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11 Cards in this Set
- Front
- Back
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Which of the following is incorrect regarding bowel obstruction?
1. Contrast CT with oral and IV is required. 2. The erect AXR view demonstrates air/fluid levels within the bowel for bowel obstruction. 3. The lateral decubitus AXR view is an AP view of the abdomen with the patient lying left side down. 4. Most gas in the bowel is swallowed air, and provides the most clinically useful information on AXR. |
1. oral contrast not essential
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Which of the following is incorrect regarding bowel obstruction?
1. Normal small bowel contains little/ no gas 2. Gas accumulates within the small bowel when intestinal motility is disturbed by mechanical obstruction or adynamic ileus. 3. When small bowel is distended, the valvulae conniventes {plicae circularis} makes indentations on the bowel gas. 4. The jejunum does not have valvulae conniventes. |
4. The distal ileum does not contain valvulae conniventes
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List the abnormal gas collections that can be found on AXR.
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1. Obstruction
2. Adynamic ileus 3. pneumoperitoneum 4. gas within: a. biliary tract / gallbladder b. hepatic portal veins c. bowel wall - intramural gas d. abscesses e. retroperitoneal tissues. |
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List the causes of Large Bowel Obstruction.
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1. Tumour - 60% - rectosigmoid Ca.
2. Volvulus sigmoid b. cecal 3. Fecal impaction 4. Benign stricture 5. Abscess a. Diverticulitis b. Inflammatory Bowel Disease c. Ischaemic Colitis |
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Management of volvulus -once confirmed with contrast enema?
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1. Flexible sigmoidoscopy - Decompression via rectal tube placement
2. Laparatomy if perforated / ischaemic bowel |
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What diameter of large bowel is at risk of
perforation in Large Bowel Obstruction (LBO) ? |
> 11-13 cm = INDICATION FOR EMERGENCY
SURGICAL DECOMPRESSION |
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Which is not a radiographic sign of Volvulus on AXR?
A. The "coffee bean " sign in sigmoid volvulus B. Proximal large bowel dilatation C. "kidney-shaped" dilated segment in cecal volvulus D. Distinctive soft tissue stripe in sigmoid volvulus extends from Right lower quadrant to Left upper quadrant. |
D. Soft tissue stripe extends from Left lower quadrant to Right upper quadrant .
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What diameter bowel makes the diagnosis of large bowel obstruction (LBO) ?
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> 5 cm
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True / False : The large bowel distal to a LBO
often does not collapse ( as in SBO) ? |
True - due to
1. Retention of fecal matter 2. Colonic air distribution 3. Rectum usually fluid filled- not visible on AXR if distended or collapsed |
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Which is incorrect regarding Contrast enema findings in LBO?
A. The "bird's peak" appearance is characteristic of volvulus B. In Adynamic ileus, Contrast only partially fills the colon. C. An "apple core appearance is characteristic of a circumferential tumour. D. The "whirl sign" is diagnostic of volvulus. |
B. Fills the entire colon until the terminal ileum.
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Which is incorrect regarding sigmoid volvulus?
A. It accounts for 60-75% of LBO B. Usually associated with the elderly, with an elongated, redundant sigmoid colon. |
A. 60-75% of Large bowel VOLVULUS
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