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72 Cards in this Set
- Front
- Back
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Esophageal diverticular disease
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Pharyngeocele
Zenker's diverticulum Traction diverticulum Pulsion diverticulum Epiphrenic diverticulum Mimics: Paraesophageal hernia, perforation with contrast extravasation |
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Esophageal luminal narrowing
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Webs: Idiopathic, Plummer-Vinson
Rings: Congenital (vascular, muscular) Strictures: Skin lesions (epidermolysis, pemphigoid-occur proximal), Tumor, Esophagitis (lye, barretts, infection), achalasia, scleroderma, chagas Extrinsic compression: Vascular aortic arch, arch anolies, aneurysm, left atrium, left bronchus, mediastinal tumors |
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Megaesophagus
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Achalasia
Scleroderma Dilation 2 to distal narrowing (tumor, stricture) Chagas disease Diabetic or alcoholic neuropathy Bulbar palsy |
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Esophageal tears
contrast extravasation fistula |
Esophagitis
Tumor Vomiting (Mallory Weiss, Boerhaaves) Tracheoesophgeal fistula (peds) Bronchopulmonary foregut malformatione with communication to esophagus |
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Solitary filling defect in esophagus
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Neoplasm: benign ( leiomyoma, fibrovascular polyp, cyst, papilloma, fibroma, hemangioma) malignant (squamous cell, adeno ca, carcinosarcoma, lymphoma, mets)
Foreign bodies Varicies Extrinsic lesions: lymphnode, engorged vessels, aneurysm, cysts |
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Thickened esophageal folds
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Early esophagitis
Neoplasm: lymphoma, varicoid carcinoma Varices |
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Air fluid level in esophagus
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Hiatal hernia
Esophageal diverticulm Motility disorder: achalasia, sclerderma Cancer |
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Gastritis
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Erosive: corrosives, alcohol, stress, drugs
Granulomatous: crohns, sarcoid, syphilis, TB, histo Eosinophilic: peripheral eosinophilia, hypoalbuminemia, hypogammaglobulinemia, hyperplastic polyps Hypertrophic: menetriers, ZE, PUD, retained gastric antrum, drugs Misc: radiation, olcer, corrosives, pseudolymphoma, suture line ulceration, intraarterial chemo |
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Target (bulls eye) lesion in stomach
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Gastritis: erosive, granulomatous, infectious
Submucosal mets: melanoma, kaposis sarcoma, breast, lung, pancreas, lymphoma Solitary and large: Leiomyoma, sarcoma |
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Filling defect ( mass lesion) in stomach
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Bezoar
Neoplasm: adeno ca, lymphoma, leiomyosarcoma, mets, kaposis Other: endometriosis, carcinoid, benign tumors, polyps, varices, extramedullary hematopoiesis, ectopic pancreas |
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Giant Rugal folds -stomach
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Tumor- lymphoma
Inflammation- menetriers, ZE, gastritis (a/w pancreatis), bile reflux gastritis, eosinophilic gastoenteritis |
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Linitis plastica
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Tumor-scirrhous cancer, lymphoma, mets, pancreatic ca (direct invasion)
Inflammation- erosvie gastritis, radiotherapy Infiltrative- sarcoid, amyloid, intramural gastric hematoma Infection- TB, syphilis |
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Antral lesions -stomach
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Tumor- adeno ca, lymphoma, mets
Inflammatory- crohns, PUD, TB, sarcoid Other- hypertrophic pyloric stenosis, pylorospasm, antral web |
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Free intraperitoneal air
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Surgery
Perforated gastric or duodenal ulcer Cecal perforation from colonic obstruction pneumotosis coli Air through genital tract in females Perforated distal bowel (IBD, diverticulitits, tumor)-usually small amts of air |
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Duodenal filling defects
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Neoplastic- Benign (often in 1st portion)- adenoma, leiomyoma, carcinoid, villous adenoma, Malignant( (often distal to 1st portion)- adeno ca, mets
Bulb- ectopic gastric mucosa, prolapsed antral mucosa, brunner galnd hyperplasia, varices Distal- lymphoid hyperplasia, ectopic pancrease, annular pancreas, papilla of vater, tumor, edema with impacted or passed gallstone, choledochocele |
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Malignancy based on location in duodenum
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Bulb: 90% benign
