Abdo Imaging

• What are some indications for CT abdo?

  Abdo pain

  Abdo sepsis

  Bowel obstruction

  Postoperative complications (e.g. anastomosis leak)

  Trauma

  Vascular compromise
• What are the benefits of CT abdo?

  Relatively quick & accessible

  Reproducible findings (e.g. for malignancy)

  Complete assessment of abdo & pelvis
• What are the limitations of CT abdo?

  Ionising radiation (100x CXR)

  Requires iodinated IV contrast

  • risk of renal impairment (pre & post CT fluids required in renal disease)
  • risk of anaphylactic reaction
• Procedure of CT abdo

  Check renal function

  Lie pt supine on CT table

  Scout image to plan study

  IV contrast injected via pump-injector

  60 second delay

  Scan from dome of diaphragms to symphysis pubis
• What are the 2 main ways that contrast can be given to give variations in CT abdo?

  Dual-phase CT abdomen

  -> 2 scans (1 arterial & 1 portovenous)

  Dual-bolus CT abdomen (Camp Bastion protocol)

  -> 2 injections of contrast

  -> single scan of abdo

  -> great in trauma
• Fill in the blanks

  A) Greater omentum

  B) Transverse colon

  C) Haustra

  
• Fill in the blanks

  A) Gastric body

  B) Antrum

  C) Gallbladder

  
• Fill in the blanks

  A) Lesser omentum

  B) Liver

  C) Vasa recta

  
• Fill in the blanks

  A) Caecum

  B) Terminal ileum

  C) Ileum

  D) Jejunum

  
• Fill in the blanks

  A) Intrahepatic portal vein branches

  B) Hepatic flexure

  C) Sigmoid colon

  D) Distal descending colon

  E) Common hepatic artery

  F) Common bile duct

  
• What are the organs numbered in the image?

  1 - ascending colon

  2 - 2nd part of duodenum

  3 - 3rd part of duodenum

  4 - duodenal-jejunal juncture

  5 - jejunum

  6 - ileum

  7 - gastrum

  8 - spleen

  9 - body of pancreas

  10 - descending colon

  
• Fill in the blanks

  A) Fat

  B) Liver

  C) Gallbladder

  D) Duodenum

  E) Portal vein

  F) Inferior vena cava

  G) Descending aorta

  H) Right crus

  I) Right kidney

  J) Vertebral body

  K) disc

  L) Spinal canal

  M) Spinous process

  N) Rectus abdominis muscle

  O) Stomach

  P) Transverse colon

  Q) Small bowel

  R) Pancreas

  S) Splenic vein

  T) Descending colon

  U) Left adrenal gland

  V) Spleen

  W) Latissimus dorsi muscle

  X) Rib

  Y) Erector spinae muscles

  
• Fill in the blanks

  A) Rectus Abdominis

  B) Transverse colon

  C) Superior mesenteric vein

  D) Superior mesenteric artery

  E) Small bowel

  F) Descending colon

  G) Left kidney

  H) Left ureter

  I) Psoas muscle

  J) Quadratus lumborum

  K) Right ureter

  L) Right kidney

  M) Inferior ven

  N) Duodenum

  O) Liver

  P) Gallbladder

  Q) Aorta

  
• Fill in the blanks

  A) Uterus

  B) Left ovary

  C) Left round ligament

  D) Left external iliac artery

  E) Left external iliac vein

  F) Left femur

  G) Left fallopian tube

  H) Left acetabulum

  I) Cervix

  J) Vagina

  K) Coccyx

  L) Rectum

  M) Endometrium

  N) Right fallopian tube

  O) Right acetabulum

  P) Right femur

  Q) Right external iliac vein

  R) Right external iliac artery

  
• What is shown in the image?

  Gallstones

  
• What is shown in the image?

  Bowel obstruction

  Secondary to hernia

  
• What is shown in the image?

  Large bowel obstruction (due to line in bowel)

  
• What is shown in the image?

  Acute pancreatitis

  
• What is shown in the image?

  Normal abdominal XR

  
• What is the 3-6-9 rule?

  Used in abdominal XR as the upper limits of normal bowel diameters

  3cm = small bowel

  6cm = large bowel

  9cm = caecum & sigmoid
• What is shown in the image?

  Faeces

  
• What is the difference between small & large bowel in abdo XR?

  Small = valvulae conniventes - cross the whole width of the bowel

  Large = haustra (white arrow), plicae semilunaris (black arrow)

  
• What is shown in the image?

  Small bowel obstruction (coiled spring apperance)

  
• What is shown in the image?

  Large bowel obstruction

  
• What is shown in the image?

  Sigmoid volvulus (coffee bean sign)

  
• What is shown in the image?

  Caecal volvulus (foetus sign)

  
• What is shown in the image?

  Staghorn calculi in kidneys

  
• What is shown in the image?

  Hydronephrosis