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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