2nd and 3rd: 50% malignant 4th: 90% malignant |
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Luminal outpouching of duodenum
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ulcer: with contained perforation, malignant
Diverticulum: pseudodiverticulum (ulcer scarring), choledochoduodenal or cholecstoduodenal fistula, true diverticuoum (2nd part) |
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Post Bulbar narrowing of duodenum
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Neoplastic: adeno ca, lymphoma, mets
Inflammatory: Intrinsic( post bulbar ulcer, duodenitis, crohns) extrinsic (pancreatitis) Other: Annular pancreas, intramural diverticulom, duodenal duplication cyst, duodenal hematoma, aortic aneuryms (3 portion), SMA syndrome (supine position causes partial obstruction of 3rd portion by SMA) |
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Papillary enlargement
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Normal variant
Choledochocele Papillary edema (pancreatitis, acute duodenal ulcer, impacted stone) Ampullary cancer (adenomatous polyp, CA) |
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Paralytic (adynamic) ileus
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Postoperative
Vascular: IBD Inflammatory: pancreatitis, appendicitis, cholecystitis, diverticulitis, peritonitis Metabolic: hypokalemia, hypocalcemia, hypomagnesemia Medication: morphine, lomotil |
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Mechanical SBO
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Adhesions
Hernias Tumors Gallstones Inflammation with strictures |
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Malabsorption patterns
Predominantly thick/irregular fold WAG CLEM |
Whipples
Amyloid Giardiasis (jejunem) Crytosporidiosis (jejunem) Lymphoma, lymphangiectasia, lactase deficiency Eosinophilic gastroenteritis Mycobacterium avium complex |
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Malabsorption patterns
Predominantly dilated loops, normal folds SOSO |
Sprue
Obstruction or ileus Scleroderma Other: medication, vagotomy |
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Thick fold without malabsorption pattern (edema, tumor, hemorrage)
Diffuse (uniformily thickened) Focal: pinky printing, stack of coins, picket fence |
Submucosal: ischemia, enteritis (infection, radiation), hypoprotienemia, GVH reaction
Submucosal tumor: lymphoma,leukemia, infiltrating carcinoid Submucosal hemorrhage: henoch schonlein disease, hemolytic uremic syndrome, coagulopathies, thrombocytopenia, DIC |
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Nodules in small bowel
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Mastocytosis
Lymphoid hyperplasia Lymphoma Mets Polyps Crohn's disease |
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Small bowel tumors
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Benign: adenoma, leiomyoma, lipoma, hemangioma, neurogenic tumors, brunner gland hyperplasis, heterotopic pancreatic tissue
Malignant: melanoma, kidney, breast, Kaposi sarcoma, lymphoma, carcinoid, sarcoma, adeno ca Polyposis syndromes |
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Mesenteric Bowel ischemia
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Occlusive disease: emboli, arterial thrombosis, venous thrombosis
Non occlusive: hypotension, hypovolemia |
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Shortened transit time
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Anxiety
Hyperthyroidism Medication: reglan, neostigmine, quinidine, methacholine Partial SB0: paradoxical rapid propulsion to point of obstruction |
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Mass lesions in colon
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Nonneoplastic: normal follicular pattern, pneumotosis coli, colitis cystica profunda, amyloidosis, endometriosis, ischemic colits
Polyps Polyposis syndromes Benign neoplasm: lipoma, leiomyomoa Malignant neoplasm: adeno ca, mets, lymphoma |
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Polyps in the colon
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Hyperplastic (90%)-no malignant potential
Adenomatous-malignant transformation Hamartomatous- peutz Jeghers |
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Ulcers in colon
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Apthoid ulcers (superficial)- crohns, amebiasis, behcets, CMV, herpes
Deep ulcers- inflammatory colitis (UC, crohns, behcets), infectious (Ambeasis, TB, salmonella, shigella, histo, AIDS (candida, herpes, CMV)) Ischemic colitis Radiation colitis |
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Bowel wall thickening of colon (thumbprinting)
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Edema- Infectious colitis ( c. dif, CMV, E coli, Shgella, salmonella, amebiasis), neutropenic colitis (typhlitis)
Tumor- lymphoma, leukemia Hemorrhage- ischemia, schonlein-henoch disease, thrombcytopenia, DIC, coagulopathies |
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Tumorlike colonic deformity
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Tumor- adenocarcinoma, mets (gastric ovarian)
