surgery abdominal films

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Author:
CircadianHomunculus
ID:
257923
Filename:
surgery abdominal films
Updated:
2014-01-29 10:09:11
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surgery abdominal films
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Description:
exam 1 abdominal films
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  1. What are the bone abnormalities?
    • scoliosis
    • osteophytes (older pt)
    • possible calcifications in right sacral area
    • ------------------------
    • **soas shadow also seen (not bone)
  2. What is the bone abnormality in this film?
    missing right femur in infant
  3. What are the arrows pointing to? What can be seen in total on this film?
    • fat stripe along flank
    • -----------------------------
    • diagonal right psoas shadow is seen (can be obscured by hematoma/inflammation
    • right colon containing feces and air
  4. What normal finding is easily seen on this film pointed out by the 3 arrows? What is pointed out with 1 arrow? 2 arrows? Which kidney is larger here?
    • psoas shadows (3)
    • tip of spleen (1)
    • tip of liver (2)
    • left kidney is larger
  5. Is the patient a child or adult? Is the amount of bowel gas in the colon normal or abnormal?
    • child
    • normal bowel gas
  6. What is the abnormality in this film?
    large spleen
  7. What is the abnormality in this film?
    ruptured spleen with surrounding hematoma (trauma)
  8. What structure has most likely ruptured?
    RT kidney
  9. What abnormality is seen? Did the patient receive contrast?
    ruptured RT kidney with IV contrast and surrounding hematoma
  10. What structures (filled with air) are seen here?
    • A: stomach (lrg longitudinal rugae seen with oral contrast)
    • B and C: abnormal small bowel filled with air (thin lines close together)
    • D: normal colon (thick haustra farther apart)
  11. What is the abnormality seen in this new born that has vomited since birth?
    there is no bowel gas (obstruction)
  12. Where is the air in this film? What can be determined with what is seen?
    • stomach
    • air does not get past the stomach into the bowel therefore there must be a congenital gastric outlet obstruction
    • ---------------------
    • **in adults gastric outlet obstruction can be caused by inflammation from duodenal ulcer, cancer of the stomach or pancreas, or duodenal hematoma from trauma
  13. What is the abnormality seen in this film? What are the common causes?
    • colon obstruction (flat film) shows C-shaped distended colon
    • causes include colon cancer (MC), volvulus, or diverticulitis
  14. What is the abnormality seen in this film? What are some common causes?
    • colon obstruction (upright film) shows abnormal air/fluid levels
    • common causes include colon cancer (MC), volvulus, or diverticulitis
  15. What is seen on this film? Is it normal?
    • air in the small bowel (reveals circular folds known as valvulae conniventes & plicae circulares shown as thin lines close together)
    • NOT NORMAL!
  16. What type of image is this and what does it show?
    • plain flat image
    • shows dilated stacked loops of small (obstructed) bowel
  17. What type of image is this and what does it show?
    • plain upright image
    • shows many air/fluid levels of small (obstructed) bowel
  18. What is the abnormality? What is it called and how does it happen?
    • free air in abdomen
    • pneumoperitoneum
    • perforated stomach/intestine (ulcer)
  19. What is the abnormality? What would be some physical findings in this patient?
    • free air in abdomen (pneumoperitoneum)
    • tympany, loss of liver dullness, tenderness
  20. Will percussion on this patient's abdomen be tympanitic or dull? Why?
    • typanitic
    • there is free air in the abdomen (darker x-ray)
  21. Will percussion on this patient's abdomen be tympanitic or dull? Why?
    • dull
    • there is much fluid in the pelvis (fluid is almost white on xray)
  22. What type of xrays are these? What do they show?
    • A: flat film, shows much fluid in the abdomen (flanks are bulging, bowel gas is floating in center)
    • B: upright film, shows fluid and also free air (ascites + free air)
  23. What are the major abnormalities in this film?
    • gallstones (usually NOT calcified) in RUQ
    • ureteral stone (larger stone toward midline)
  24. What is the abnormality?
    • large bladder stone (long standing)
    • **makes patient prone to UTIs; a more flat calcification in this area could be the prostate
  25. What is the calcification on this film?
    appendicolith (but don't count on finding these)
  26. What is the finding on this film? Is it common? What can they be mistaken for?
    • phleboliths (calcifications in small clots of pelvic veins)
    • VERY common
    • don't mistake for ureteral stones
  27. Which artery is calcified on the left? Which one on the right?
    • Left: splenic artery (very tortuous/long & twisting)
    • Right: aorta (the wals of the arch and abdominal aorta often have calcifications in older people)
  28. What does this film show? What does it suggest?
    • fetal skeleton far from the bladder that has been filled with air (contrast)
    • might suggest placentia previa
  29. What imaging study is this?
    barium swallow (upper esophagus)
  30. What imaging study is this?
    barium swallow (mid-esophagus)
  31. What imaging study is this?
    barium swallow (distal esophagus during valsalva- pt has reflux)
  32. What imaging study is this?
    • UGI (upper GI series) to see esophagus, stomach, duodenum plus SBFT to show small bowel
    • **patient must be moved around in various positions for different views while radiologist watches on fluoroscopy**
  33. What imaging study is this? What structure is being looked at?
    • air contrast barium enema (ACBE) aka double contrast
    • colon
  34. What imaging study is this?
    single contrast barium enema (no air) to see colon
  35. What imaging study is this? What is the abnormality?
    • intravenous pyelogram (IVP)
    • hydronephrosis on the left side
  36. What imaging study is this? What is the abnormality?
    • urethrogram, cystogram
    • extravasation (leaking) of contrast from bladder
  37. What is this imaging study? What does it show?
    • nuclear medicine imaging after injection of radioactive tracer
    • meckel's diverticulum

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