On Call Radiology
Abdomen
This lecture is dedicated to radiology, internal medicine and surgery residents.
Become familiar with common imaging findings which you might see
during your call or in the Emergency room.
Based on the OnCallRadiology series (www.oncallradiology.com), which has been presented at several international Radiology meetings (RSNA, ARRS, ECR, ICR etc.)
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Haha, the last guy was my favorite!
Must have had some chronic iron deficiency!
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Must have had some chronic iron deficiency!
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nice tutorial..... thanks Dr.Roland.... what did tat last guy eat
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Really great video...i watched it twice to save these photos in my mind...
I can summarize it here...& add few things i learnt...
In ER room 1st thing to do,,,take patient history so can target your look (if suspected trauma , pathological # or degeneration you will sharpen your eyes to skeleton FOR #,dislocation,lytic ,blastic lesion,degeneration or deformity... while if acute abdomen or abdominal pain you concentrate in looking to
1.Calcification (GB stone,,mostly non radioopaque /Renal stone,,mostly radioopaque...can diffrenciate ()both by history,lateral film if infront of spine highly for GB if on spine highly for renal / phlepolith / appendicolith / calcified fibroid or prostate or seminal vesicle / old hematoma)
2. Intestinal loops for
---Distension with air & fluid levels ,, (SI more than 3 cm,LI more than 5cm)... We should have 1. ERECT film :to see multiple fluid levels..
2.SUPINE film:to determine level of obstruction by gas pattern in distended intestine proximal to obst... (Fine transverse striations produced by circular mucosal folds & pass from mesentric to antimesentric border in distended jejunal loops,structureless cylindrical shadow in in distended ileum,while atypical haustrated gas shadow which not cross from one edge to the other in distended colon)
---Air ....either *in wall (pneumatosis) & may extends to portal venous system,,,,,,BUT not forget that it mimics pneumobilia.... so history again will help you (of ERCP,biliary surgery)
Or * Free intra-abdominal air(gas under diaphragm) in cases of perforated viscus,iatrogenic or neoplasm surgery or laparoscopy...this mimics colon interpositionn() liver & RT copula ...so lateral film will solve this.
---Displacement by Mass effect as in(neoplasm,abscess,hydronephrosis,distended GB or UB),,,that may also displaces diaphragm.
---Dont forget to check lines & tubes in its exact site if present....for fear of displacement.
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I can summarize it here...& add few things i learnt...
In ER room 1st thing to do,,,take patient history so can target your look (if suspected trauma , pathological # or degeneration you will sharpen your eyes to skeleton FOR #,dislocation,lytic ,blastic lesion,degeneration or deformity... while if acute abdomen or abdominal pain you concentrate in looking to
1.Calcification (GB stone,,mostly non radioopaque /Renal stone,,mostly radioopaque...can diffrenciate ()both by history,lateral film if infront of spine highly for GB if on spine highly for renal / phlepolith / appendicolith / calcified fibroid or prostate or seminal vesicle / old hematoma)
2. Intestinal loops for
---Distension with air & fluid levels ,, (SI more than 3 cm,LI more than 5cm)... We should have 1. ERECT film :to see multiple fluid levels..
2.SUPINE film:to determine level of obstruction by gas pattern in distended intestine proximal to obst... (Fine transverse striations produced by circular mucosal folds & pass from mesentric to antimesentric border in distended jejunal loops,structureless cylindrical shadow in in distended ileum,while atypical haustrated gas shadow which not cross from one edge to the other in distended colon)
---Air ....either *in wall (pneumatosis) & may extends to portal venous system,,,,,,BUT not forget that it mimics pneumobilia.... so history again will help you (of ERCP,biliary surgery)
Or * Free intra-abdominal air(gas under diaphragm) in cases of perforated viscus,iatrogenic or neoplasm surgery or laparoscopy...this mimics colon interpositionn() liver & RT copula ...so lateral film will solve this.
---Displacement by Mass effect as in(neoplasm,abscess,hydronephrosis,distended GB or UB),,,that may also displaces diaphragm.
---Dont forget to check lines & tubes in its exact site if present....for fear of displacement.
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