What is the ideal choice of contrast media for the detection of perforation or postoperative anastomotic leak? Water-soluble contrast agents are the medium of choice for the radiographic evaluation of patients with suspected upper GI perforation or postoperative leak. However, water-soluble media are less sensitive in the detection of leaks in comparison with barium because …
What are the roles of barium and water-soluble (iodinated) contrast media for opacification of the lumen of the gastrointestinal (GI) tract? Barium contrast media, which consist of barium sulfate particles suspended in water, are usually preferred over water-soluble iodinated agents because they produce better images as a result of greater mucosal detail, are more resistant …
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Causes of intraabdominal calcification Renal calculi (80% radio dense) and bladder calculi Cholelithiasis (10%-15% radio dense) and “milk of calcium” Porcelain gallbladder (20% risk for cancer) Pancreas (usually chronic pancreatitis, includes cancer, vessels and cysts) Calcified lymph nodes (chronic inflammation, includes spleen) Vascular calcifications (aortic aneurysm or dissection) Appendicoliths (plus acute right lower quadrant pain …
Which types of foreign bodies are encountered on abdominal radiographs? A wide range of foreign bodies are radiopaque and therefore visible at abdominal radiography. They can be categorized as intraluminal or extraluminal for logistical purposes. Common Causes of Radiopaque Foreign Bodies Intraluminal Extraluminal Bezoars Surgical clips (either in expected or migrated position) Markers for measurement …
What distinguishes portal venous gas from septic pneumobilia? Although in both conditions gas is in a branching, tapering pattern, the location within the liver of the gas is usually distinctive. Because portal venous blood normally flows toward the periphery, gas in portal veins tends to accumulate in the periphery of the liver. Because bile normally …
Is ascites detectable on abdominal X ray? Abdominal radiographs are insensitive for identification of ascites and should never be used as a diagnostic test for that indication. However, there are several findings that suggest the presence of ascites on supine radiography, such as centrally located, air-filled loops of bowel and lack of visualization of the …
What are the hallmark features of gallstone ileus? Although representing an infrequent cause of small bowel obstruction, gallstone ileus has significant associated mortality if the diagnosis is delayed. The characteristic imaging findings are referred to as Rigler’s triad: pneumobilia; small bowel obstruction; and an ectopic, intraabdominal, radiodense gallstone (most often lodged at the ileocecal valve).