Inflammation- diverticulitis, IBD (crohns, UC) Infection- ameboma, TB Other- endometriosis, pelvic abscess, epiplioc appendagitis |
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Long (>10cm) colonic narrowing
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Scirrhous adenocarcinoma
Lypmhoma UC Crohns Ischemic stricture Radiation |
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ahaustral colon
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Cathartic abuse
UC, crohns Amebiasis Aging (usually left colon) |
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Colonic obstruction
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Carcinoma (65%)
Diverticulitis (20%) Volvulus Other (impaction, hernia) |
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Megacolon
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Toxic- UC, crohns, infectious (c dif, amebiasis, shigellosis)
Acute colonic distention- obstructive (cancer), paralytic ileus, volvulus Chronic megacolon- cathartic colon, colonic pseudoobstruction (ogilivies, ileus), psychogenic, congenital (hirshsprung) chagas, neuromuscular (parkinson, diabetes, scleroderma, amyloid), metabolic (hypothyroidism, electrolyte imbalance) |
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Adult intussusception
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Ileoileal (40%)>ileocolic (15%)> other
Idiopathic Tumors- polyps, lipoma, malignant tumors Other- Meckels, adhesions, aberrant pacreas |
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Pneumotosis coli
Pneumatosis cystoides- large cyst like collection of air, few symptoms, a/w benign etiologies |
COPD
Patients on ventilator Mucusal injury ( rectal tube insertion, colonoscopy, srugery) Scleroderma Steroids Chemotherapy |
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Pneumatosis coli
Pneumoatosis intestinalis- symptomatic, a/w serious etiologies |
Infarcted bowel
Necortizing enterocolitis Toxic megacolon Typhlitis |
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Ileocecal deformities
Inflammation - coned cecum |
Crohns- apthous lcers, linear fissures, nodules, cobblestone, stricture, spasm, fistula
UC-valve wide open, labia atrophied, termial ileum dilated TB- narrow cecem (fleischner sign) Typhlitis- inflammatory changes of cecum and ascending colon in neutropenic pts |
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Ileocecal defomities
Tumor |
Lymphoma
Adenocarcinoma Carcinoid Intussusception |
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Proctitis
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Condylomata acuminata
Lymphogranuloma venereum Gonococcal proctitis UC, Crohns |
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Liver masses
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Solid- hemangioma, primary, mets, focal fatty, regenerating nodules
Cystic- infectious(echinococcus, amebiasis, other), smilple cyst, polycystic liver disease, biliary cystadenoma, obstructed intrahepatic GB, biloma, cystadenocarcinoma, cystic mets, necrotic tumors, cholangiocarcinoma |
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Abnormal liver density
Increased |
hemochromatosis
glycogen storage disease Wilson's disease Drugs: amiodarone, cisplatin Appaent increased density in patiens with anemia |
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Abnormal liver density
decreased |
Fatty liver- obesity, alcolhol, diabetes, steroids, chemotherapy
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Hypervascular liver lesions
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hemangioma
Hemangioedothelioma, hemagiopericytoma, angiosarcoma, intrahepatic cholangiocarcinoma Mets- islet cell, melanoma, carcinoid, RCC, thyroid, breast, sarcoma |
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Hyperechoic liver lesion
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Round- hemangioma, hyperechoic mets (hypervascular mets, sarcoma, calcified mets), primary liver tumors (HCC, fibrolamellar HCC), focal fat, lipoma, angiomyolipoma (TS), Gauchers disease
Linear lesions: air in biliary tree, air in portal veins, biliary ascariasis |
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Multiple hypoechoic liver lesions
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Tumor- mets, lymphoma, multifocal HCC
Infection- Multiple pyogenic abscesses, amebic abscesses, echinococcus, candiasis, schistosomiasis Other- regeneratin nodules, cirrhosis, sarcoid, extramedullary hematopoiesis, hematomas, hemangiomas |
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Gas in liver
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Biliary: ERCP, surgery
Portal venous: bowel necrosis, diverticulitis Abscess Emphysematous cholecystitis |
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Extrahepatic biliary dilatation
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Intrapancreatic obstruction: pancreatic cancer, calculus, chronic pancreatitis
Supra pancreatic obstruction: primary biliary ductal ca, met lymph nodes Portal obstruction: invasive GB carcinoma, surgical strictures, hepatoma, cholangiocarcinoma |
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Types of biliary obstruction
