Cystic Fibrosis in Children and Young Adults: Findings on Routine Abdominal Sonography

Size: px
Start display at page:

Download "Cystic Fibrosis in Children and Young Adults: Findings on Routine Abdominal Sonography"

Transcription

1 bdominal Sonography in Cystic Fibrosis bdominal Imaging Pictorial Essay Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Hans P. Haber 1 Haber HP Keywords: cystic fibrosis, liver disease, pancreaticobiliary imaging, pediatric imaging, small bowel, sonography DOI: /JR Received ugust 8, 2006; accepted after revision January 15, Department of Pediatrics, University of Tuebingen, Hoppe-Seyler-Str. 1, D Tuebingen, Germany. ddress correspondence to H. P. Haber (peter.haber@med.uni-tuebingen.de). JR 2007; 189: X/07/ merican Roentgen Ray Society Cystic Fibrosis in Children and Young dults: Findings on Routine bdominal Sonography OJECTIVE. The gastrointestinal manifestations of cystic fibrosis predispose patients to morbid conditions involving the pancreas, liver, biliary tract, spleen, and intestine. This article reviews the sonographic appearance of these abdominal manifestations. CONCLUSION. Numerous gastrointestinal complications have sonographic manifestations that must be interpreted correctly to ensure appropriate therapy. ystic fibrosis (CF) is the most common lethal genetic defect in white C populations [1]. iochemical studies have shown dysfunction of epithelial chloride transport caused by defects in the CF transmembrane regulation (CFTR) gene on chromosome 7. The dysfunction produces abnormally thick secretions that cause abnormal changes throughout multiple organ systems, such as the lungs, pancreas, liver, intestine, and reproductive tract. Gastrointestinal symptoms occur in 85 90% of cases of CF [1 3]. ecause of diagnostic and therapeutic advances, life expectancy has lengthened. larger number of older children and young adults than in the past are at risk of abdominal complications such as fecal impaction, appendicitis, intussusception, fibrosing colonopathy, liver cirrhosis, and portal hypertension [2]. bdominal sonography, used commonly in the diagnostic evaluation, can depict abnormalities of the pancreas, liver, gallbladder, spleen, and bowel. wareness of these manifestations is important not only in evaluation of the extent of disease but also in determining treatment requirements and efficacy in patients with CF. This article reviews the sonographic appearance of the abdominal manifestations of CF. One hundred twenty patients with CF whose ages ranged from 1 month to 27 years underwent routine abdominal sonography over 8 years. The examinations were part of the usual protocol for evaluation of CF performed to detect liver disease and to monitor bowel-wall thickening during follow-up. The sonographic system used (Sonoline Elegra or ntares, Siemens Medical Solutions) had 7.5-MHz curved array and highresolution 12-MHz linear array probes. Pancreas y childhood, approximately 85% of CF patients have pancreatic exocrine insufficiency, which causes steatorrhea, flatulence, and abdominal pain [3, 4]. The pancreatic lesions are caused by obstruction of small ducts by secretions and cellular debris. The abnormal changes in the pancreas are a function of the duration and intensity of CF [3]. On sonography, the severely affected pancreas is hyperechoic and small, signs of the presence of pancreatic atrophy and replacement of the pancreatic parenchyma by fibrous tissue and fat [4, 5] (Figs. 1 and 2). Hypoechoic areas representing pancreatic fibrosis sometimes are found, as are pancreatic calcifications and small pancreatic cysts measuring 1 3 mm (Fig. 3). Pancreatic cystosis, complete replacement of the pancreas by cysts, is well depicted with sonography, CT, and MRI [6] (Fig. 4). Pancreatitis is a rare complication among patients with CF. The reported incidence was 1.2% in a large cohort of patients with CF [7]. Pancreatitis should be considered in all patients with suggestive clinical features. Liver Hepatic involvement in CF is common. It ranges from hepatic steatosis to characteristic focal biliary fibrosis and eventual multilobular biliary cirrhosis. Studies have shown an increasing incidence of liver involvement with age, ranging from 20% to 50%. However, only approximately 1 5% of cases progress to clinically apparent liver disease [2]. Steatosis of the liver is not rare in neonates and infants [4]. Hepatic enlargement and enhanced echogenicity representing fatty infiltration of the liver are the classic sonographic findings JR:189, July

