I. Intussusception in Children: Diagnostic Imaging and Treatment
|
|
- Joleen Jones
- 5 years ago
- Views:
Transcription
1 1 I. Intussusception in Children: Diagnostic Imaging and Treatment II. Author Kimberly E. Applegate, MD, MS Indiana University Department of Radiology Riley Hospital for Children 702 Barnhill Rd., Rm 1053b Indianapolis, IN
2 2 III. KEY POINTS VI. ISSUES: 1. Intussusception: Issue 1. Who should undergo imaging? Issue 2. What imaging should be performed? Issue 3. How should therapeutic enema be performed? Issue 4. What is appropriate management in recurrent cases? Special case: Intussusception limited to small bowel Special case: Intussusception with a lead point mass. IV. KEY POINTS: -Children with clinically suspected intussusception should undergo enema reduction after surgical consultation. The only absolute contraindications to enema are signs of peritonitis on clinical exam or free air on abdominal radiographs. Air enema has better overall reduction rates than liquid enema but the outcome depends on the experience of the radiologist. (MODERATE EVIDENCE) 2
3 3 -Barium should not be used due to the poorer outcomes in those children who perforate. (MODERATE EVIDENCE) - Ultrasound (US) is the primary imaging modality for initial diagnosis outside of the USA and a growing majority of pediatric radiologists in the USA. US also plays a role in the evaluation of reducibility of intussusception, presence of a lead point mass, potential incomplete reduction after enema, and of intussusception limited to small bowel. (LIMITED EVIDENCE) -Abdominal radiographs have poor sensitivity for the detection of intussusception but may serve to screen for other diagnoses in the differential diagnosis, such as constipation, and for free peritoneal air. For screening children with a low probability for intussusception, sonography is the preferred screening test. (LIMITED EVIDENCE) -The use of delayed repeat enema for the reduction of intussusception shows promise but there are few data on the appropriate methods or time. (LIMITED EVIDENCE) - For recurrence of intussusception, including multiple recurrences, enema is the preferred method for reduction. (LIMITED EVIDENCE) 3
4 4 X. Discussion of Issues Issue 1: Diagnosis of Intussusception:What are the clinical predictors? Who should undergo imaging? At this point there are no reliable clinical prediction models that can accurately identify all patients with intussusception (LIMITED EVIDENCE).Determination of which children should undergo imaging, and which should not undergo imaging, has not been studied in formal prospective trials. Issue 2: What imaging should be performed? Ultrasound has higher accuracy in the diagnosis of intussusception than plain radiographs. Ultrasound also has higher diagnostic accuracy in identifying pathologic lead points than plain radiographs or enema. The role of ultrasound findings in predicting success of reduction is not well known with available literature. Given current evidence, the diagnostic approach should include: (a) abdominal radiographs if concern for other diagnoses or for perforation (b) sonography for diagnosis or exclusion of intussusception, (c) if positive, a surgical consult should be obtained prior to the enema reduction attempt, and (d) air enema reduction (or if no experience with the air technique, liquid enema) (MODERATE EVIDENCE). 4
5 5 Issue 3: Treatment of intussusception: How should the enema be performed? The air enema is considered superior at reduction, cleaner (based on appearance of peritoneal cavity at surgery when perforation occurs), safer, and faster, with less radiation when compared to liquid enema (MODERATE EVIDENCE). The recurrence rates for air versus liquid enema reductions do not differ (both are approximately 10%). The Rule of Threes used to guide liquid enema technique is supported by limited evidence. Barium is no longer the liquid contrast medium of choice due to the risk of barium peritonitis, infection, and adhesions when perforation occurs during the enema. Neither sedation nor medications increase the enema success rate (Limited Evidence). Direct comparison of reduction with fluoroscopy versus ultrasound has not been studied (Insufficient Evidence). Issue 4: What is the appropriate management in recurrent cases? Intussusception recurrence rates average 10% in large series, with a range of 5.4% to 15.4%, regardless of air versus liquid enema technique (MODERATE EVIDENCE). The recurrence rates are less than or equal to 5% when surgical reduction is performed, presumably due to the 5
