Download - Gi radiology mbbs final
RADIOLOGY OF GASTRO- INTESTINAL TRACT
Dr Rekha Khare MD Radiology
GASTRO-INTESTINAL SYSTEM
HOW TO IMAGE GASTROINTESTINAL TRACT?
Plain X-ray Contrast study : Barium study Ultrasound CT scan MRI
PLAIN –X RAY ABDOMEN
Indication: Intestinal obstruction Intestinal perforation Imperforate anus Routine views: Erect abdomen AP Supine abdomen AP (Include part from diaphragm to pubic
symphysis)
Lateral upside down– Invertogram only for imperforate anus
INTESTINAL OBSTRUCTIONDILATED BOWELS, HORIZONTAL AIR FLUID LEVEL, NO AIR IN THE RECTUM
INTESTINAL OBSTRUCTION
INTESTINAL OBSTRUCTION ON CT & U/S
INTESTINAL PERFORATIONAIR UNDER RT DIAPHARGM
INVERTOGRAM: IMPERFORATE ANUS
BARIUM STUDY FOR GIT
What is Barium? Barium sulphate
It is contrast agent inert material when reaches to gastrointestinal tract whether oral or per rectal route, it opacifies the tract ( seen white on x ray)
BARIUM SWALLOW--OESOPHAGUS
Common problem: Dysphagia difficulty in swallowing
Ask for Barium swallow:
Paste like Barium Ask the patient to swallow X-ray under fluoroscopy in
different views
BENIGN STRICTURESMOOTH LONG NARROW SEGMENT NEEDS DILATATION
CAUSES OF SIMPLE STRICTURE
MALIGNANT STRICTUREIRREGULAR SHORT NARROW SEGMENT WITH PROXIMAL HOLD UP AND SHOULDER SIGN
ACHLASIA CARDIAFAILURE OF ORGANISED PERISTALSIS WITH IMPAIRED RELAXATATION OF LOWER OESOPHAGEAL SPHINCTER
BIRD BEAK APPEARANCE CHRONIC SMOOTH DILATATION OF PROXIMAL OESOPHAGUS
DIVERTICULUMSAC OR PROJECTIONS ARISING FROM SIDES OF OESOPHAGUS
MOTILITY DISORDER NEUROMUSCULAR DISORDER ---CORK SCREW OESOPHAGUS
OESOPHAGEAL ATRESIA
BARIUM SWALLOW IN NEONATEOESOPHAGEAL ATRESIA
CAUTION
If in doubt of tracheo-oesophageal fistula never be tempted to give liquid Iodine contrast, might cause Pulmonary oedma
OESOPHAGEAL VARICESSERPIGINIOUS DEFECT DUE TO EXTREMELY DILATED SUB MUCOSAL VEINS IN LOWER THIRD OF OESOPHAGUS AS IN PORTAL HYPERTENSION
BARIUM MEAL FOR STOMACH & DUODENUM
Common gastric problem: Acid peptic disease Peptic ulcer Mass epigastrium- after ultrasound Gastric outlet obstruction
Barium like thick milk, ask pt to drink, films in different projection
GIT ON BARIUM STUDY
ANATOMY OF STOMACH
GASTRIC ULCER
DUODENAL ULCER
MASS STOMACH
GASTRIC OUTLET OBSTRUCTION
PYLORIC STENOSIS
BARIUM MEAL FOLLOW THROUGH( FOR SMALL BOWEL)
Common problem: Any symptom causing subacute intestinal obstruction Right iliac fossa mass or TB ileocaecal
region
BARIUM MEAL FOLLOW THROUGH
BARIUM MEAL FOLLOW THROUGH
DEFORMED CECUM, DILATED TERMINAL ILEUM AND OBTUSE ILEOCECAL ANGLE
MULTIPLE STRICTURES _STRING SIGN
SPASTIC CECUMTRANSIT TIME _ 10 HRS
TB ILEOCAECAL REGIONCONTRACTED CECUM, NARROW IRREGULAR TERMINAL ILEUM & DISTORTED ILEOCAECAL ANGLE
ILEOCECAL T.B. STRICTURE IN TRANSVERSE COLONASCITIC FLUID CYTOLOGY_ T.B. NATURE
BARIUM ENEMA FOR LARGE BOWEL
INDICATION FOR BARIUM ENEMA
Bleeding per rectum not for the haemorrhoids Difficulty in daefecation Altered bowel habit Chronic constipation
BARIUM ENEMA
MICROCOLON DOLICHOCOLON
ULCERATIVE COLITIS DIVERTICULUMPIPE STEM COLON POUCH OR SAC
POLYPOSISSINGLE CONTRAST & DOUBLE CONTRAST BARIUM ENEMA
MALIGNANCY COLONSTRICTURE/ NARROWING, APPLE CORE DEFECT, FILLING DEFECT
HIRSCHSPRUNG DISEASEAGANGLIONIC DISTAL COLON , NO PERISTALSIS, PROXIMAL DILATATION
HIRSCHSPRUNG DISEASE
ANAL ATRESIA- INVERTOGRAM
CROHNS VERSUS ULCERATIVE COLITIS
CROHNS VERSUS ULCERATIVE COLITIS
COLITIS – PIPE STEM COLON
COLLAR STUD ULCER- TOTAL COLITIS
EXTENSIVE MUCOSAL ULCERATION
HEPATOBILIARY SYSTEM
Ultrasound is the first choice then depending on CT scan or MRI could be the complementary investigation
Indication: Acute pain Rt hypochondrium Jaundice
HEPATOBILIARY SYSTEMCASE WITH JAUNDICE
GB CALCULUS ACUTE CHOLELITHIASIS
PANCREAS ON ULTRASOUND NORMAL CHRONIC PANCREATITIS
CHRONIC PANCREATITIS CALCIFICATION ON PLAIN X-RAY ON ULTRASOUND
AC.CHOLECYSTITIS AC. PANCREATITIS
T-TUBE CHOLANGIOGRAPHY CBD DILATATION
HEPATIC MASS MRI ULTRASOUND
THANK YOU Have a nice day