2 Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved (Fig. 5). There is no evidence to suggest that steatosis progresses to cirrhosis [2]. Focal biliary fibrosis, characterized by eosinophilic concretions and variable portal fibrosis, is pathognomonic of CF-related liver disease and affects more than 20% of children and adolescents with CF. On sonography, the liver exhibits hyperechoic periportal thickening caused by fibrosis or focal fat. Diffuse increased echogenicity of the liver parenchyma also is present (Fig. 6). The sonographic findings may precede clinical and biochemical evidence of liver disease. pproximately 5% of cases of focal biliary fibrosis progress to multilobular biliary cirrhosis characterized by irregular regeneration nodules larger than those usually seen in other forms of biliary or portal cirrhosis and with extensive fibrosis and bile duct proliferation. Jaundice is rare, and in many instances, results of liver function tests are unremarkable [3]. Sonography reveals a small, nodular liver with irregular echotexture (Fig. 7). When portal hypertension develops, splenic enlargement, portosystemic collateral vessels, and, occasionally, ascites are seen on sonography [4] (Fig. 8). iliary Tract Cholesterol gallstones, often within a shrunken gallbladder (microgallbladder) occur in as many as 12% of children and young adults with CF [3] (Figs. 9 11). These abnormalities are not usually associated with symptoms. s in sclerosing cholangitis, the intrahepatic bile duct abnormalities include strictures, dilatation, and ductal calculi [2] (Fig. 12). These abnormalities can be evaluated with sonography, and color Doppler mode can be helpful for differentiating vessels and bile duct (Fig. 12), but MR cholangiography is more accurate for diagnosis [2]. Gastrointestinal Tract variety of abnormalities of gastrointestinal function, such as meconium ileus, distal intestinal obstruction syndrome, intussusception, mucoid appendix, and fibrosing colonopathy, can occur in CF. Meconium ileus occurs in 10 15% of newborns with CF, and it is the earliest clinical manifestation of CF [1]. The obstruction is caused by impaction of inspissated meconium in the terminal ileum. small colon associated with proximal small-bowel distention is the typical sonographic finding (Fig. 13). However, identical findings are seen in smallbowel atresia unrelated to CF. lthough meconium ileus can be detected with sonography, the standard of reference is abdominal radiography followed by contrast enema for diagnosis and treatment. s many as one half of cases of meconium ileus are complicated by volvulus, atresia, or meconium peritonitis [3]. The term distal intestinal obstruction syndrome, previously called meconium ileus equivalent, is applied to intestinal impaction and partial or complete obstruction in older patients [3]. bdominal pain, a palpable right lower quadrant abdominal mass, and bowel obstruction are the most common symptoms and signs. Large amounts of fecal material in the ileocecal region may be visible at sonography (Fig. 14). Contrast enema examinations not only help to define the fecal mass but also may relieve the obstruction. CT is not indicated for the diagnosis or management of this entity. Intussusception affects approximately 1% of patients with CF. It is most frequently ileocolic and can occur as a complication of distal intestinal obstruction syndrome [2]. Sonography readily depicts intussusception, showing the target sign of edematous bowel and intermixed mesenteric fat on transverse images [3]. In the absence of perforation or signs of peritonitis, hydrostatic enema can be performed under sonographic guidance to reduce the intussusceptum [1]. Transient asymptomatic small-bowel intussusception, usually jejunal, is seen in as many as 5% of CF patients [8] (Fig. 15). Unlike those of ileocolic intussusception, the intussuscepta are small in diameter, short (< 5 cm), and usually central in the abdomen or in the left upper quadrant. In patients with no symptoms in whom no definitive pathologic lead point is recognized on imaging, conservative observation is warranted. Intermittent sonographic examinations over a 45-minute period may reveal spontaneous reduction of this benign type of intussusception [9]. bnormalities of the appendix are found in as many as 16% of patients with asymptomatic CF. These abnormalities include swollen and distended mucoid appendix caused by inspissated mucoid contents (Fig. 16). Progress to acute appendicitis is rare, occurring in 1 4% of CF patients in comparison with 7% of the general population [2]. However, differentiating acute appendicitis from chronically distended, mucoid appendix with imaging alone may be especially difficult in patients with CF, resulting in delayed diagnosis and a high rate of appendiceal perforation and abscess formation. These complications can be detected with sonography, but CT is more accurate for diagnosis. The colon is often abnormal in patients with CF [8]. Fibrosing colonopathy is a well-described feature in CF patients, particularly in children taking high-strength pancreatic enzyme supplements. The condition is characterized by marked fibrosis of the submucosa and predominantly involves the proximal portion of the colon. In severe cases, colonic stricture and obstruction occur. Colonic shortening, focal or extensive narrowing, and poor distensibility during contrastenhanced enema studies are considered highly suggestive of the prestricture state [3]. Sonography is a means of detecting mucosal changes and bowel-wall thickening and has supplemented the conventional diagnostic methods, that is, barium enema and endoscopy [8]. Submucosal bowelwall thickening is visualized on sonography in as many as 81% of patients with asymptomatic CF (Fig. 17). In severe cases, the findings probably represent a sonomorphologic correlate of an early stage of fibrosing colonopathy [8]. Conclusion Gastrointestinal involvement in CF predisposes patients to morbid conditions. Numerous gastrointestinal complications develop with sonographic manifestations that must be interpreted correctly to ensure appropriate therapy. In addition to careful clinical and laboratory examinations of each patient, sonography may aid in the management of the disease. References 1. Milla PJ. Cystic fibrosis: present and future. Digestion 1998; 59: Robertson M, Choe K, Joseph PM. Review of the abdominal manifestations of cystic fibrosis in the adult patient. RadioGraphics 2006; 26: grons G, Corse WR, Markowitz RI, et al. Gastrointestinal manifestations of cystic fibrosis: radiologic-pathologic correlation. RadioGraphics 1996; 16: Chaudry G, Navarro OM, Levine DS, Oudjhane K. bdominal manifestations of cystic fibrosis in children. Pediatr Radiol 2006; 36: Philips HE, Cox KL, Reidl MH, McGahan JP. Pancreatic sonography in cystic fibrosis. JR 1981; 137: errocal T, Pajares MP, Zubillaga F. Pancreatic cystosis in children and young adults with cystic fibrosis: sonographic, CT, and MRI findings. JR 2005; 184: De oeck K, Weren M, Proesmans M, Kerem E. Pancreatitis among patients with cystic fibrosis: correlation with pancreatic status and genotype. Pediatrics 2005; 115: Haber HP, enda N, Fitzke G, et al. Colonic wall thickness measured by ultrasound: striking differences in patients with cystic fibrosis versus healthy controls. Gut 1997; 40: Kornecki, Daneman, Navarro O, et al. Spontaneous reduction of intussusception: clinical spectrum, management and outcome. Pediatr Radiol 2000; 30: JR:189, July 2007

3 bdominal Sonography in Cystic Fibrosis Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig. 1 9-year-old boy with cystic fibrosis and pancreatic exocrine insufficiency. and, Longitudinal () and transverse () sonograms at level of pancreatic head show small pancreas (arrows) with areas of markedly increased echogenicity, resembling echogenicity of retroperitoneal fat (star, ). Scale segment distance, 10 mm. s = superior mesenteric artery, ao = aorta. Fig. 2 9-year-old boy in good health. and, Longitudinal () and transverse () sonograms show normal pancreas (arrows) for comparison with Figure 1. Pancreatic echogenicity is equivalent to that of liver. Scale segment distance, 10 mm. Star indicates retroperitoneal fat. ao = aorta, vci = inferior vena cava. JR:189, July

4 Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig year-old man with asymptomatic cystic fibrosis and pancreatic fibrosis. ao = aorta, s = superior mesenteric artery, vci = inferior vena cava., Transverse sonogram at level of pancreatic head (arrow) shows hypoechoic areas representing areas of fibrosis. Small anechoic areas within pancreas represent small cysts. Tiny echogenic foci with acoustic shadowing represent pancreatic calcification. Scale segment distance, 5 mm., xial contrast-enhanced T1-weighted MR image obtained at same level as shows intermixed low signal intensity (arrow) representing pancreatic fibrosis. Fig year-old boy with asymptomatic cystic fibrosis and pancreatic cystosis. and, Longitudinal () and transverse () sonograms at level of pancreatic head show enlarged pancreas with numerous sonolucent lesions (arrows) corresponding to cysts distributed throughout gland. Small amount of echogenic pancreatic tissue is present between cysts. Scale segment distance, 10 mm. ao = aorta. 92 JR:189, July 2007

5 bdominal Sonography in Cystic Fibrosis Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved C Fig. 5 5-year-old girl with cystic fibrosis, hepatic steatosis, and slightly elevated liver enzyme levels. Scale segment distance, 10 mm. and, Longitudinal () and transverse () sonograms (3.5-MHz probe) of right lobe of liver show coarse liver parenchyma with diffusely enhanced echogenicity. In comparison, kidney (star) appears hypoechoic. Diminished throughtransmission is evident. C, High-resolution sonogram through right lobe of liver shows poor visualization of portal triads (arrows). JR:189, July

