KEYS OF RADIOLOGY SPOTTERS GIT
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KEYS OF RADIOLOGY SPOTTERS GIT
- 1. SPOTTERS-KEYS DR. ANISH CHOUDHARY, JR 3 30.05.16
- 2. 1.
- 3. Zenker’s diverticulum Findings: Focal contrast collection along the posterior lateral proximal esophagus connecting by a thin neck Found at the cricopharyngeus, the Killian’s dehiscence ddx: NONE! This is an Aunt Minnie!
- 4. 2.
- 5. Gastric carcinoma Findings: Large mass projecting into the fundus with a large central ulcer loss of normal folds and wall contour ddx: leiomyosarcoma lymphoma metastasis
- 6. 3.
- 7. Long esophageal stricture Findings: long segment of esophageal narrowing loss of normal mucosal pattern ddx: Long-term nasogastric intubation radiation
- 8. 4.
- 9. Achalasia Findings: tight stenosis of the distal gastroesophageal junction = “bird’s beak” appearance dilated proximal esophagus ddx: pseudoachalasia Malignant stricture Benign stricture Chagas disease
- 10. 5.
- 11. Pancreatitis Findings: diffuse narrowing of the duodenum splaying of the “C-loop loss of normal mucosal pattern ddx: large tumor pseudocyst hemorrhage
- 12. 6.
- 13. Area gastrica Findings: Fine linear polygonal pattern of the gastric body seen on a double contrast study This is a normal fold pattern ddx: NONE! This is an Aunt Minnie!
- 14. 7.
- 15. Ascariasis Findings: serpentine intraluminal foreign bodies = ascaris worms thin ribbon of contrast = barium WITHIN worm GI tract ddx: NONE! This is an Aunt Minnie!
- 16. 8.
- 17. Barrett’s esophagus Findings: Segmental narrowing of the distal esophagus with smooth tapering margins, ulcerations, and loss of normal mucosal pattern ddx: GERD radiation malignancy
- 18. 9.
- 19. Boerhaave’s syndrome Findings: focal horizontal contrast extravasation in the posterior distal esophagus surrounding abnormal posterior mucosa ddx: Iatrogenic Tumor
- 20. 10.
- 21. Brunner’s gland hyperplasia Findings: multiple smooth and round filling defects up to 1cm involving the bulb and descending duodenum due to increased acidity in the duodenal bulb ddx: Hyperplastic polyps Familial polyposis syndromes
- 22. 11.
- 23. Bezoar Findings: mass-like gastric luminal filling defect composed of undigested or partially digested food may cause obstruction ddx: NONE! This is an Aunt Minnie!
- 24. 12.
- 25. Pseudomembranous colitis Findings: numerous thickened folds of the transverse and descending colon sloughed mucosa or debris within the lumen ddx: Ischemic colitis Ulcerative colitis Crohn’s disease Infectious colitis
- 26. 13.
- 27. Candida esophagitis Findings: numerous plaque-like filling defects of the distal esophagus no erosions or narrowing seen may appear worse with disease severity ddx: NONE! This is an Aunt Minnie!
- 28. 14.
- 29. Caroli’s disease Findings: percutaneous cholangiogram shows marked dilated and beaded appearance of the intrahepatic biliary system ddx: NONE! This is an Aunt Minnie!
- 30. 15.
- 31. Cholangiocarcinoma Findings: percutaneous cholangiogram shows smooth narrowing of the biliary duct confluence and proximal common hepatic duct ddx: NONE! This is an Aunt Minnie!
- 32. 16.
- 33. Lye stricture & colonic interposition Findings: Long segmental distal esophageal narrowing Anteriorly located bowel loop connecting mouth of stomach = interposed colonic loop ddx: NONE! This is an Aunt Minnie!
- 34. 17.
- 35. Apthous ulcers Findings: Numerous shallow mucosal defects with a surrounding mound of edema = “bull’s eye” or “target” lesions do NOT penetrate beyond the muscularis mucosa ddx: Crohn’s disease Infectious colitides
- 36. 18.
- 37. Inflammatory polyps Findings: islands of normal or edematous mucosa seen during active inflammation they protrude into the lumen because the surrounding mucosa is sloughed or deeply ulcerated ddx: ulcerative colitis Infectious colitis Crohn’s disease (“cobblestone pattern”)
- 38. 19.
- 39. Crohn’s disease Findings: multiple loops of small bowel show segmental narrowing, loss of normal mucosal pattern (cobblestone), and fistula formation striking involvement of the terminal ileum ddx: lymphoma Tuberculosis Yersinia (TI only)
- 40. 20.
- 41. Duodenal adenocarcinoma Findings: eccentric sessile lesion with an irregular, ulcerated surface along the lateral wall of the descending duodenum ddx: sessile polyp leiomyoma / leiomyosarcoma metastasis
- 42. 21.
- 43. Heterotopic gastric mucosa of the duodenal bulb Findings: numerous, slightly elevated lesions measuring a few millimeters clustered in a small segment of the duodenal bulb may have angulated or plaque-like margins occur in up to 20% of pts. no clinical significance ddx: benign lymphoid hyperplasia (if 1-2mm smooth filling defects)
- 44. 22.
- 45. Erosive gastritis Findings: numerous 3-4mm shallow mucosal defects with a surrounding mound of edema = “bull’s eye” or “target” do NOT penetrate beyond the muscularis mucosa ddx: Idiopathic (50%) NSAIDs (greater curve) Crohn’s disease (apthous ulcers) Alcohol ingestion
- 46. 23. A 35 yo in a motor vehicle accident with severe injuries.
- 47. 23. CT Hypotension Complex Shock Bowel
- 48. 23.
- 49. 24.
- 51. 25. 81 YEAR OLD WITH HISTORY OF NON VEG DIET.
- 52. 25. Foreign Body (Chicken Bone) Perforation of Bowel
- 53. 25. Foreign Body (Chicken Bone) Perforation of Bowel
- 54. THANK YOU