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Looking for
Gas pattern
Calcifications
Soft tissue masses
Substitute none
Looking for
Free air
Air-fluid levels
Substitute left
lateral decubitus
Hemorrhage
GI perforation
Bowel obstruction
Inflammatory disorder
Circulatory impairment
Intraperitoneal hemorrhage
Rupture:
hepatoma
aortic anuerysm
ectopic pregnancy
ovarian bleeding
Gastrointestinal hemorrhage
Upper GI hemorrhage
Duodenal ulcer
Gastric ulcer
Hemorrhagic gastritis
Esophageal or gastric varices ect.
Lower GI hemorrhage
Bleeding of colon cancer
Ischemic colitis ect.
US finding
Free peritoneal fluid accumulation on the
Abdominal CT
CTgold standars for specific intraabdominal
pathology
Radiological appearances:
Plain abdominal film:
- Oval/linear collection of gas:
Subhepatic space
Morisons pouch
Beneath the diaphragm (the cupola sign)
In the centre of the abdomen over a fluid
collection (the football sign)
Fissure for ligamentum teres
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Riglers sign
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Extrinsic
Bowel wall
Intraluminal
Adhesions
Neoplasia
Intussusception
Hernia
Volvulus
Intestinal
ischaemia
Inflammation/abscess
Malignant infiltration
(e.g. peritoenal
deposits)
Gallstone ileus
Etiology:
- Adhesions due to previous
surgery
- Strangulated hernias
- Volvulus
- Gallstone ileus
- Intussusception
- Neoplastic, etc.
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US:SBO
CT sign of SBO
Small
Fluid-filled loops
Etiology:
- Neoplastic (benign & malignant)
- Volvulus (caecal & sigmoid), etc.
Radiological appearances:
Depends on the state of competence
of the ileocaecal valve:
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Plain film:Sigmoid
volvulus
Radiological appearances:
- Both small & large-bowel dilatation
- Horizontal-ray films: multiple fluid levels
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Acute appendicitis
Acute pancreatitis
Acute cholecystitis
Abdominal absces
Peritonitis
Non-specific finding
Approximately 10%a calcified appendicolith
US
US finding
Echogenic hallo form by omental tissues draped
CT finding
90% diagnostic accuracy to detect acute appendicitis
With the good contrastfilling of the terminal ileum
Plain film:apendicolith
Severity of acute
pancreatitis
rangesmild edema
with minimal
symptoms to a
severe necrotizing
process that
culminates in
multiple organ failure
US and CT most
precisely define the
anatomic extent of
the lesions and the
detect local
complications
US finding:
The acutely inflamed pancreasenlarged with
Approximately 85%-90%
of cases with acute
cholecystitis (AC) develop
as a complication of
cholelithiasis
Conversely, approximately
10%-20% of patients with
gallstone will require
surgery for complication,
usually cholecystitis,
within 15 years after their
stone disease is
diagnosed
Acalculous cholecystitis
account for 5%-15% of
cases of acute
cholecystitis
(immunocompromize,
critically ill,iatrogenic,
congenital etc)
Peritonitisan inflammatory or
suppurative reaction of the peritoneum
to direct irritation
Cause:
Inflammatory
Infectious
Ischemic
Exudation,
Hematogenous,
Contiguous extension,
Iatrogenic manipulation
USnonspecific
Abdominal CT
CT signs
Ascites (free or encapsulated)
Infiltration of the omentum and/or mesentery
Thickening of the parietal peritoneum
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Etiology:
Vascular insufficiency & bleeding into the wall
of the colon.
Sudden onset of severe abd.pain in the early
hours of the morning, followed by bloody
diarrhoea.
In middle-aged & elderly patients.
The wall of splenic flexure & descending colon is
greatly thickened thumb printing (plain films).
The right side of colon is frequently distended.
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thumb printing
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