6 Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig year-old girl with asymptomatic cystic fibrosis and focal biliary fibrosis., Longitudinal sonogram of left lobe shows coarse heterogeneous hepatic parenchyma and diminished visibility of intrahepatic vessels. Scale segment distance, 10 mm., High-resolution sonogram of liver shows irregular echotexture and hyperechoic periportal thickening (arrows) due to presence of focal fat. Fig year-old man with cystic fibrosis, multilobular biliary cirrhosis, and slightly elevated liver enzyme levels., Longitudinal sonogram of left lobe of liver shows small heterogeneous liver with numerous large, irregular regenerative nodules (stars). Scale segment distance, 10 mm., High-resolution sonogram of liver surface shows irregular margin with lobulation (arrow) due to scarring. Scale segment distance, 5 mm. 94 JR:189, July 2007

7 bdominal Sonography in Cystic Fibrosis Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved C Fig year-old man with cystic fibrosis, multilobular biliary cirrhosis, and portal hypertension., Longitudinal sonogram of left lobe of liver shows small liver with irregular margin. scites (star) next to liver is evident. Scale segment distance, 10 mm., Color Doppler sonogram obtained at same level as shows numerous vessels (arrow) within minor omentum, representing portosystemic collateral vessels. Star indicates ascites. C, Pulsed Doppler image shows hepatofugal flow within varices. D, Longitudinal sonogram shows marked enlargement of spleen, measuring 19 cm in length, indicating portal hypertension. D JR:189, July

8 Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig. 9 6-year-old boy with asymptomatic microgallbladder. Longitudinal sonogram shows example of biliary abnormality in fasting patient with cystic fibrosis. Small, empty gallbladder (G) (arrow) is 25 mm long. Scale segment distance, 10 mm. Fig year-old boy with sludge (arrow) within small gallbladder. Sonogram shows example of biliary abnormality in fasting patient with cystic fibrosis. Echogenic fat tissue surrounds gallbladder. Fig year-old girl with asymptomatic cholelithiasis. Longitudinal sonogram of gallbladder shows example of biliary abnormality in fasting patient with cystic fibrosis. Microgallbladder containing multiple shadowing echogenic calculi (arrowhead) and mild diffuse thickening of gallbladder wall (arrow) are evident. 96 JR:189, July 2007

9 bdominal Sonography in Cystic Fibrosis Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig year-old boy with asymptomatic cystic fibrosis and dilatation of intrahepatic bile duct. and, Transverse high-resolution -mode () and color Doppler () sonograms of left lobe of liver show dilated bile duct (arrowhead) beside hepatic artery (star) and portal vein (arrow). Scale segment distance, 5 mm. VP = portal vein, D = bile duct, H = hepatic artery. Fig day-old boy with cystic fibrosis and meconium ileus. and, Transverse () and longitudinal () high-resolution sonograms show small descending colon with diminished caliber (microcolon) (arrows) and dilated, meconiumfilled small bowel (star). Scale segment distance, 5 mm. s = spleen, k = kidney, sp = spine. JR:189, July

10 Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig month-old girl with cystic fibrosis and distal intestinal obstruction syndrome., bdominal radiograph obtained with patient in left recumbent position shows right colon filled with fecal mass (star) and multiple air-filled levels within dilated small bowel., Transverse sonogram of right lower quadrant shows dilated bowel loaded with fecal material (star). Scale segment distance, 5 mm Fig year-old girl with asymptomatic cystic fibrosis and small-bowel intussusception., Transverse high-resolution sonogram of left upper quadrant shows multiple concentric ring sign of jejunal intussusception caused by entering and returning limbs of infolded intussusceptum. Star-shaped center (star) represents transverse section of infolded jejunal loop of intussusceptum. Scale segment distance, 5 mm., Longitudinal sonogram shows short-segment intussusception (length, 10 mm). Entering and returning wall of intussusceptum (arrows) is known as sandwich sign. Spontaneous reduction was found during real-time sonographic examination. 98 JR:189, July 2007

11 bdominal Sonography in Cystic Fibrosis Downloaded from by on 01/08/18 from IP address Copyright RRS. For personal use only; all rights reserved Fig year-old girl with asymptomatic cystic fibrosis and mucoid appendix. and, Transverse () and longitudinal () high-resolution sonograms at level of right psoas muscle show swollen appendix (diameter, 9 mm) with hypoechoic luminal contents (star) corresponding to inspissated mucoid secretions. Small amount of free fluid is present. Linear echogenic appearance of preserved submucosal layer (arrows, ) and lack of periappendiceal inflammatory changes are evident. Scale segment distance, 5 mm. Fig year-old boy with asymptomatic cystic fibrosis and colonic wall thickening. and, Transverse () and longitudinal () high-resolution sonograms of ascending colon show fecal content (star) within lumen and pronounced (4.5 mm) nodular thickening (double arrow) of wall with increased thickness of echogenic submucosal layer (arrow). Pericolonic fat proliferation (arrowhead, ) is evident. Scale segment distance, 5 mm. JR:189, July

Abdominal Manifestations of Cystic Fibrosis in Children: Report of 50 cases

Abdominal Manifestations of Cystic Fibrosis in Children: Report of 50 cases Abdominal Manifestations of Cystic Fibrosis in Children: Report of 50 cases Poster No.: C-2070 Congress: ECR 2013 Type: Scientific Exhibit Authors: B. Iturre Salinas 1, A. Gozalo García 2, N. Martinez

More information

Pediatric Hepatobiliary, Pancreatic & Splenic US

Pediatric Hepatobiliary, Pancreatic & Splenic US Pediatric Hepatobiliary, Pancreatic & Splenic US Susan J. Back, MD Department of Radiology, The Children s Hospital of Philadelphia No Disclosures Objectives Normal Abnormal: cases and US advances Objectives

More information

Summary and conclusions

Summary 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 information

Guidelines, Policies and Statements D5 Statement on Abdominal Scanning

Guidelines, Policies and Statements D5 Statement on Abdominal Scanning Guidelines, Policies and Statements D5 Statement on Abdominal Scanning Disclaimer and Copyright The ASUM Standards of Practice Board have made every effort to ensure that this Guideline/Policy/Statement

More information

US in non-traumatic acute abdomen. Lalita, M.D. Radiologist Department of radiology Faculty of Medicine ChiangMai university

US in non-traumatic acute abdomen. Lalita, M.D. Radiologist Department of radiology Faculty of Medicine ChiangMai university US in non-traumatic acute abdomen Lalita, M.D. Radiologist Department of radiology Faculty of Medicine ChiangMai university Sagittal Orientation Transverse (Axial) Orientation Coronal Orientation Intercostal