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Tumor- abrupt termination of duct, mass adjacent to duct
Pancreatitis- smooth, long, tapering Lithiasis-related- calculus visible, mensicus sign (ERCP, CT) Cholangitis- sclerosing cholangitis, AIDS cholangitis, intrahepatic biliary calculi(oriental cholangiohepatitis) Caroli's disease- Intrahepatic biliary neoplasm- cystadenoma, cystadenocarcinoma |
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Ultrasound signs of intrahepatic dilatation
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Color doppler flow absent in ducts
Acoustic enhancement behind dialted ducts Double duct sign- dilated biliary vessel accompanies portal vein Caliber irregularity and tortuosity of dilated bile ducts (veins are smooth and taper) Spoke wheel appearance at points of conversion of ducts |
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Diffuse (concentric) GB wall thickening (>3mm)
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Nonfasting GB
Acute cholecystitis Chronic cholecystits Portal venous htn Hypoalbuminemia Hepatitis AIDS (crypto, CMV, MAI) Ascites |
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Focal (eccentric) GB wall thickening
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GB carcinoma
Mets (melanoma>> gastric, pancreas Benign tumors ( polyps, adenomyomatosis) Tumefactive sludge adherant to GB wall AIDS |
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Hyperechoic foci in GB wall
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Calculus
Polyp Cholesteral Emphysematous cholecystitis Porcelain GB |
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Dense GB on CT
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Hepatobiliary excretion of contrast
Calculi Milk of calcium bile Emphysematous cholecystitis Porcelain GB |
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Focal pancreatic signal abnormality
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Tumor
Focal pnacreatitis Adenapathy |
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Cystic pancreatic lesions
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Benign- serous cystadenoma
Premalignant- mucinous cystadenoma, mucinous cystadenocarcinoma, duct ectatic cystadenocarcinoma (IPMT), epithelial Cyst- simple cyts, pseudo cyst, vonhippel lindau, duct ectasia |
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Hyperechoic pancreas
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cystic fibrosis
pancreatic lipomatosis |
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Focal splenic lesions
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Tumor - mets, hemangioma, lymphangioma, hamartoma
Infection- abscess, candidiasis, TB, MAI, schistosomiasis, PCP Other- infarcts, hematoma, cysts, fatty nodules in gauchers disease |
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Splenomegaly
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Tumor-leukemia, lymphoma
Infection- mononucleosis, Histo Metabolic- Gauchers, amyloid, hemochromotosis Trauma Vascular- portal htn, hematological disorders (anemia, sickle cell, thalassemia, myelfibrosis, myelosclerosis) |
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Peritoneal fluid collections
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Water- ascites, urinoma, biloma, seroma, lymphocele, pnacreatic pseudocyst, CSF pseudocyst form VP shunt
Complex-abscess, hematoma, pseudomyxoma peritonei, pancreatic necrosis |
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Intraperitoneal calcifications
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Arterial calc
Appendicolith Mesentartic node Cholelithiasis Pacreatic calc Porcelain GB Renal/ureteral calc Old hematoma/abscess Uterine fibroid fetal skeletal part Pelvic phelbolith Teratoma Liver:echinococcal cyst |
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AIDS
causes of GI manifestations |
CMV
Candida Herpes Crypto MAI Kaposi Lymphoma |
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AIDS
Common manifestation in esophagus |
Ulcers: candida, CMV. herpes
Sinus tracts: TB, actinomycosis |
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AIDS
Common manifestation in Proximal SB |
Ulcers: cryptococcosis
Nodules: Kaposi's sarcoma, MAI |
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AIDS
Common manifestation in distal SB |
Enteritis: TB, MAI, CMV
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AIDS
Common manifestation in colon |
Colitis: CMV, pseudomembranous colitis
Typhlitis |
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AIDS
Common manifestation in biliary |
Strictures: CMV, Crytococcosis
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Abdominal trauma
Frequency of injury |
Liver lac
Splenic lac Renal trauma Bowel trauma Pancreatic fx Rare: GB injury, adrenal hemorrhage |
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Abdominal complications after cardiac surgery
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GI hemorrhage (50%)
Cholecystitis (20%) Pancreatitis (10%) Perforated peptic ulcer (10%) Mesenataric ischemia (5%) Perforated diverticular disease (5%) |