6 6 development of adhesions. Repeat enema is both safe and effective in recurrent intussusception as long as the child remains clinically stable (LIMITED EVIDENCE). There is insufficient evidence to support any particular approach beyond the performance of the enema and referral to a surgeon for shared decision-making with the patient. Special case: Intussusception limited to the small bowel With the increasing use of multi-detector CT scanners, radiologists are reporting more frequent presence of small, asymptomatic small bowel-small bowel intussusception (LIMITED EVIDENCE). These intussusceptions are typically transient and, since the children are asymptomatic, they are of no known clinical significance. There is little evidence in the literature regarding the optimal diagnosis and treatment of symptomatic intussusception limited to the small bowel. Most authors agree however, that the diagnosis is more difficult both clinically and radiologically. Small bowel intussusceptions are unlikely to have associated abdominal mass or rectal bleeding. Treatment is virtually always surgical reduction. Special risk factors for small bowel intussusception include the early postoperative period after either intraperitoneal and retroperitoneal surgery, the presence of long enteric feeding tubes, diffuse PLP (cystic fibrosis or HSP), and small bowel polyps (LIMITED EVIDENCE). Special case: Intussusception with a known lead point mass 6
7 7 The optimal imaging approach to children with intussuception and known PLP is unknown. However, Daneman surveyed the SPR members at their 2004 annual meeting and found that 76% of respondents attempt reduction in these patients. Some surgeons may request enema reduction in these children to partially reduce the intussusception and perhaps decrease the laparotomy incision size. There is insufficient evidence to support any particular approach beyond referral to a surgeon for shared decision-making with the patient and if requested, the performance of an enema. 7
Adult Intussusception
Bahrain Medical Bulletin, Vol. 27, No. 3, September 2005 Adult Intussusception Suhair Alsaad, MBCHB, CABS, FRCSI* Mariam Al-Muftah, MBCHB** Objectives: Adult intussusception is a rare entity. We present
More informationBack to Basics: What Imaging Test should I order? Jeanne G. Hill, M.D. Pediatric Radiology Medical University of South Carolina
Back to Basics: What Imaging Test should I order? Jeanne G. Hill, M.D. Pediatric Radiology Medical University of South Carolina Disclosure Neither I nor any member of my immediate family has a relevant
More informationBasic Abdominal and Pelvic Imaging Concepts. David L. Smith, MD Assistant Professor of Radiology
Basic Abdominal and Pelvic Imaging Concepts David L. Smith, MD Assistant Professor of Radiology Basic Imaging Concepts Contrast Resolution vs Spacial Resolution Spacial Resolution......refers to the ability
More informationObjectives. Pediatric Mortality. Another belly pain. Gastroenteritis. Spewing & Pooing Child 4/18/16
Gastro-tastrophies A Review of Pediatric GI Emergencies Objectives Discuss common presentations of Pediatric Abdominal Pain complaints Discuss work up and physical exam findings Discuss care, management
More informationISPUB.COM. P Johnson, S Shah, D Soares INTRODUCTION
ISPUB.COM The Internet Journal of Radiology Volume 9 Number 2 Air insufflation for the treatment of intussusception in the Radiology Department at the University Hospital of the West Indies (UHWI) between
More informationPneumatic Reduction of Intussusception Using Equipment Readily Available in the Hospital
ORIGINAL ARTICLE Pneumatic Reduction of Intussusception Using Equipment Readily Available in the Hospital M A Zulfiqar, MMed*, M Noryati, MMed**, A H Hamzaini, MMed*, C R Thambidorai, FRACS*** *Department
More informationTherapeutic Enema for Intussusception
Scan for mobile link. Therapeutic Enema for Intussusception Therapeutic enema is used to help identify and diagnose intussusception, a serious disorder in which one part of the intestine slides into another
More informationInfluence of pulsed fluoroscopy and special radiation risk training on the radiation dose in pneumatic reduction of ileocoecal intussusceptions.