More information

Normal Sonographic Anatomy

Normal Sonographic Anatomy hapter 2:The Liver DUNSTAN ABRAHAM Normal Sonographic Anatomy Homogeneous, echogenic texture (Figure 2-1) Measures approximately 15 cm in length and 10 12.5 cm anterior to posterior; measurement taken

More information

Nasogastric tube. Stomach. Pylorus. Duodenum 1. Duodenum 2. Duodenum 3. Duodenum 4

Nasogastric tube. Stomach. Pylorus. Duodenum 1. Duodenum 2. Duodenum 3. Duodenum 4 Esophagus Barium Swallow Stomach and Duodenum 4 year old Upper GI Nasogastric tube Stomach and Duodenum 4 year old Upper GI Nasogastric tube Stomach Pylorus Duodenum 1 Duodenum 2 Duodenum 3 Duodenum 4

More information

Imaging of common diseases of hepatobiliary and GI system

Imaging of common diseases of hepatobiliary and GI system Imaging of common diseases of hepatobiliary and GI system Natthaporn Tanpowpong, M.D. Diagnostic radiology Faculty of Medicine, Chulalongkorn University Normal plain radiograph A = Common bile duct

More information

Radiology of hepatobiliary diseases

Radiology of hepatobiliary diseases GI cycle - Lecture 14 436 Teams Radiology of hepatobiliary diseases Objectives 1. To Interpret plan x-ray radiograph of abdomen with common pathologies. 2. To know the common pathologies presentation.

More information

Medical application of transabdominal ultrasound in gastrointestinal diseases

Medical application of transabdominal ultrasound in gastrointestinal diseases Medical application of transabdominal ultrasound in gastrointestinal diseases Hsiu-Po Wang Department of Emergency Medicine National Taiwan University Hospital Real-time ultrasound has become a standard

More information

Abdominal ultrasound:

Abdominal ultrasound: Abdominal ultrasound: Non-traumatic acute abdomen Wittanee Na-ChiangMai, MD Department of Radiology ChiangMai University 26/04/2017 Contents Technique of examination Normal anatomy Emergency conditions

More information

Lab Monitor Images Dissection of the Abdominal Vasculature + Lower Digestive System

Lab Monitor Images Dissection of the Abdominal Vasculature + Lower Digestive System Lab Monitor Images Dissection of the Abdominal Vasculature + Lower Digestive System Stomach & Duodenum Frontal (AP) View Nasogastric tube 2 1 3 4 Stomach Pylorus Duodenum 1 Duodenum 2 Duodenum 3 Duodenum

More information

IT 의료융합 1 차임상세미나 복부질환초음파 이재영

IT 의료융합 1 차임상세미나 복부질환초음파 이재영 IT 의료융합 1 차임상세미나 2013-4-3 복부질환초음파 이재영 나는오늘누구를위하여 종을울리나? 전통적의료 의사 공학설계자 의사 최첨단진단장비들 USG, CT, MRI 환자 환자 현대의료 사용자중심의사고 US in the Abdomen Detection DDx Look Behavior Response by external stimuli Guiding Tool

More information

Abdominal Ultrasound. Diane Hallinen, MD. Bloodroot

Abdominal Ultrasound. Diane Hallinen, MD. Bloodroot Abdominal Ultrasound Diane Hallinen, MD Bloodroot Abdominal Ultrasound Vasculature Hepatobiliary Spleen Kidney Bladder Bowel Where to put the probe? Vasculature We are going to talk about Celiac Trunk

More information

Appendix 5. EFSUMB Newsletter. Gastroenterological Ultrasound

Appendix 5. EFSUMB Newsletter. Gastroenterological Ultrasound EFSUMB Newsletter 87 Examinations should encompass the full range of pathological conditions listed below A log book listing the types of examinations undertaken should be kept Training should usually

More information

Abdomen and Retroperitoneum Ultrasound Protocols

Abdomen and Retroperitoneum Ultrasound Protocols Abdomen and Retroperitoneum Ultrasound Protocols Reviewed By: Anna Ellermeier, MD Last Reviewed: March 2018 Contact: (866) 761-4200, Option 1 **NOTE for all examinations: 1. If documenting possible flow

More information

Abdominal manifestations of cystic fibrosis in

Abdominal manifestations of cystic fibrosis in Pictorial Essay Australasian Radiology (2004) 48, 450 458 Abdominal manifestations of cystic fibrosis in Pictorial Essay adults: A review S Constantine, 1 VWK Au 2 and JP Slavotinek 2 1 Department of Radiology,

More information

... Inflammatory disorder of the colon that occurs as a complication of antibiotic treatment.

... Inflammatory disorder of the colon that occurs as a complication of antibiotic treatment. Definition Inflammatory disorder of the colon that occurs as a complication of antibiotic treatment. " Epidemiology Humans represent the main reservoir of Clostridium difficile, which is not part of the

More information

Gastroenterology. Certification Examination Blueprint. Purpose of the exam

Gastroenterology. Certification Examination Blueprint. Purpose of the exam Gastroenterology Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified gastroenterologist

More information

Diffuse Gallbladder Wall Thickening: Differential Diagnosis

Diffuse Gallbladder Wall Thickening: Differential Diagnosis van reda Vriesman et al. Diffuse Gallbladder Wall Thickening Hepatobiliary Imaging Pictorial Essay driaan C. van reda Vriesman 1 Marc R. Engelbrecht 2 Robin H. M. Smithuis 1 Julien. C. M. Puylaert 3 van

More information

Anatomy Jessica Ferguson Ashley Dobos May 31, 2006 LIVER

Anatomy Jessica Ferguson Ashley Dobos May 31, 2006 LIVER Anatomy Jessica Ferguson Ashley Dobos May 31, 2006 LIVER 1) Other Names: Reidel s Lobe normal anatomic variant; projection of the right lobe that can extend as far as the iliac crest (Tempkin, p.54, Anatomy).

More information

Plain abdomen The standard films are supine & erect AP views (alternative to erect, lateral decubitus film is used in ill patients).

