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63 Cards in this Set

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Extraluminal Intra-Abdominal Gas
Pneumoperitonium
Gas in Bowel wall (pneumatosis coli, linear pneumotosis intestinalis)
Biliary tree Gas
Portal Vein Gas
Urinary tract gas
Abscess
Pneomoperitoneun
ERECT free gas under the diaphragm can detect 10 ml of gas

SUPINE
Rigglers Sigh
Infant air collects centrally producing a round relatve translucency over the central abdomen
Falciform ligament may be outlined by fee gas-characterstic curvilinear white line in the right upper abdomen
Perforation
Iatrogenic
Pnemomediastinum
Per vagina
pneumothorax
idiopathic
Gasless Abdomen

Adult
High Obstruction
Ascites
Excessive Vomiting
Fluid filled bowel (closed loop obstruction, total active colitis)
Large abdominal mass
Gasless Abdomen

Child
High obstruction Duodenal atresia, volvulus, hypertrohic pyloric stenosis)
Vomiting
Fluid filled bowel
congenital diaphragmatic hernia
Ascites
Hazy appearaance of entire abdomen
bowel gas floats centrally on supine film
Bulging flank lines
cirrhosis
Tumors (meig's, ovarian peritoneal mets)
Hypoalbinemia
Peritonitis
Incresed pressure in vascular system distal to the liver
Lymphatic obstruction
Abdominal Mass in a Neonate

Renal 55%
hydroneohrosis
multicystic kidney
infantile polycystic kidneys
mesoblastic nephroma
renal vein thrombosis
renal ectopia
Wilm's tumor
Abdominal Mass in a Neonate

Genital 15%
hydrometrocolpos
ovarian cyst
Abdominal Mass in a Neonate

GIT 15%
Duplication most common
Mesenteric Cyst
Abdominal Mass in a Neonate

Non Renal Retroperitoneal 10%
Adrenal hemorrhage
Neuroblastoma
teratoma
Abdominal Mass in a Neonate

Hepatosplenobiliary 5%
hepatoblastoma
hepatic cyst
splenic hamartoma
choledochal cyst
Abdominal Mass in a Child

Renal 55%
Wilm's Tumor (2nd most common in childhood just behind neuroblastoma)
Hydronephrosis
Cysts
Abdominal Mass in a Neonate

Non Renal Retroperitoneal 23%
Neuroblastoma 21%
Abdominal Mass in a Neonate

GIT 18%
Appedix abscess
hepatoblastoma (more commonly R lobe 40% both)
hemangioma
choledochal cyst (mass pain jaundice)
Abdominal Mass in a Neonate

Genital 4%
ovarian cyst teratoma
Intestinal obstruction in a neonate

High Intestinal Obstruction
pyloric atresia
pyloric or prepyloric membrane /antral web
duodenal stenosis atresia
preduodenal portal vein
malrotation volvulus
Ladds bands
jejunal atresia
Intestinal obstruction in a neonate

Low Intestinal Obstruction
meconium ilues
ileal atresia
inguinal hernia
small left colon syndrome (maternal diabetes)
insoissated milk
colonic atresias
Imperforate anus (high sacral agenesis and gas in bladder (due to rectovesicular fistula), low perineal or urethral fistula
Abnormalities of Bowel rotation
Exomphalos (different from gastroschisis, in which bowel protrudes through a defect in the abdominal wall

Non Rotation (small bowel on the right side large bowel on the left. small and large bowel lie on either side of the SMA with a common mesentary US scan shows SMV to the left of the SMA (opposite to normal location)

Malrotation ( the duodenal flexture lies to the right and caudad to its usual position which is to the left of midline in the same axial plane as as the 1st part of the duodenum) The caecum is more usually 95%more cephalad than normal US scan shows SMV anterior to SMA

Reverse rotation (rare colon lies dorsal to the SMA with jejunum and duodenum anterior to it)
Intra-abdominal calcification in the newborn
Extraluminal
Fetal perforation and meconium peritonitis

Intramural
bowel atresia
meconium ileus
intrauterine volvulus

Intraluminal
Non hereditary intestinal obstruction (Hirscsprungs disease, small bowel atresia, imperforate anus)
Hematemasis
Esophagus
hiatis hernia
varices
neoplasms
Mallory Weiss tears