Influence of pulsed fluoroscopy and special radiation risk training on the radiation dose in pneumatic reduction of ileocoecal intussusceptions. Poster No.: C-0599 Congress: ECR 2013 Type: Authors: Keywords:
More informationManaging Radiation Risk in Pediatric CT Imaging
Managing Radiation Risk in Pediatric CT Imaging Mahadevappa Mahesh, MS, PhD, FAAPM, FACR, FACMP, FSCCT. Professor of Radiology and Cardiology Johns Hopkins University School of Medicine Chief Physicist
More informationUNDERSTANDING X-RAYS: ABDOMINAL IMAGING THE ABDOMEN
UNDERSTANDING X-RAYS: ABDOMINAL IMAGING THE ABDOMEN Radiology Enterprises radiologyenterprises@gmail.com www.radiologyenterprises.com STOMACH AND SMALL BOWEL STOMACH AND SMALL BOWEL Swallowed air is a
More informationImaging Children with Acute Abdominal Pain -- Role/Protocols of US, CT, MR
Imaging Children with Acute Abdominal Pain -- Role/Protocols of US, CT, MR Kimberly E. Applegate, MD, MS Emory University Financial disclosures: AIM (American Imaging Management) radiation protection advisory
More informationInteresting Pediatric ultrasound cases. Presented by: Falguni Patel (RDMS, RVT)
Interesting Pediatric ultrasound cases Presented by: Falguni Patel (RDMS, RVT) Role of ultrasound to rule out Appendicitis Overview: Ultrasound is relatively inexpensive, safe and quick solution to rule
More informationA Trip Through the GI Tract: Common GI Diseases and Complaints. Jennifer Curtis, MD
A Trip Through the GI Tract: Common GI Diseases and Complaints Jennifer Curtis, MD Colon Cancer How does it develop? Most cancers arise from polyps Over time these can turn into cancer Combination of genetic
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal injuries clinical presentation of, 23 24 Abdominal trauma evaluation for pediatric surgeon, 59 74 background of, 60 colon and
More informationAbdominal Imaging Update. Tom Sutherland MBBS MMed FRANZCR
Abdominal Imaging Update Tom Sutherland MBBS MMed FRANZCR Objectives Review selected radiological abdominal studies. CT Colonography Rectal MRI Small bowel Imaging Liver Imaging. Discuss limitations, advantages
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 8/20/2011 Radiology Quiz of the Week # 34 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationThe Role of the FAST exam in the EDRU
The Role of the FAST exam in the EDRU A. Robb McLean, MD, MHCM Vice Chair of Clinical Operations, Department of Emergency Medicine Joint Trauma Conference June 20, 2017 Disclosures Goals Describe the performance,
More informationACUTE ABDOMEN IN OLDER CHILDREN. Carlos J. Sivit M.D.
ACUTE ABDOMEN IN OLDER CHILDREN Carlos J. Sivit M.D. ACUTE ABDOMEN Clinical condition characterized by severe abdominal pain developing over several hours ACUTE ABDOMINAL PAIN Common childhood complaint
More informationAppendicitis. Diagnosis and Surgery
Appendicitis Diagnosis and Surgery What Is Appendicitis? Your side may hurt so much that you called your doctor. Or maybe you went straight to the hospital emergency room. If the symptoms came on quickly,
More informationAbdominal Pain in Pediatric Patients Image Gently
Abdominal Pain in Pediatric Patients Image Gently Susan D. John, M.D. Baptist Health Emergency Radiology 2017 Disclosure I have no financial relationships with a commercial entity producing healthcarerelated
More informationContrast Materials Patient Safety: What are contrast materials and how do they work?
Contrast Materials Patient Safety: What are contrast materials and how do they work? Which imaging exams use contrast materials? How safe are contrast materials? How should I prepare for my imaging procedure
More informationEffective Utilization of Imaging. John V. Roberts, M.D. Premier Radiology Abdominal Imaging
Effective Utilization of Imaging John V. Roberts, M.D. Premier Radiology Abdominal Imaging Safety Contrast and Radiation What to order Abdomen/Pelvis Brain/Spine Chest Musculoskeletal Ob/Gyn Head and Neck
More information2. Blunt abdominal Trauma
Abdominal Trauma 1. Evaluation and management depends on: a. Mechanism (Blunt versus Penetrating) b. Injury complex in addition to abdomen c. Haemodynamic stability assessment: i. Classically patient s
More informationX-ray (Radiography) - Lower GI Tract
Scan for mobile link. X-ray (Radiography) - Lower GI Tract Lower gastrointestinal tract radiography or lower GI uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to
More informationColon Investigation. Flexible Sigmoidoscopy
Colon Investigation Flexible Sigmoidoscopy What is a flexible sigmoidoscopy? Flexible sigmoidoscopy is a frequently performed test to investigate the lower part of the bowel. This is an endoscopic test
More informationDiagnostic imaging and minimally invasive interventions
Diagnostic imaging and minimally invasive interventions 2018 Old and new Different questions to be answered, new tasks Specific, focused examinationsfókuszált, specifikus vizsgálatok Ionic radiation Cost/benefit
More informationAdult Intussusception: A Complication of Metastatic Melanoma or Primary Malignancy?