Plain abdomen The standard films are supine & erect AP views (alternative to erect, lateral decubitus film is used in ill patients). Plain abdomen The standard films are supine & erect AP views (alternative to erect, lateral decubitus film is used in ill patients). The stomach can be readily identified by its location, gastric rugae

More information

Pancreas & Biliary System. Dr. Vohra & Dr. Jamila

Pancreas & Biliary System. Dr. Vohra & Dr. Jamila Pancreas & Biliary System Dr. Vohra & Dr. Jamila 1 Objectives At the end of the lecture, the student should be able to describe the: Location, surface anatomy, parts, relations & peritoneal reflection

More information

My Patient Has Abdominal Pain PoCUS of the Biliary Tract and the Urinary Tract

My Patient Has Abdominal Pain PoCUS of the Biliary Tract and the Urinary Tract My Patient Has Abdominal Pain PoCUS of the Biliary Tract and the Urinary Tract Objectives PoCUS for Biliary Disease PoCUS for Renal Colic PoCUS for Urinary Retention Biliary Disease A patient presents

More information

Elastography in the. technically difficult patient. EPIQ ultrasound system. Ultrasound

Elastography in the. technically difficult patient. EPIQ ultrasound system. Ultrasound Ultrasound Elastography in the technically difficult patient EPIQ ultrasound system Chairman Department of Diagnostic Radiology Allegheny General Hospital Pittsburgh, PA, USA You can offer more information

More information

SWISS SOCIETY OF NEONATOLOGY. Prenatal diagnosis and postnatal management of meconium pseudocysts

SWISS 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 information

Hepatic Imaging: What Every Practitioner Should Know

Hepatic Imaging: What Every Practitioner Should Know Hepatic Imaging: What Every Practitioner Should Know Shuchi K. Rodgers, MD Section Chief, Abdominal Imaging Director of Ultrasound Department of Radiology Einstein Medical Center rodgerss@einstein.edu

More information

Anatomy of the biliary tract

Anatomy of the biliary tract Harvard-MIT Division of Health Sciences and Technology HST.121: Gastroenterology, Fall 2005 Instructors: Dr. Jonathan Glickman Anatomy of the biliary tract Figure removed due to copyright reasons. Biliary

More information

FHS Appendicitis US Protocol

FHS Appendicitis US Protocol FHS Appendicitis US Protocol Reviewed By: Shireen Khan, MD; Sarah Farley, MD; Anna Ellermeier, MD Last Reviewed: May 2018 Contact: (866) 761-4200 **NOTE for all examinations: 1. If documenting possible

More information

Case Study: #3: Gallbladder Carcinoma?

Case Study: #3: Gallbladder Carcinoma? Case Study: #3: Gallbladder Carcinoma? By: Megan Wyatt K. SON Wyatt 225 2B1 RDMS, RVT Patient: Male 85 YOA Caucasian Indication: Elevated Alkaline Phosphatase History Annual physical showed elevated alkaline

More information

Sonographic Appearances of Common Gut Pathology in Paediatric Patients: Comparison with Plain Abdominal Radiography

Sonographic Appearances of Common Gut Pathology in Paediatric Patients: Comparison with Plain Abdominal Radiography 3668 Radiographer Text 1/4/04 2:57 PM Page 11 The Radiographer vol. 51: 11-17 Sonographic Appearances of Common Gut Pathology in Paediatric Patients: Comparison with Plain Abdominal Radiography Lino Piotto

More information

Job Task Analysis for ARDMS Abdomen Data Collected: June 30, 2011

Job Task Analysis for ARDMS Abdomen Data Collected: June 30, 2011 Job Task Analysis for ARDMS Abdomen Data Collected: June 30, 2011 Reported: Analysis Summary for: Abdomen Examination Survey Dates 06/13/2011-06/26/2011 Invited Respondents 6,000 Surveys with Demographics

More information

Policies, Standards, and Guidelines. Guidelines for Abdominal Ultrasound Examination

Policies, Standards, and Guidelines. Guidelines for Abdominal Ultrasound Examination Policies, Standards, and Guidelines Guidelines for Abdominal Ultrasound Examination Approved by Council Feb 2018 Disclaimer and Copyright The ASUM Standards of Practice Board have made every effort to

More information

ASSESSING 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 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 information

Vomiting 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 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 information

Bowel Obstructions in Older Children

Bowel Obstructions in Older Children Residents Section Pattern of the Month Hryhorczuk et al. owel Obstructions in Older Children Residents Section Pattern of the Month Residents inradiology nastasia Hryhorczuk 1 Edward Y. Lee 1,2 Ronald

More information

Pocket-sized versus standard ultrasound machines in abdominal imaging

Pocket-sized versus standard ultrasound machines in abdominal imaging Singapore Med J 2014; 55(6): 325-333 doi: 10.11622/smedj.2014078 CMEArticle Pocket-sized versus standard ultrasound machines in abdominal imaging Ka Hei Tse 1, MBChB, Wing Hang Luk 1, FRCR, FHKAM, Mau

More information

Gastrointestinal Tract. Anatomy of GI Tract. Anatomy of GI Tract. (Effective February 2007) (1%-5%)

Gastrointestinal Tract. Anatomy of GI Tract. Anatomy of GI Tract. (Effective February 2007) (1%-5%) Gastrointestinal Tract (Effective February 2007) (1%-5%) Anatomy of GI Tract Esophagus bulls-eye or target EG junction seen on sagittal scan posterior to left lobe of liver and anterior to aorta Anatomy

More information

USMLE Step 1 Problem Drill 17: Gastrointestinal System

USMLE Step 1 Problem Drill 17: Gastrointestinal System USMLE Step 1 Problem Drill 17: Gastrointestinal System Question No. 1 of 10 1. A surgeon is planning to remove a patient s gallbladder endoscopically. During the procedure, the endoscope will traverse

More information

Intraperitoneal cysts in infancy and childhood An overview and sonographic differentiation

Intraperitoneal cysts in infancy and childhood An overview and sonographic differentiation Intraperitoneal cysts in infancy and childhood An overview and sonographic differentiation M. Mearadji International Foundation for Pediatric Imaging Aid Rotterdam, The Netherlands Intraperitoneal cysts

More information

Small Animal Abdominal Ultrasonography LIVER & GALLBLADDER: PART 2

Small Animal Abdominal Ultrasonography LIVER & GALLBLADDER: PART 2 IMGING ESSENTILS Peer Reviewed Small nimal bdominal Ultrasonography LIVER & GLLLDDER: PRT 2 Danielle Mauragis, S, CVT, and Clifford R. erry, DVM, Diplomate CVR University of Florida Welcome to our series

More information

Pitfalls in the CT diagnosis of appendicitis

Pitfalls in the CT diagnosis of appendicitis The British Journal of Radiology, 77 (2004), 792 799 DOI: 10.1259/bjr/95663370 E 2004 The British Institute of Radiology Pictorial review Pitfalls in the CT diagnosis of appendicitis 1 C D LEVINE, 2 O