Stomach
ulcer
erosions
carcinoma

Duodenum
ulcer

Others
Osler-Rendu-Weber (telangiectasia)
Connective Tissue disease (Ehrlers Danlos)
Dysphagia

Adult

Intrinsic
Reflux Stricture
Tumors
Ingstion of corrosives
Iatrogenic RX
Pummer-Vinson web
Schatzki ring (marks the sc junction above the diaphragm, acute obstruction if internal diameter is < 6mm)
Candid (painful dysphagia, can involve entire esophagus Shaggy, Herpes, CMV may cause identical changes)
Dysphagia

Adult

Extrinsic
Tumors
Vascular (abberant left pulmonary artery (anterior indentation) right sided aortic arch (right lateral and posterior indentation))
Pharangeal pouch
Goitre
Enterogenous/neuroenteric cyst
Prevertebral abcess of hematoma
Dysphagia

Adult

Neuromuscular
Achalasia
Scleroderma
Chagas
Myasthenia Gravi
Bulbar/pseudobulbar palsey
Dysphagia

Neonate
Cleft Palate
Macroglossia Piere Robin
Esophageal atresia
choanal atresia
neuromuscular defects (prematurity, malnutrition, mental retardation)
Pharangeal esophageal pouches
Upper Third
Zenkers (post on the left side)
Lateral pharangeal pouch and diverticulum (glass blowers)
Lateral cervical esopahgeal pouch and diverticulum Killian Jamieson space

Middle Third
traction
Developmental (failure of complete closure of tacheoesophageal fistula)

Lower Third
Epiphrenic
Ulcer
Mucosal tear
Esophageal Ulceration
Inflammatory
refluc Esophagitis
Barret's esophagitis
candida esophagitis
Viral (herpes CMV)
Caustic ingestion
Radiotherapy
Crohns Disease

Neoplastic Carcinoma
leiomyoma
leiomyosarcoma
lymphoma
melanoma
Esophageal Stricture Smooth
Inflammatory
Peptic
Scleroderma
Corrosives
Iatrogenic

Neoplastic
Carcinoma
Mediastinal tunmors
Leiomyoma

Othres
Achalasia
Esophageal Stricture Irregular
Carcinoma
leiomyosarcoma
carcinosarcoma
lymphoma

Inflammatory
Reflux
Crohn's dx

Iatrogenic
Radiotherapy
Fundoplication
Tertiary Contraction of the Esophagus
Reflux esophagitis
presbyesophagus
obstruction at the cardia
Neuropathy (DM, Alcoholism Cgas)
Stomach Masses and Filling Defects
Primary malignant Neoplasms
carcinoma
Lymphoma

polyps
Hyperplastic
Adenamatous
Hamartomatous

SubMucosal Neoplasms
Leiomyoma
Lipoma
neurofibroma
Mets

Extrinsic Indentation
Pancreatic Tumor pseudocyst
Slno/hepatomegaly
retroperitoneal tumors

Others
Nissen fudoplication
Bezoar
lymphoid hyperplasia (association with H pylori)
pancreatic rest
Thick Stomach Folds
Infalmmatory
Gastritis
Zollinger Ellison Syn
Pancreatitis
Crohns Dx

Infiltrative/Neoplastic
lymphoma
carcinoma
pseudolymphoma
eosinophillic gastroenteritis

Others
Menetrieres Dx
Varices
Linitis Plastica
Neoplastic
gastric Ca
Lymphoma
Mets
Local Invasion

Inflammatory
Corrosives
RX
Granuloma (Crohn's TB)
Eosiniphillic Enteritis
Gastrocolic Fistula
Inflammatory
peptic ulcer
crohn's Dx
Panceatitis (chronic0
infections

Neoplstic
carcinoma
mets
Gastric Dilation
Mechanical Obstruction
Fibrosis Secondary to ulceration
malignancy
Volvulus (organoaxial associated with hiatis henia verticla axial not associted with HH)
Infantile hypertrophic pyloric stenosis (string sign barium in narrowed pyloric canal, shoulder sign pyloric mass indendint the barium filled antrum, beak sign incomplete extension of barium into the pyloric canal, Double track sign parralel mucosal folds in the pyloric channel)
Proximal bowel obstruction
Bezoar

