Abdominal
6.1// systematic approach to ab x-ray analysis
- book By 5 basic radiographic densities
- Air
- Fat
- soft tissue/fluid
- Mineral
- metal
- altu B B C approach
- B - bowel + other organs — 3 / 6 / 9 rule → normal diameter of intestines do not exceed:
- 3cm for small bowel
- 6cm for large bowel
- 9cm for caecum
- B - bones
- C - calcification + artefact
6.2// Small bowel obstruction
- asynchronous air-fluid levelling (only seen on erect or decubitus x-rays) → stair step pattern
6.4// pneumoperitoneum
- P sits upright for 5-10m → air gathers underneath right diaphragm
- P unable to sit upright → left decubitus x-ray → free air collects beneath right lateral abdominal wall.
- Rigler's sign (double wall sign) → gas outlines both sides of the bowel wall
6.6// Acute abdominal series
- 3-views on x-ray are obtained
- ① Supine
- ② Left lateral decubitus
- ③ PA chest x-ray
6.7// CT
- procedure of choice for nearly any abdominal condition w/ exception of gallbladder
a lot of stuff pg 80-81
6.8// Ultrasound
- generally best for fluid + vascular imaging
- large patients + p w/ gaseous distention are poor candidates bc air scatters sound than conducting.
Renal cyst, renal obstruction, gallbladder, abdominal aortic aneurysm.
6.9// MRI
- can reveal info about water content, lipid content and tissue vascularity
- → info can be used to refine differential diagnosis or make a specific diagnosis
hepatic haemangioma, staging cancer, arterial pathology (MRA)