More information

Abdominal Pain in Pediatric Patients Image Gently

Abdominal 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 information

Intraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma

Intraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma Intraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma Authors: R. Revert Espí, Y. Fernandez Nuñez, I. Carbonell, D. P. Gómez valencia,

More information

4/9/2018 OBJECTIVES PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS

4/9/2018 OBJECTIVES PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS Jean Yves Sewah Kaiser Permanente West Los Angeles 1 OBJECTIVES Discuss the role of ultrasound in the evaluation of the gallbladder, biliary tree and

More information

elical CT plays an important role

elical CT plays an important role bdominal Imaging Yu et al. Helical CT of cute RLQ Pain Pictorial Essay Jinxing Yu 1 nn S. Fulcher Mary nn Turner Robert. Halvorsen Yu J, Fulcher S, Turner M, Halvorsen R Helical CT Evaluation of cute Right

More information

Radiological Investigations of Abdominal Trauma

Radiological 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 information

CT Findings of Acute Cholecystitis and Its Complications

CT Findings of Acute Cholecystitis and Its Complications Gastrointestinal Imaging Pictorial Essay Shakespear et al. CT of cute Cholecystitis Gastrointestinal Imaging Pictorial Essay Downloaded from www.ajronline.org by 46.3.194.29 on 01/20/18 from IP address

More information

Preview from Notesale.co.uk Page 1 of 34

Preview from Notesale.co.uk Page 1 of 34 Abdominal viscera and digestive tract Digestive tract Abdominal viscera comprise majority of the alimentary system o Terminal oesophagus, stomach, pancreas, spleen, liver, gallbladder, kidneys, suprarenal

More information

Cirrhosis and Portal Hypertension Gastroenterology Teaching Project American Gastroenterological Association

Cirrhosis and Portal Hypertension Gastroenterology Teaching Project American Gastroenterological Association CIRRHOSIS AND PORTAL HYPERTENSION Cirrhosis and Portal Hypertension Gastroenterology Teaching Project American Gastroenterological Association WHAT IS CIRRHOSIS? What is Cirrhosis? DEFINITION OF CIRRHOSIS

More information

Pathology of Intestinal Obstruction. Dr. M. Madhavan, MBBS., MD., MIAC, Professor of Pathology Saveetha Medical College

Pathology of Intestinal Obstruction. Dr. M. Madhavan, MBBS., MD., MIAC, Professor of Pathology Saveetha Medical College Pathology of Intestinal Obstruction Dr. M. Madhavan, MBBS., MD., MIAC, Professor of Pathology Saveetha Medical College Pathology of Intestinal Obstruction Objectives list the causes of intestinal obstruction

More information

Spectrum of Causes of Pancreatic Calcifications

Spectrum of Causes of Pancreatic Calcifications Pictorial Essay Downloaded from www.ajronline.org by 46.3.200.2 on 12/21/17 from IP address 46.3.200.2. Copyright RRS. For personal use only; all rights reserved Spectrum of Causes of Pancreatic Calcifications

More information

Basic Abdominal Sonography

Basic Abdominal Sonography 24S Basic Abdominal Sonography Procedural Overview JOHN FATCHETT II, RDMS is provided. Patient preparation (i.e., fasting) scanning techniques, spleen, transducer. evaluation of abdominal anatomy in the

More information

Imaging Features of Encapsulating Peritoneal Sclerosis in Continuous Ambulatory Peritoneal Dialysis Patients

Imaging Features of Encapsulating Peritoneal Sclerosis in Continuous Ambulatory Peritoneal Dialysis Patients Genitourinary Imaging Pictorial Essay Ti et al. Encapsulating Peritoneal Sclerosis in CPD Patients Genitourinary Imaging Pictorial Essay Joanna P. Ti 1 li l-radi 2 Peter J. Conlon 2 Michael J. Lee 1 Martina

More information

Gastrointestinal tract

Gastrointestinal tract Chapter 7 Gastrointestinal tract NORMAL SONOGRAPHIC ANATOMY Sonographically, the fetal stomach is visible from 9 weeks of gestation as a sonolucent cystic structure in the upper left quadrant of the abdomen.

More information

Body MRI from the Liver to the Bladder

Body MRI from the Liver to the Bladder Body MRI from the Liver to the Bladder I Want You! Audience Participation Methodist Hospital Continuing Education Seminar Jordan Swensson, MD November 7, 2015 Objectives Observe the uses of MRI for organs

More information

Biliary Ultrasonography Kathleen O Brien MD MPH RDMS Kaiser Permanente South Sacramento

Biliary Ultrasonography Kathleen O Brien MD MPH RDMS Kaiser Permanente South Sacramento Biliary Ultrasonography Kathleen O Brien MD MPH RDMS Kaiser Permanente South Sacramento https://www.google.com/search?sa=g&hl=en&q=public+disclosure&tbm=isch&tbs=simg:caqsigeahwelekju2aqaaawlelcmpwgaygpgcamskpib_1qnza7ai

More information

Accessory Glands of Digestive System

Accessory Glands of Digestive System Accessory Glands of Digestive System The liver The liver is soft and pliable and occupies the upper part of the abdominal cavity just beneath the diaphragm. The greater part of the liver is situated under

More information

Biliary Tree Ultrasound - In a nutshell. Pamela Parker Lead Sonographer

Biliary Tree Ultrasound - In a nutshell. Pamela Parker Lead Sonographer Biliary Tree Ultrasound - In a nutshell Pamela Parker Lead Sonographer Aims Review what we know about the biliary system Common pathologies Pitfalls Reporting tips The Nutshell Background Biliary examinations

More information

Mimics of Appendicitis: Alternative Nonsurgical Diagnoses with Sonography and CT

Mimics of Appendicitis: Alternative Nonsurgical Diagnoses with Sonography and CT van reda Vriesman and Puylaert Mimics of ppendicitis bdominal Imaging Pictorial Essay Downloaded from www.ajronline.org by 46.3.193.220 on 12/27/17 from IP address 46.3.193.220. Copyright RRS. For personal

More information

Abdominal Complications After Bone Marrow Transplantation in Children: Sonographic and CT Findings

Abdominal Complications After Bone Marrow Transplantation in Children: Sonographic and CT Findings 1023 Pictorial Essay Abdominal Complications After Bone Marrow Transplantation in Children: Sonographic and CT Findings Ellen C. Benya,1 2 Carlos J. Sivit, 2 and Ralph R. Quinones2 3 Bone marrow transplantation

More information

General Data. 王 X 村 78 y/o 男性

General Data. 王 X 村 78 y/o 男性 General Data 王 X 村 78 y/o 男性 Chief Complaint Vomiting twice this early morning Fever up to 38.9ºC was noted Present Illness (1) Old CVA with left side weakness for more than 10 years and with bed ridden

More information

Jaundice. Agnieszka Dobrowolska- Zachwieja, MD, PhD

Jaundice. Agnieszka Dobrowolska- Zachwieja, MD, PhD Jaundice Agnieszka Dobrowolska- Zachwieja, MD, PhD Jaundice definition Jaundice, as in the French jaune, refers to the yellow discoloration of the skin. It arises from the abnormal accumulation of bilirubin

More information

Neonatal intestinal obstruction: how to make etiological diagnosis?

Neonatal 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 information

Interesting Pediatric ultrasound cases. Presented by: Falguni Patel (RDMS, RVT)

Interesting 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 information

Neonatal intestinal obstruction: how to make etiological diagnosis?

Neonatal 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 information

Spontaneous portosystemic venous shunts in liver cirrhosis: Anatomy, pathophysiology, hemodynamic changes and imaging findings

Spontaneous portosystemic venous shunts in liver cirrhosis: Anatomy, pathophysiology, hemodynamic changes and imaging findings Spontaneous portosystemic venous shunts in liver cirrhosis: Anatomy, pathophysiology, hemodynamic changes and imaging findings Poster No.: C-3193 Congress: ECR 2010 Type: Educational Exhibit Topic: Vascular

More information

GASTROENTEROLOGY Maintenance of Certification (MOC) Examination Blueprint

GASTROENTEROLOGY Maintenance of Certification (MOC) Examination Blueprint GASTROENTEROLOGY Maintenance of Certification (MOC) Examination Blueprint ABIM invites diplomates to help develop the Gastroenterology MOC exam blueprint Based on feedback from physicians that MOC assessments

More information

GI Tract Lynn Ta Jennifer Zhang July 6, 2006 GI TRACT. 1) Other Names: Gastrointestinal tract Digestive tract Alimentary tract

GI Tract Lynn Ta Jennifer Zhang July 6, 2006 GI TRACT. 1) Other Names: Gastrointestinal tract Digestive tract Alimentary tract GI Tract Lynn Ta Jennifer Zhang July 6, 2006 GI TRACT 1) Other Names: Gastrointestinal tract Digestive tract Alimentary tract 2) Definition/Location: Digestion and absorption are the primary functions

More information

Development of pancreas and Small Intestine. ANATOMY DEPARTMENT DR.SANAA AL-AlSHAARAWY DR.ESSAM Eldin Salama

Development of pancreas and Small Intestine. ANATOMY DEPARTMENT DR.SANAA AL-AlSHAARAWY DR.ESSAM Eldin Salama Development of pancreas and Small Intestine ANATOMY DEPARTMENT DR.SANAA AL-AlSHAARAWY DR.ESSAM Eldin Salama OBJECTIVES At the end of the lecture, the students should be able to : Describe the development

More information

Alice Fung, MD Oregon Health and Science University

Alice Fung, MD Oregon Health and Science University Alice Fung, MD Oregon Health and Science University Disclosure Comments The speaker Alice Fung, MD Has relevant financial relationships to disclose. Received honorarium from (Guerbet). This individual

More information

Imaging iconography of gallbladder cancer. Assessment by CT.

Imaging iconography of gallbladder cancer. Assessment by CT. 1 REVISTA DE IMAGENOLOGIA- EII / Vol. XVI / Num. 2 Imaging iconography of gallbladder cancer. Assessment by CT. Doctors Crisci, Alejandro (1); Landó, Fernando.(2). CASMU CT Department Hospital of Tacuarembó

More information

Appendix 9: Endoscopic Ultrasound in Gastroenterology

Appendix 9: Endoscopic Ultrasound in Gastroenterology Appendix 9: Endoscopic Ultrasound in Gastroenterology This curriculum is intended for clinicians who perform endoscopic ultrasonography (EUS) in gastroenterology. It includes standards for theoretical

More information

Vascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD

Vascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD Vascular Imaging in the Pediatric Abdomen Jonathan Swanson, MD Goals and Objectives To understand the imaging approach, appearance, and clinical manifestations of the common pediatric abdominal vascular

More information

Imaging of liver and pancreas

Imaging of liver and pancreas Imaging of liver and pancreas.. Disease of the liver Focal liver disease Diffusion liver disease Focal liver disease Benign Cyst Abscess Hemangioma FNH Hepatic adenoma HCC Malignant Fibrolamellar carcinoma

More information

Biliary Tree Ultrasound - In a nutshell. Pamela Parker Lead Sonographer

Biliary Tree Ultrasound - In a nutshell. Pamela Parker Lead Sonographer Biliary Tree Ultrasound - In a nutshell Pamela Parker Lead Sonographer Aims Review what we know about the biliary system Common pathologies Pitfalls Reporting tips The Nutshell Background Biliary examinations

More information

PATHOLOGY MCQs. The Pancreas

PATHOLOGY MCQs. The Pancreas PATHOLOGY MCQs The Pancreas A patient with cystic fibrosis is characteristically: A. more than 45 years of age B. subject to recurring pulmonary infections C. obese D. subject to spontaneous fractures

More information

Gastroschisis Sequelae and Management

Gastroschisis Sequelae and Management Gastroschisis Sequelae and Management Mary Finn Gillian Lieberman, MD Primary Care Radiology Beth Israel Deaconess Medical Center Harvard Medical School April 2014 Outline I. Definition and Epidemiology

More information

US LI-RADS v2017 CORE

US LI-RADS v2017 CORE US LI-RADS v2017 CORE Screening or surveillance US in patient at high risk for HCC US category US-1 US-2 US-3 Negative Subthreshold Positive Category Concept Definition US-1 Negative US-2 Subthreshold

More information

Abdomen Sonography Examination Content Outline

Abdomen Sonography Examination Content Outline Abdomen Sonography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 Anatomy, Perfusion, and Function Pathology, Vascular Abnormalities, Trauma, and Postoperative Anatomy

More information

Disclosures. Overview. Case 1. Common Bile Duct Sizes 10/14/2016. General GI + Advanced Endoscopy: NAFLD/Stones/Pancreatitis

Disclosures. Overview. Case 1. Common Bile Duct Sizes 10/14/2016. General GI + Advanced Endoscopy: NAFLD/Stones/Pancreatitis Disclosures General GI + Advanced Endoscopy: NAFLD/Stones/Pancreatitis 123 Blank Blank, LLC Aldo Maspons, MD Assistant Professor Director of Endoscopy Department of Pediatrics Texas Tech University Health

More information

Abdominal radiology 腹部放射線學

Abdominal radiology 腹部放射線學 Abdominal radiology 腹部放射線學 台北醫學大學 - 市立萬芳醫院 留偉順 laowilson@hotmail.com The Normal Abdominal Series Chest Supine abdomen Erect abdomen Left lateral decubitus abdomen Learning objectives Understanding normal

More information

Ultrasound of: Appendicitis Intussusception Pyloric Stenosis

Ultrasound of: Appendicitis Intussusception Pyloric Stenosis Ultrasound of: Appendicitis Intussusception Pyloric Stenosis Andrew Phelps MD Assistant Professor Pediatric Radiology UCSF Benioff Children s Hospital No Disclosures Take Home Message Appendicitis occurs

More information

Portal Venous Thrombosis: Tumor VS Bland Thrombus

Portal Venous Thrombosis: Tumor VS Bland Thrombus June 2015 Portal Venous Thrombosis: Tumor VS Bland Thrombus SERGIO ALFARO, HARVARD MEDICAL SCHOOL YEAR III GILLIAN LIEBERMAN, MD Overview 2 Index Patient History Portal Venous Thrombosis (PVT) Imaging

More information

Introduction and Definitions

Introduction 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

GENERAL ABDOMINAL IMAGING PERITONEAL SPACE, PANCREAS, & SPLEEN. VMB 960 March 25, 2013

GENERAL ABDOMINAL IMAGING PERITONEAL SPACE, PANCREAS, & SPLEEN. VMB 960 March 25, 2013 GENERAL ABDOMINAL IMAGING PERITONEAL SPACE, PANCREAS, & SPLEEN VMB 960 March 25, 2013 REFERENCE Chapters 35-36 Pages 650-678 Chapter 37 Pages 694-701 Chapter 3 Pages 38-49 OBJECTIVES Radiography and Ultrasound

More information

ACUTE ABDOMEN IN OLDER CHILDREN. Carlos J. Sivit M.D.

ACUTE 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 information

Exploring Anatomy: the Human Abdomen

Exploring Anatomy: the Human Abdomen Exploring Anatomy: the Human Abdomen PERITONEUM AND PERITONEAL CAVITY PERITONEUM The peritoneum is a thin serous membrane that lines the abdominal cavity and covers, in variable amounts, the viscera within

More information

DIAGNOSTIC IMAGING: LIVER DISEASE

DIAGNOSTIC IMAGING: LIVER DISEASE Vet Times The website for the veterinary profession https://www.vettimes.co.uk DIAGNOSTIC IMAGING: LIVER DISEASE Author : Abby Caine Categories : Vets Date : February 1, 2010 ABBY CAINE reviews both established

More information

Personal Profile. Name: 劉 XX Gender: Female Age: 53-y/o Past history. Hepatitis B carrier

Personal Profile. Name: 劉 XX Gender: Female Age: 53-y/o Past history. Hepatitis B carrier Personal Profile Name: 劉 XX Gender: Female Age: 53-y/o Past history Hepatitis B carrier Chief complaint Fever on and off for 2 days Present illness 94.10.14 Sudden onset of epigastric pain 94.10.15 Fever

More information

A novel plain abdominal radiograph sign to diagnose malrotation with volvulus

A novel plain abdominal radiograph sign to diagnose malrotation with volvulus A novel plain abdominal radiograph sign to diagnose malrotation with volvulus Nataraja RM 1, Mahomed AA 1* 1. Department of Paediatric Surgery, Royal Alexandra Hospital for Sick Children, Brighton,UK *

More information

DR JAIKISHOR JOTHIRAJ MD POST GRADUATE DEPT OF RADIODIAGNOSIS

DR 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 information

Biliary cancers: imaging diagnosis. Study of 30 cases

Biliary cancers: imaging diagnosis. Study of 30 cases Biliary cancers: imaging diagnosis. Study of 30 cases N Hammoune, S Semlali, M Eddarai, T. Amil, M Zentar, S. El Kandri,, M Benameur,, S Chaouir. Radiology Department. Mohamed V Military Hospital. Rabat-

More information

Emergent Right Upper Quadrant Sonography

Emergent Right Upper Quadrant Sonography Image Presentation Emergent Right Upper Quadrant Sonography Susanna C. Spence, MD, Davis Teichgraeber, MD, Chitra Chandrasekhar, MD Objective. The purpose of this presentation is to review the sonographic

More information

Case 7729 Child with choledochal cyst presenting with episodes of vomitting and jaundice

Case 7729 Child with choledochal cyst presenting with episodes of vomitting and jaundice Case 7729 Child with choledochal cyst presenting with episodes of vomitting and jaundice dos Santos R 1, Almeida J 1, Mendes PP 2, Pereira S 3, Borges C 3, Soares E 4. 1) Radiology resident, 2) Radiology

More information

CT EVALUATION OF GASTRIC LESIONS:

CT EVALUATION OF GASTRIC LESIONS: CT EVALUATION OF GASTRIC LESIONS: Pictural essay Hasni Bouraoui I, Kahloun A, Jemni H, Elouni F, Moulahi H, Daadoucha A, Ben Ali A, Sriha B, Tlili Graies K Departments of Radiology, Gastro enterology,

More information

Liver Ultrasound - Beyond the Basics. Pamela Parker Lead Sonographer

Liver Ultrasound - Beyond the Basics. Pamela Parker Lead Sonographer Liver Ultrasound - Beyond the Basics Pamela Parker Lead Sonographer Aims Review what we know about the liver Reasons for imaging Focal lesions Diffuse disease Can we do more? The Liver The Liver The Liver

More information

IMAGING OF LIVER, BILIARY TREE, PANCREAS

IMAGING OF LIVER, BILIARY TREE, PANCREAS IMAGING OF LIVER, BILIARY TREE, PANCREAS Department of Radiology West China Hospital, Sichuan University Yao Jin Learning Points The methodology for imaging the LBP (liver, biliary tree, and pancreas )

More information

Intrahepatic Cholangiocarcinoma (ICC) Detected by Sonography

Intrahepatic Cholangiocarcinoma (ICC) Detected by Sonography 661245JDMXXX10.1177/8756479316661245Journal of Diagnostic Medical SonographyHamer research-article2016 Case Study Intrahepatic Cholangiocarcinoma (ICC) Detected by Sonography Journal of Diagnostic Medical

More information

Digestive system L 4. Lecturer Dr. Firdous M. Jaafar Department of Anatomy/Histology section

Digestive system L 4. Lecturer Dr. Firdous M. Jaafar Department of Anatomy/Histology section Digestive system L 4 Lecturer Dr. Firdous M. Jaafar Department of Anatomy/Histology section objectives 1-Describe the structure of liver. 2-Define liver lobule, and identify its zones. 3-Define portal

More information