Paralytic Ileus
postoperative
Post Vagotomy
Drugs
Metabolic
Acute gastric dilatation
Bulls Eye target lesion in the Stomach
Submucosal Mets
Leeiomyoma
Pancreatic rest
Neurofibroma
Gas in the Stomach Wall
Interstitial Gastric Emphysema
Raised intragastric pressure
Post gastroscopy
peptic Ulceration
Necrotizing enterocolitis

Emphysematous Gastritis
Diabetes
EtOH
Corrosive ingestion

Cystic Pneumatosis 9often assiciated with COPD)
Cobblestone Duodenal Cap
Big Polypoid
Edema
Hypertrophied Brunner's Glands (occur in people with renal failue)
Crohn's dx
varices
Lymphoma
Carcinoma

Small Duodenitis
Nodular lymphoid Hyperplsia
Fodd residue
Heterotrophic gastric mucosa
decreased Absnt Duodenal Folds
Scleroderma
Crohn's Dx
Stongyloides
CF
Amyloidosis
Thickened Duodenal Folds
Inflammatory
Duodenitis
Pancreatitis
Croh n's Dx
Zollinger Ellison Synd.

Neoplastic
Lymphoma
mets

Infiltrative
Amyloidosis
Eiosinophic enteritis
mastocytosis (dense bones)
Whipples Disease

Vascular
Intramural hematoma
Ischemia

Edema
Hyperproteneimia
Venous obstruction
Lymphatic Obstruction


Infestations
Worms
Giardisis
Dilated Duodenum
Mechanical Obstruction
Bands
Atresis, wegs, stenosis
Annular pancreas
SMA Syndrome

Paralytic Ileus (particularly due to pancreatitis

Scleroderma
Dilated Small Bowel
prox jejunum > 3.5 cm
mid small bowel > 3 cm
ileum > 2.5 cm
Normal folds
Mechanical obstruction
paralytic ileus
coeliac disease, sprue
scleroderma
iatrogenic

Thick Folds
Ischaemia
Crhn's dx
Rx
Zollinger-Ellison Synd.
Extensive small bowel resection
amyloidosis
Strictures in the Small Bowel
Adhesions
Crohns Dx
Ischemia
Radiation Enteritis
Tumors
Thickened Folds in Non Dilated Small Bowel-Smooth and Regular
Vascular
Intramural hematoma
Ischemia

Radiotherapy

Edema
Adjacent Inflamation
Hyperproteineamia
venous obstruction
lymphatic obstruction

Early Infiltration
Amyloidosis
Eiosinophilic Enteritis

Coeliac Dx
Thickened Folds in Non Dilated Small Bowel-Irregular and Distorted

Localized
Inflammatory
Crohn's Dx
Zollinger Ellison Synd.

Neoplastic
Lymphoma
Mets
carcinoid

Infective
TB
Thickened Folds in Non Dilated Small Bowel-Irregular and Distorted

Widespread
Infiltrative
Amyloidosis
Eiosinophilic enteritis
Mastocytosis
Whipples Dx

Inflammatory
Crohns

Infestations
Giardiasis
Strogyloides
Multiple Nodules in the Small Bowel
Nodular Lymphoid Hyperplasia
Crohn's Disease

Infiltrative
Whipples Disease
Waldenstrom's macroglobulinemia
Mastocytosis

Neoplastic
Lymphoma
polyposis
mets

Infective
typhoid
yersinia
Malabsorbtion
Mucosal
Celiac Dx
Inflammation
Ischemia
Infiltration
Lymphangiectasia
Parasites (Giardia ,strongiloides)

Digestive
gastrectomy
biliary obstruction
pancreatic dysfunction
dissacharide deficiency

Anatomical
fistula
resection
jejunal diverticulosis
Protein Loosing Enteropathy
Mucosal
Celiac Dx
Menetriers Dx
Sprue

Inflammatory
Crohn's Dx
UC
Rx

Ulceration
Ca stomach
Villous adenoma

Venous obstruction
Cirrhosis
IVC thrombosis


Chronic arterial Obstruction

Lymphatic Obstruction
lymphagiectasia
lymphoma
retroperitoneal fibrosis

Infiltrative
Whipple Dx
Eiosinophilic enteritis
Lesions in the Terminal Ileum
Inflammatory
Crohn's dx
UC
Rx

Infective
TB
Yersinsia
Actinomycosis

Neoplastic
Lymphoma
Carcinoid
Mets

Iscaemia (cobblestone)
Colonic Polyps
Adenamatous
simple tubular adenoam
tubulovillous adenoma
villous adenoma

Familial Polyposis Coli
Gardners Syndrome

Hyperplastic
Solitary/multiple
nodular lymphoid hyperplasia

Hamartomatous
Juvenile polyposis
Peutz Jeghera Synd.

