Cecal Volvulus: Case Presentation and Review of CT Findings
|
|
- Charity Holt
- 6 years ago
- Views:
Transcription
1 August 2011 Cecal Volvulus: Case Presentation and Review of CT Findings Omar Pardesi, Harvard Medical School Year III
2 Our Patient LD: History & Physical HPI: 28 y.o. female presents with diffuse abdominal pain; began suddenly this AM, worst in LLQ. Began menses yesterday Had normal BM without relief Denies fever, chills, vaginal discharge, hematuria, dysuria, diarrhea, melena, or hematochezia. 2
3 Patient LD: History & Physical (cont.) PMH: Ruptured ovarian cyst Meds: Oral contraceptives Social: Not currently sexually active Pertinent exam findings: abdomen soft and mildly distended, moderately tender in all quadrants without rebound or guarding; normal bowel sounds. 3
4 Initial Differential: Broad Categories Gynecologic (ovarian torsion, ectopic pregnancy, menstrual, etc.) Infection (gastroenteritis, pyelonephritis, etc.) Primary abdominal pathology (diverticulitis, ischemic bowel, intussusception, etc.) 4
5 Patient LD: Initial Labs CBC: WBC 5.2, Hct 39.9, Plt 223 HCG negative AST 26, ALT 16, Alk Phos 78, Tbili 0.2, Lipase 32 UA negative 5
6 Patient LD: Initial Imaging LD had an abdominal + pelvic ultrasound Showed normal ovaries, but large amount of free fluid in the right pelvis Next imaging test to work up abdominal pain and free fluid: CT of the abdomen. We will briefly view images from this CT now, but will revisit the findings in more detail later in this presentation. 6
7 Patient LD: Abdominal CT Scan 1 Dilated cecum, located in LUQ Blue Box: Transition point C CT abdomen, axial view PACS, BIDMC 7
8 LD: Abdominal CT Scan 2 Whirl Sign C CT abdomen, sagittal view PACS, BIDMC 8
9 These findings on CT are diagnostic of cecal volvulus; we will now proceed to briefly review the anatomy of cecal volvulus. We will then revisit these images in order to review important CT findings of cecal volvulus. 9
10 Cecal Volvulus: Definition and Illustration Defined as torsion of the bowel around its own mesentery This image shows cecum twisting and inverting upward, tangling with ileum. Moore CJ et al. CT of Cecal Volvulus: Unraveling the Image. AJR. 2001; 177:
11 Sites of Volvulus in the Bowel Cecum accounts for 11 40% of intestinal volvulus Cecal volvulus usually only occurs in patients with a developmental failure of fixation of proximal right colon to peritoneum More common in younger patients Sigmoid colon is most common site of volvulus Caplan, Geralyn M. