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Common Diseases
Zhang Huiyu
esophageal varices
Esophageal varices
Pathogeny and pathology :
a complication of portal hypertension
cirrhosis of liver → portal
hypertension(PV↑)→blood obstructed in portal
vein →flow into latteralcirculation→varices of
submucosal and periesophageal v. →azygos
vein→SVC
clinical symptoms : hematemesis and melaena
Esophageal varices
obstruction.
Esophageal carcinoma
• Medullary type: irregular stricture, long range,
10cm in length
• fungating type: irregular filling defect and
lateral stricture
• ulcerative type: meniscus sign
• scirrhous type:localized and annular stricture.
• intracavitary type:giant filling defect
Imageological diagnosis
of the gastric diseases
gastric ulcer
The main X-ray findings of round ulcer
Crater
projecting beyond the lumen of the
stomach. <2cm
in profile : nipple-like or triangular
protrusion
en face: a round collection of barium
Hampton’s line
lucent line at the edge of niche, 1-2mm
width
The main X-ray findings of round ulcer
collar sign :
a lucent zone at the edge of ulcer, 0.5-1.0cm in
width
Narrow neck sign :
the edge of ulcer is very narrow like a long neck
Pathogeny :
external cause: environment,diet
internal cause: many kinds
Pathology :
early stage (Ⅰ 、Ⅱ、Ⅲ )
advanceed stage (BorrmannⅠ-Ⅳ)
Diagnosis :imaging endoscopy
Gastric Carcinoma
The common x-ray findings of advanced gastric carcinoma
Irregular filling defect in the stomach
Narrowing of stomach and rigidity of the wall of stomach
Meniscus syndrome :
ulcer: irregular shape, meniscus-like, with even outer edge and
irregular inner edge
ulcer: in the outline of stomach
periphery of ulcer: a lucent zone with the different width around
ulcer , nodule on it is often seen
Destruction , interruption and disappearance of mucosa
Loss of peristalsis of the involved stomach
Imageological
Diagnosis of the
Small Intestine
Imageological Diagnosis
of Duodenal diseases
Duodenal ulcer
Direct signs :
Niech or crater :
en face : the ulcer shows round opaque with
lucent zone around the its periphery and radiating
mucosal folds toward the edge of niech
in profile : nipple-like or lapper protrusion
Deformed bulb : (due to scar)
unilateral or lateral
Duodenal ulcer
Indirect signs :
accelerating evacuation
Pyloric spasm
Hypersecretion of stomach
Fixed tenderness on bulb
Imageological Diagnosis
of the Large Intestine
Carcinoma of the large intestine
Hyperplastic(polypoid)type :
Irregular filling defect projecting into the
lumen of the bowel
eccentric stricture
Rigidity of the wall of intestine,destruction
of mucosa and loss of peristalsis
Main X-ray findings of advanced large intestine
Ulcerative type :
Large and irregular ulcer seen in the lumen of
intestine
A lucent zone with different width around the
ulcer
Rigidity of the wall of intestine , destruction of
mucosa, loss of peristalsis
Main X-ray findings of advanced large intestine
Infiltrative type :
Irregular and annular stricture ,
obstruction
Destruction of mucosa, rigidity of
the wall of intestine, loss of
haustration