Inflammatory
UC
Crohn's Dx

Infective
Schistosomiasis
Amebiasis

Others
Turcot (+ glioma)
Canada Cronkhite
Colonic Strictures
Neoplastic
carcinoma
lymphoma

Inflammatory
UC
Crohn's Dx
Pericolic abscess
Rx

Ischemia

Infective
Schistosomiasis
Amebiasis
TB
lymphogranuloma venereum

Extrinsic masses

Cathartic colon
Pneumatosis Intestinalis (gas in the bowel wall)
Primary 15%
Pneumatosis coli

Secondary 85%
NEC
Steroid and Immunotherapy
Collagen Disorders (scleroderma, dermatomyositis, JRA)
Leukemia
Colitis and Enteritis
Megacolon in an Adult
Non toxic (without mucosal abnormalities)
Distal obstruction
ileus
pseudo-obstruction
purgative abuse

Toxic (with severe mucosal abnormalities)
Inflammatory (UC, Crohn's< Pseudomembranous colitis)
Ischemic colitis
Dysentary (amoebiasis, salmonella)
Thumbprinting in the Colon
UC
Crohn's
Pseudomembranous colitis
Ischemic Colitis
Amoebic colitis
Schistosomiasis

Neoplastic
lymphoma
mets

DDx
lymphoma , mets
Apthoid Ulcers
In Colon
Crohn's dx
yersinia
Amebic colitis
Ischemic colitis

In Small Bowel
Crohn's Dx
Yersinai
polyarteritis nodosa
Anterior Indentation of the Rectosigmoid Junction
tumors
abscess
hematoma
ascites
endometriosis
hydatid
Sx
Widening of the Rectosigmois Junction
Normal Variant

Inflammatory
UC
Crohn's Dx
Rx
diverticulitis
Abscess

Neoplastic
Ca rectum
mets to rectum
sacral tumors (plasmycytoma, mets, chordoma, inkid sacrococcygeal teratoma)

others
CT of a Retriperitoneal Cystic Mass
Pancreas
psuedocyst
cystadenona.carcinoma
von Hippel Lindau

Kidney see later

Paraaortic cystic nodes
testicular teratoma carcinoma cervix

Retroperitoneal cystic tumoe
lymphangioma
leiomyosarcoma
hemangiopericytoma
Ct of Mesenteric Cystic Lesions
cysts
pancreatic pseudocyst
enteric duplication cyst
mesothelial cyst

Tumor
Teratoma
cystic leiomyoma/sarcoma
cystic mesothelioma
lymphangioma
Somatostatin Receptor Scintigraphy
Neuroendocrine Tumors Pituatary, gastrinoma, glucagonoma, insulinoma, paraganglioma, medullary thyroid ca, carcinoid)
Brai tumors (meningioma, astrocytoma)
breast ca
Lymphoma
sarcoidosis
False positive (Bleomycin)
Visualization of normal organs (pit, thyroid, spleen, liver, GB,Kidneys, urinary bladder,nasal region and lung hila with common cold)
Localization of Gastrointestinal Bleeding
Ulcers benign malignant
vascular lesions
tumors
inflammtory lesions
varices
sx anastamosis
Meckel's Diverticulum
Interssusception
Metastatic disease
Diverticula
False positive

Techniques
Technecium labelled red blood cells
Technecium labelled colloid
Meckel's Diverticulun
Tc Pertechtenate
Appears at the same time as the stomach
Blood in the bowel would be apparent hwever not rounded like a diverticulun
Localization of Infection

techniques 111ln leucocytes
Tc HMPAO hexamethylpropyleneamineoxiime)
Collection of pus
IBD
infected Prosthesis
Sinisitis
Acute infarcts
Myocarditis
Rejected transplant
Pancreatitis
infected tumor
Gallium Uptake
24 hours for inflammatory
lesions
72 hours for tumor
Inflammatory
Inflammation or abscess
sarcoidosis
diffuse lung disease
heart (myocarditis etc)


Tumors
lymphoma
Bronchial Ca
Gastrointestinal tumors
Hepatoma

Normal Variants
nasopharynx
bowel
breast