January 2013 Adult Intussusception: A Complication of Metastatic Melanoma or Primary Malignancy? Johanna Sheu, Harvard Medical School Year III 1 Agenda Menu of tests Definition/anatomy/classification Pediatrics
More informationBurkitt s Lymphoma of the Abdomen: The Northern California Kaiser Permanente Experience
ISPUB.COM The Internet Journal of Surgery Volume 18 Number 2 Burkitt s Lymphoma of the Abdomen: The Northern California Kaiser Permanente Experience J McClenathan Citation J McClenathan. Burkitt s Lymphoma
More informationCT Colonography. A Radiologist s View of the Colon from Outside-In. Donny Baek, MD
CT Colonography A Radiologist s View of the Colon from Outside-In Donny Baek, MD Computed Tomography (CT) CT Image Reconstruction CT Image Reconstruction CT Image Reconstruction Colorectal Cancer Annual
More informationGastrointestinal Tract Imaging. Objectives. Reference. VMB 960 April 6, Stomach Small Intestine Colon. Radiography & Ultrasound
Gastrointestinal Tract Imaging VMB 960 April 6, 2009 Stomach Small Intestine Colon Objectives Radiography & Ultrasound Contrast Examination of the Small Intestine Reference Chapters 45 47 Pages 750 805
More informationP R E S E N T S Dr. Mufa T. Ghadiali is skilled in all aspects of General Surgery. His General Surgery Services include: General Surgery Advanced Laparoscopic Surgery Surgical Oncology Gastrointestinal
More informationWhat is CT Colonography?
What is CT Colonography? It stands for computerized tomographic (CT) colonography. CT colonography is a test used to check your colon for colorectal cancer and other health conditions in your gastrointestinal
More informationPresenters: Dr JS Lapointe with the assistance of Dr BD Sarkodie, Dr J Oblitey, Dr S Mensah and Dr F Ofei
Presenters: Dr JS Lapointe with the assistance of Dr BD Sarkodie, Dr J Oblitey, Dr S Mensah and Dr F Ofei Debate common problems between clinicians and Radiology and possible solutions (for ex. how to
More informationPercutaneous Cecostomy Tube Placement
Information About Your Child s Procedure Percutaneous Cecostomy Tube Placement Read this form so you understand the procedure and its risks. Please ask questions about anything you do not understand. What
More informationSummary and conclusions
Summary and conclusions 7 Chapter 7 68 Summary and conclusions Chapter 1 provides a general introduction to this thesis focused on the use of ultrasound (US) in children with abdominal problems. The literature
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 09/17/2011 Radiology Quiz of the Week # 38 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationCENTERS FOR DISEASE CONTROL AND PREVENTION CENTERS FOR DISEASE CONTROL AND PREVENTION. Incidence Male. Incidence Female.
A Call to Action: Prevention and Early Detection of Colorectal Cancer (CRC) 5 Key Messages Screening reduces mortality from CRC All persons aged 50 years and older should begin regular screening High-risk
More informationCNGOF Guidelines for the Management of Endometriosis
CNGOF Guidelines for the Management of Endometriosis Anatomoclinical forms of endometriosis Definitions Endometriosis is defined as the presence of endometrial tissue containing both glands and stroma
More informationNecrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability
Necrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability Ricardo Faingold, MD. Department of Medical Imaging The Montreal Children s Hospital McGill University SPR Vancouver
More informationPaediatric surgical emergencies. Mani Thyagarajan BWCH
Paediatric surgical emergencies Mani Thyagarajan BWCH General points Always discuss Call consultant for help ASAP CT scan is a bad modality in paediatrics Ultrasound? Intussusception? Renal colic? UTI
More informationMAKING THE BEST USE OF CLINICAL RADIOLOGY SERVICES. Dr Martina Paetzel Consultant Radiologist
MAKING THE BEST USE OF CLINICAL RADIOLOGY SERVICES Dr Martina Paetzel Consultant Radiologist LEARNING OBJECTIVES To be aware of guidelines regulating ionising radiation & radiation dose To introduce how
More informationDr. Asadur J. Tchekmedyian Montevideo - Uruguay.
