Overview of GI Series in Various Pathologies of the Gastrointestinal Tract
Dr. Paul Gottlieb ,MD, Head of Imaging Dept. Dr. Michael Dvoyris ,MD,PhD, Senior Specialist Dr Lihi Ringler, MD, Resident
NORMAL PLAIN FILM
PLAIN ABDOMINAL FILM
Bone stone Gas mass Intestinal obstruction Free air in abdomen
INTESTINAL GAS
GAS DISTRIBUTION IN LARGE BOWEL
NORMAL GAS PATTERN IN S.B.
Rule of 3’s: • wall thickness < 3 mm • valvulae conniventies < 3 mm • diameter < 3 cm • air fluid levels < 3
NORMAL L.B. CALIBER
• 6 cm max. size of transverse colon • 9 cm max. size of cecum • 12 cm max. size of cecum before it may burst
CALCIFIED GALLSTONES & RENAL STONES
CALCIFIED GALLSTONE
CHRONIC PANCREATITIS
CALCIFIED UTERINE LEYOMIOMA
SMALL BOWEL OBSTRUCTION (ADHESIONS)
FLUID LEVELS IN SMALL BOWEL
CONTRAST IN WIDTHENED SMALL BOWEL
ADYNAMIC ILEUS - POSTOPERATIVE
ADYNAMIC ILEUS - VERTICAL PLAIN FILM
LARGE BOWEL OBSTRUCTION
LARGE BOWEL OBSTRUCTION - SIGMOID CA
PERITONEAL AIR - GASTRIC ULCER PERFORATION
THE SAME CASE - VERTICAL POSITION
RETROPERITONEAL AIR
SINGLE CONTRAST BARIUM ENEMA EXAM
TUMOR OBSTRUCTION
PHARYNX Radiographic examination of the P.is helpful in evaluating of the large group of patients with pharyngeal disorders. Approximately 35% of nursing home patients have some form of swallowing dysfunction. Aspiration pneumonia and choking are frequent causes of morbidity and mortality.Squamous carcinoma of the head and neck accounts for approximately 4% of tumors in males.
PHARYNX ====== Nasopharynx- skull base-soft palate Oropharynx : soft palate – hyoid bone Hypopharynx :hyoid bone – cricopharyngeal fold
Tonsillar fossa
Vallecula
Pyriform recess
Soft palate
Base of tongue
Post.pharyn.wall Aryepiglottic fold
epiglottis vallecula
ESOPHAGUS
ESOPHAGUS • Motility disorders • esophagitis • strictures • neoplasm • others
TERTIARY CONTRACTIONS
SPASM
ACHALASIA
ESOPHAGITIS
STRICTURE - RADIATION
SQUAMOUS CELL CARCINOMA
FOREIGN BODY
PERFORATION
UPPER GI PATTERNS
• mucosal irregularity • ulcers • fold thickening • abnormal distensibility • filling defects
STOMACH
FUNDUS
STOMACH
gastritis gastric ulcer gastric tumor / polyp
ANTRAL EROSIVE GASTRITIS
BENIGN ULCER
BENIGN ULCER
HYPERPLASTIC GASTRIC POLYPS
LEIOMYOMA
GASTRIC CARCINOMA
GASTRIC LYMPHOMA
DUODENUM
PYLORUS
DUODENAL ULCER
DUODENAL ULCER
DUODENAL CARCINOMA
LEOMYOSARCOMA
SMALL BOWEL PASSAGE
ENTEROCLISIS
SMALL BOWEL OBSTRUCTION BY ADHESIVE BAND
CROHN’S DISEASE
“COBBLESTONE” APPEARANCE
ADENO CA OF JEJUNUM
NON-HODGKIN`S LYMPHOMA SMALL BOWELL ORIGIN
ADENO CA OF JEJUNUM
COLON
DOUBLE CONTRAST BARIUM ENEMA OF LARGE BOWEL
ULCERATIVE COLITIS
ULCERATIVE COLITIS
COLONIC POLYP
SIGMOID COLON Sygmoid carcinoma
SYNCHRONUS COLONIC CARCINOMAS
CA OF COLON - COMPLICATED UC
DIVERTICULITIS
DIVERTICOLOSIS WITH COLO-VESICAL FISTULA