN, ANDREW
Tumor
Volvulus
Hernia
Diverticulitis
Intussusception
o
o
o
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RAD 250
B. EXTRALUMINAL AIR
FREE AIR: CAUSES
(not presented or skipped but in the powerpoint)
PNEUMOPERITONEUM
(Left image: fluid collection at the R side of patient;
look at CP angle)
GALLSTONE ILEUS
Aerobilia
It happened so fast haha. Sorry. Wala din yung slide na yun sa
copy naming ng ppt.
KAREN, ANDREW
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RAD 250
Urolothiases are are usually benign unless there are too much.
KAREN, ANDREW
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RAD 250
Hepatosplenomegaly
o Plain films poor for judging liver size
Tumor or cyst
o Bowel displacement
Paucity of gas
LES segment
phrenic ampulla
KAREN, ANDREW
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RAD 250
ZENKERS DIVERTICULUM
FOREIGN BODY
Frontal and Lateral Esophagogram of Zenkers Diverticulum
1.
SLIDING / AXIAL
The
gastroesophageal junction (GEJ) or B-line herniates
>2cm above the diagphragm
Associated with GERD
Comprises 99% of all hiatal hernias
2. PARAESOPHAGEAL / ROLLING
Have a normal GEJ but the gastric fundus extends
through the esophageal hiatus into the mediastinum
Comprises 1% of all hiatal hernias
Life-threatening due to risk of volvulus and
incarceration
KAREN, ANDREW
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progressi
ve
luminal narrowing
ESOPHAGEAL CARCINOMA
B. STOMACH
CHEMICAL GASTRITIS
KAREN, ANDREW
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ASCARIASIS
C. SMALL INTESTINES
FOREIGN BODY
radiating
folds
DUODENAL DIVERTICULA
KAREN, ANDREW
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III. CHOLANGIOGRAM
T-TUBE, PTC, ERCP:
BILIARY TREE
ECTOPIC GALLBLADDER
Right
plate
shows
GALLSTONES
BOCKDALEK HERNIA
KAREN, ANDREW
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RAD 250
positions:
CHOLEDOCHOLITHIASES
BILIARY ASCARIASIS
Position 3, Anteroposterior
KAREN, ANDREW
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RAD 250
HIRSCHPRUNGS DISEASE
Position 4, Post-evac
Red arrow: Transitional zone. Fuzzy bowel since it is
feces-filled.
INTUSSUSCEPTION
END OF TRANSCRIPTION
Andrew: Hello blockmates! Libre ko kayo after ng
Radio exam!
Intussuscipiens: white, with barium enema
KAREN, ANDREW
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