Dr. Asadur J. Tchekmedyian Montevideo - Uruguay asadurjorge@gmail.com Symptoms that point to a condition or disease involving the digestive system. Abdominal pain Changes in bowel habits Colon cancer screening
More informationRadiology. Undergraduate Radiology Sample Questions
Radiology Undergraduate Radiology Sample Questions April 2012 The following examples are offered of questions that might be used to assess undergraduate radiology. There are 3 different styles: An OSCE
More informationPEDIATRIC EMERGENCY DEPARTMENT CLINICAL GUIDELINE: GI SURGICAL EMERGENCIES: VOMITING
GI SURGICAL EMERGENCIES: VOMITING PYLORIC STENOSIS Population: Infants: onset between 2-5 weeks of age 1 in 250 births Male: female ratio 4:1 Familial incidence History: No vomiting in the first few weeks
More informationOverview. Imaging Indications. Paediatric Radiation Safety 2015/03/12. Paediatric radiation safety General guidelines Protocols
Overview Paediatric radiation safety General guidelines Protocols Paediatric Radiation Safety Paediatric patients are unique Children are more susceptible to radiation induced cancer than adults Younger
More informationNeonatal intestinal obstruction: how to make etiological diagnosis?
Neonatal intestinal obstruction: how to make etiological diagnosis? Poster No.: C-1414 Congress: ECR 2013 Type: Educational Exhibit Authors: W. Mnari, M. Zguidi, A. Zrig, M. Maatouk, B. Hmida, R. Salem,
More informationNeonatal intestinal obstruction: how to make etiological diagnosis?
Neonatal intestinal obstruction: how to make etiological diagnosis? Poster No.: C-1414 Congress: ECR 2013 Type: Educational Exhibit Authors: W. MNARI, M. Zguidi, A. Zrig, M. MAATOUK, B. Hmida, R. Salem,
More informationChristopher Lau Kings County Hospital SUNY Downstate Medical Center February 24, 2011
Christopher Lau Kings County Hospital SUNY Downstate Medical Center February 24, 2011 37 year old male presented with 1 day history of abdominal pain Pain was diffuse but worst in the epigastric area No
More informationRadiology of the abdomen Lecture -1-
Radiology of the abdomen Lecture -1- Objectives To know radiology modalities used in abdomen imaging mainly GI tract. To know advantages and disadvantages of each modality. To know indications and contraindications
More informationSocietà Medico Chirurgica di Ferrara 12 maggio Malattia diverticolare del colon. La TC in faseacuta
Società Medico Chirurgica di Ferrara 12 maggio 2012 La TC in faseacuta Pier Marco Cervi U.O. Radiodiagnostica Ospedaliera Direttore Dott. Stefano Bighi Azienda Ospedaliera Universitaria S. Anna di Ferrara
More informationThe Children s Hospital Intussusception and its treatment Information for parents
The Children s Hospital Intussusception and its treatment Information for parents What is intussusception? Intussusception occurs when one part of the bowel slides into another part of bowel, like a telescope,
More informationDR JAIKISHOR JOTHIRAJ MD POST GRADUATE DEPT OF RADIODIAGNOSIS
DR JAIKISHOR JOTHIRAJ MD POST GRADUATE DEPT OF RADIODIAGNOSIS YASHODAMMAL 70 YRS OD LADY had C/o diffuse lower abdominal pain 20 days h/o blood in stools 4 days h/o vomiting 2 days h/o burning micturation
More informationCOMPUTED TOMOGRAPHIC COLONOGRAPHY
COMPUTED TOMOGRAPHIC COLONOGRAPHY Protocol: GAS021 Effective Date: November 1, 2017 Table of Contents Page COMMERCIAL & MEDICAID COVERAGE RATIONALE... 1 MEDICARE COVERAGE RATIONALE... 2 DESCRIPTION OF
More informationRadiology. General radiology department. X-ray
The radiology directorate provides a diagnostic, interventional and therapeutic service for its local population, and a tertiary service for the region. It also provides support to some national work such
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal surgery prior as factor in laparoscopic colorectal surgery, 554 555 Abscess(es) CRC presenting as, 539 540 Adenocarcinoma of
More informationUltra-low dose CT of the acute abdomen: Spectrum of imaging findings
