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14 Cards in this Set
- Front
- Back
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US
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operator dependent and limited by bowel gas and fat
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MRI
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degraded by motion artifact that is inherent to the bowerl
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CT
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one picture in time.
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Barium and small bowel
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pumped in via tube beyond the pylorus.
it distends the small bowel loops for better detail. |
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Presentation of gallstone ileus
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dilate small bowel loops to RLQ intraluminal stone with intracholecystic hematoma and ecidence of fistula in region of common bile duct.
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Biliary-enteric fistula (bila leakage)
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with gallstone ileus
85% stone passes directly into duodenum without obstruction 15% develop bowel obstruction. Stone is lodged in...(decreasing order)...terminal ileum, proximal ileum, distal jejunum, colon, duodenum, stomach. Last two - Bouveret's syndrome |
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Bouveret's syndrome
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Gallstone in duodenum or stomach with obstruction.
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Angiography and embolization
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minimally invasive
for percutaneous arterial access localize and ID the bleeding branch. superselect to minimize vasc injury to bowel and optimize embolization results. |
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US to liver (previously it was for GI tract)
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no ionizing radiation and least expensive
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CT for liver (previously it was for GI tract)
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radiation and higher soft tissue resolution
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MRCP
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for gallbladder and biliary tree
non-invasive diagnostic alternative to ERCP (Endoscopic Retrograde Cholangiopancreatography) Magnetic resonance cholangiopancreatography |
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ERCP
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for gallbladder and biliary tree
invasive ductal imaging and has therapeutic options with it. |
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Pt with RUQ pain, fever, leukocytosis and Murphy's sign (no deep insp when hand on gallbladder because it causes pain once fingers tough gallbladder)
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suspect gallstones
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Transhepatic cholangiogram
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invasive.
good when ERCP is not an option due to s/p bypass. therapeutic internal/external biliary drainage catheter placed. |
