GI IMAGING

1
GI IMAGING
2
WHO ARE THE PATIENTS ?

• Esophageal cancer / Hiatal hernia / Reflux
• Gastritis / Ulcer
• Small bowel obstruction
• Appendicitis
• Crohns disease
• Colon cancer
• Diverticulitis
• GI bleed

3
AP SUPINE ABDOMEN XRAY GAS PATTERNS
STOMACH
COLON
STOMACH
SM. BOWEL
SM. BOWEL
COLON
SUBTLE GAS PATTERN
OBVIOUS GAS PATTERN
4
WHO ARE THE PATIENTS ?

• ESOPHAGEAL CANCER
• HIATAL HERNIA
• REFLUX
• SIGNS / SYMPTOMS
• CHEST PAIN
• DIFFICULTY SWALLOWING
• HOARSENESS

5
IODINE vs. BARIUM

• IODINE IS WATER SOLUABLE AND CAN BE A VASCULAR
  CONTRAST
• BARIUM IS INERT, NON SOLUABLE NOT FOR VASCULAR
  USE
• STANDARD IS BARIUM FOR GI EXAMINATION
• IF THERE IS RISK OF PERFORATION---IODINE
• IF THERE IS RISK OF ASPIRATION---BARIUM

6
NORMAL ESOPHAGUS
7
RADIOLOGY DIAGRAM
8
ESOPHAGEAL CANCER
9
ESOPHAGEAL CANCER
10
ESOPHAGEALVARICES
11
NORMAL ESOPHAGUS
HIATAL HERNIA
DIAPHRAGM
DIAPHRAGM
12
HIATAL HERNIA
L
CXR FINDINGS
13
ASPIRATION
NORMAL SWALLOW
14
WHO ARE THE PATIENTS ?

• GASTRITIS / ULCER
• SIGNS / SYMPTOMS
• PAIN
• ANEMIA
• HEMATOCHEZIA
• MELENA

15
FUNDUS
NORMAL GASTRIC ANATOMY
DUODENUM
BODY
ANTRUM
JEJUNUM
C-LOOP
16
BENIGN GASTRIC ULCER
17
GASTRIC CARCINOMA
18
NORMAL GAS PATTERN
AIR UNDER THE DIAPHRAGM
19
UPRIGHT
ERECT AND DECUBITUS ABDOMEN FILMS SHOW FREE AIR
UNDER THE DIAPHRAGM.
DECUBITUS
20
WHO ARE THE PATIENTS ?

• SMALL BOWEL OBSTRUCTION
• SIGNS / SYMPTOMS
• PAIN
• DISTENSION
• HYPOVOLUMIA

21
NORMAL SMALL BOWEL
IMMEDIATELY AFTER INGESTION OF BARIUM
ONE HOUR LATER
22
SMALL BOWEL OBSTRUCTION
ERECT
SUPINE
ERECT
23
PARTIAL SMALL BOWEL OBSTRUCTION
DILATED BOWEL

OBSTRUCTION
NON DILATED BOWEL
24
CT- SMALL BOWEL OBSTRUCTION
PROXIMAL DILATED BOWEL
DISTAL NORMAL BOWEL
OBSTRUCTION MOST LIKELY DUE TO ADHESIONS IN A
PATIENT WITH HISTORY OF ABDOMINAL SURGERY
25
HERNIA
CT
SM. BOWEL BARIUM STUDY
26
POST OP ADYNAMIC ILEUS
LARGE AND SMALL BOWEL
27
WHO ARE THE PATIENTS ?

• CROHNS DISEASE
• INFLAMATORY BOWEL DISEASE
• SIGNS / SYMPTOMS
• PAIN
• DIARRHEA
• WEIGHT LOSS

28
CHROHNS DISEASE
29
WHO ARE THE PATIENTS ?

• APPENDICITIS
• SIGNS / SYMPTOMS
• RIGHT LOWER QUADRANT PAIN
• FEVER
• ELEVATED WBCs

30
APPENDICOLITH
31
ACUTE APPENDICITIS
32

ABSCESS
DRAINAGE
33
WHO ARE THE PATIENTS ?

• COLON CANCER
• SIGNS / SYMPTOMS
• SCREENING
• POSITIVE HEMOCULT
• WEIGHT LOSS
• OBSTRUCTION
• PAIN

34
SPLENIC FLEXURE
HEPATIC FLEXURE
NORMAL COLON
TRANSVERSE COLON
DESENDING COLON
ASCENDING COLON
TERMINAL ILEUM
CECUM
35
PEDUNCULATED COLON POLYP
(DESCENDING COLON)
36
COLON POLYP
37
COLON OBSTRUCTION
38
COLON CANCER
39
COLON
SIGMOID VOLVULUS
40
COLONVOLVULUS
BEAK SIGN
41
WHO ARE THE PATIENTS ?

• DIVERTICULITIS
• SIGNS / SYMPTOMS
• LEFT LOWER QUADRANT PAIN / FEVER
• ELEVATED WBCS

42
DIVERTICULOSIS
43
COLON CT
DIVERTICULITIS