Ultra-low dose CT of the acute abdomen: Spectrum of imaging findings Poster No.: C-1452 Congress: ECR 2010 Type: Educational Exhibit Topic: GI Tract Authors: P. A. Vlachou, C. Kloeters, S. Kandel, P. Hein,
More informationVomiting in children: The good coordination between radiologists and pediatricians is the key to success
Vomiting in children: The good coordination between radiologists and pediatricians is the key to success C. Santos Montón 1, M. T. Garzon Guiteria 2, A. Hortal Benito-Sendín 1, K. El Karzazi 1, P. Sanchez
More informationFrequency of Diagnosis of Colorectal Cancer with Double Contrast Barium Enema
Bahrain Medical Bulletin, Vol.24, No.3, September 2002 Frequency of Diagnosis of Colorectal Cancer with Double Contrast Barium Enema Najeeb S Jamsheer, MD, FRCR* Neelam. Malik, MD, MNAMS** Objective: To
More informationPitfalls of the Pediatric Chest and Abdomen SPR 2017
Pitfalls of the Pediatric Chest and Abdomen SPR 2017 Richard I. Markowitz, MD, FACR Children s Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania No Disclosures Cognitive Perceptual
More informationn Make tremendous difference in patients lives: n Diagnosing or excluding disease and injury n Evaluating response to therapy
Imaging: Choosing the Appropriate Exam Rob Milman, MD Austin Radiological Association What is a Radiologist? A physician who specializes in diagnosing and treating disease and injury by using medical imaging
More informationColonoscopy. patient information from your surgeon & SAGES. Colonoscopy 1
Colonoscopy patient information from your surgeon & SAGES Colonoscopy 1 Colonscopy About colonoscopy What is a colonoscopy? Colonoscopy is a procedure that enables your surgeon to examine the lining of
More informationThe Focused Assessment with Sonography for Trauma, (FAST) procedure.
The Focused Assessment with Sonography for Trauma, (FAST) procedure. ROBERT H. WRIGLEY Professor Veterinary Diagnostic Imaging University of Sydney Veterinary Teaching Hospital Professor Emeritus Colorado
More informationTeamwork radiology and surgery
Catchment area Teamwork radiology and surgery Jigsaw TRAUMA Cholecystitis Perforation Appendicitis OP X-ray Abdominal wall Endoscopy GI bleeding Diverticulitis Pancreatitis Ileus Complex and timeconsuming
More informationTechnetium-99m pertechnetate imaging in diagnosis
Archives of Disease in Childhood, 1974, 49, 21. Technetium-99m pertechnetate imaging in diagnosis of Meckel's diverticulum JOHN C. LEONIDAS and DONALD R. GERMANN From the Departments of Radiology, Children's
More informationAbdominal compartment syndrome: radiological signs
Abdominal compartment syndrome: radiological signs Poster No.: C-0903 Congress: ECR 2011 Type: Scientific Exhibit Authors: R. Ignarra, C. Acampora, R. MAZZEO, C. muzj, L. Romano ; 1 1 2 2 3 3 1 4 4 napoli/it,
More informationADULT RETROGRADE INTUSSUSCEPTION Brian Tiu Richmond University Medical Center September 3, 2015
ADULT RETROGRADE INTUSSUSCEPTION Brian Tiu Richmond University Medical Center September 3, 2015 CASE PRESENTATION 41 yo woman presented one day hx abdominal pain, worsening nausea/vomiting denied flatus/bm
More informationLAPAROSCOPIC APPENDICECTOMY
LAPAROSCOPIC APPENDICECTOMY WHAT IS THE APPENDIX? The appendix is a small, fingerlike pouch of the intestinal tract located where the small and large join. It has no known use. It is postulated that the
More informationBOWEL CANCER. Cancer information.
BOWEL CANCER Cancer information www.cancervic.org.au What is bowel cancer? Bowel cancer is the second most common cancer in both men and women in Australia1 and is more common in people over the age of
More informationVentriculoperitoneal Shunt with Communicating Peritoneal & Subcutaneous Pseudocysts Formation
International Journal of Health Sciences, Qassim University, Vol. 8, No. 1 (January-March 2014) Case Report Ventriculoperitoneal Shunt with Communicating Peritoneal & Subcutaneous Pseudocysts Formation
More informationKeyhole Laparoscopic Hernia Repairs: What s the Benefit for Your Patients?
InTouch ARTICLE Keyhole Laparoscopic Hernia Repairs: What s the Benefit for Your Patients? Author: Mr Steve Warren Date: Mary 2015 17 19 View Road, Highgate, London, N6 4DJ Tel. 020 8341 4182 Email. enquiries@highgatehospital.co.uk
More informationLower GI Series. National Digestive Diseases Information Clearinghouse
Lower GI Series National Digestive Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is a lower gastrointestinal (GI) series? A lower GI
More informationThe purpose of this pathway is to assist the health care team with clinical decisions regarding the management of a patient with intussusception.
1.0 Introduction The purpose of this pathway is to assist the health care team with clinical decisions regarding the management of a patient with intussusception. Target Population: Inclusion: Children
More informationEsophageal Cancer. Source: National Cancer Institute
Esophageal Cancer Esophageal cancer forms in the tissues that line the esophagus, or the long, hollow tube that connects the mouth and stomach. Food and drink pass through the esophagus to be digested.
More informationLOOKING FOR AIR IN ALL THE WRONG PLACES Richard M. Gore, MD North Shore University Health System University of Chicago Evanston, IL
SIGNIFICANCE OF EXTRALUMINAL ABDOMINAL GAS: LOOKING FOR AIR IN ALL THE WRONG PLACES Richard M. Gore, MD North Shore University Health System University of Chicago Evanston, IL SCBT/MR 2012 October 26,
More informationAbdomen and Pelvis CT (1) By the end of the lecture students should be able to:
RAD 451 Abdomen and Pelvis CT (1) By the end of the lecture students should be able to: State the common indications for Abdomen and pelvis CT exams Identify possible contra indications for Abdomen and
More informationA: PARTICIPANT INFORMATION
A: PARTICIPANT INFMATION 1. What is your age today? Years of age 2. What is the date of your birth? Month: Day: Most of the questions we will be asking you in this follow-up questionnaire are about the
More informationASSESSING THE PLAIN ABDOMINAL RADIOGRAPH M A A M E F O S U A A M P O F O
ASSESSING THE PLAIN ABDOMINAL RADIOGRAPH M A A M E F O S U A A M P O F O Introduction The abdomen (less formally called the belly, stomach, is that part of the body between the thorax (chest) and pelvis,
More informationColorectal Cancer Screening
Scan for mobile link. Colorectal Cancer Screening What is colorectal cancer screening? Screening examinations are tests performed to identify disease in individuals who lack any signs or symptoms. The
More informationLife is hard. Question? Abdominal Imaging: The practical Utility of Radiography and Ultrasound 2/16/2012
Abdominal Imaging: The practical Utility of Radiography and Ultrasound Jonathan Hayles, DVM, MS, Dipl ACVR Life is hard Internist Surgeon Oncologist Neurologist Dermatologist Radiologist!!! The digital
More informationPre-operative prediction of difficult laparoscopic cholecystectomy
International Surgery Journal http://www.ijsurgery.com pissn 2349-3305 eissn 2349-2902 Research Article DOI: http://dx.doi.org/10.18203/2349-2902.isj20151083 Pre-operative prediction of difficult laparoscopic
More informationScreening & Surveillance Guidelines
Chapter 2 Screening & Surveillance Guidelines I. Eligibility Coloradans ages 50 and older (average risk) or under 50 at elevated risk for colon cancer (personal or family history) that meet the following
More informationGastrointestinal obstruction Dr Iain Lawrie
Gastrointestinal obstruction Dr Iain Lawrie Consultant and Honorary Clinical Senior Lecturer in Palliative Medicine The Pennine Acute Hospitals NHS Trust / The University of Manchester iain.lawrie@pat.nhs.uk
More informationCT Colonography. What is CT Colonography?
Scan for mobile link. CT Colonography Computed tomography (CT) colonography or virtual colonoscopy uses special x-ray equipment to examine the large intestine for cancer and growths called polyps. During
More informationFecal Incontinence. What is fecal incontinence?
Scan for mobile link. Fecal Incontinence Fecal incontinence is the inability to control the passage of waste material from the body. It may be associated with constipation or diarrhea and typically occurs
More informationThe Alimentary System
The Alimentary System Contrast Medium: 1. Barium Examinations of different parts of the GI tract require different densities of Barium suspension. The escape of Barium into the peritoneal cavity is extremely
More informationGet tested for. Colorectal cancer. Doctors know how to prevent colon or rectal cancer- and you can, too. Take a look inside.
Get tested for Colorectal cancer Doctors know how to prevent colon or rectal cancer- and you can, too. Take a look inside. 1 If you re 50 or older, you need to get tested for colorectal cancer. It s one
More informationAUA Guidelines for Imaging Known or Suspected Ureteral Calculi. Michael Ferrandino, MD Assoc Professor of Urology Duke University Medical Center
AUA Guidelines for Imaging Known or Suspected Ureteral Calculi Michael Ferrandino, MD Assoc Professor of Urology Duke University Medical Center Imaging for Urolithiasis Justification for the Guidelines
More informationRadiology. Undergraduate Radiology Curriculum
Radiology Undergraduate Radiology Curriculum April 2012 INTRODUCTION This curriculum is intended to form a framework for undergraduate learning and teaching in radiology. It refers to the relevant competencies
More informationKaryn A. Ledbetter, MD; Andrew K. Moriarity, MD; Safwan Halabi, MD Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI, 48202
LEARNING FROM OUR MISSED OPPORTUNITIES: INITIAL EXPERIENCE USING SONOGRAPHER REPORT CARDS TO IMPROVE THE DIAGNOSTIC ACCURACY OF PEDIATRIC APPENDIX ULTRASOUND AND DECREASE CT UTILIZATION Karyn A. Ledbetter,
More informationPatologia sistematica V Gastroenterologia Prof. Stefano Fiorucci. Colon polyps. Colorectal cancer
Patologia sistematica V Gastroenterologia Prof. Stefano Fiorucci Colon polyps Colorectal cancer Harrison s Principles of Internal Medicine 18 Ed. 2012 Colorectal cancer 70% Colorectal cancer CRC and colon
More informationCOLORECTAL CARCINOMA
QUICK REFERENCE FOR HEALTHCARE PROVIDERS MANAGEMENT OF COLORECTAL CARCINOMA Ministry of Health Malaysia Malaysian Society of Colorectal Surgeons Malaysian Society of Gastroenterology & Hepatology Malaysian
More informationSWISS SOCIETY OF NEONATOLOGY. Prenatal diagnosis and postnatal management of meconium pseudocysts
SWISS SOCIETY OF NEONATOLOGY Prenatal diagnosis and postnatal management of meconium pseudocysts September 2007 2 Burch E, Caduff JH, Hodel M, Berger TM, Neonatal and Pediatric Intensive Care Unit (BE,
More informationRadiological Investigations of Abdominal Trauma
76 77 Investigations of Abdominal Trauma Introduction: Trauma to abdominal organs is a common cause of patient morbidity and mortality among trauma patients. Causes of abdominal trauma include blunt injuries,
More informationPediatric Imaging Spine MRI and Spine CT Test Request Tip Sheet
Pediatric Imaging Spine MRI and Spine CT MRI is almost always preferred over CT scan; if ordering CT, CLEARLY document why MRI is not appropriate. In cases of back pain without red flags, six weeks of
More informationONE of the most severe complications of diverticulitis of the sigmoid
CLEVELAND CLINIC QUARTERLY Copyright 1970 by The Cleveland Clinic Foundation Volume 37, July 1970 Printed in U.S.A. Colonic diverticulitis with perforation to region of left hip: a rare complication Report
More informationInformation on Laparoscopic Extended Right Hemicolectomy. Colon surgery. The Colon. Laparoscopic Extended Right Hemicolectomy
Colon surgery Patients undergo colon surgery for a number of conditions including: colorectal cancer, polyps, inflammatory bowel disease (Crohn s disease and ulcerative colitis), colonic inertia, stricture
More informationManaging Patient Dose in Computed Tomography (CT) INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION
Managing Patient Dose in Computed Tomography (CT) International Commission on Radiological Protection Information abstracted from ICRP Publication 87 Available at www.icrp.org Task Group: M.M. Rehani,
More informationIntroduction and Definitions
Bowel obstruction Introduction and Definitions Accounts for 5% of all acute surgical admissions Patients are often extremely ill requiring prompt assessment, resuscitation and intensive monitoring Obstruction
More information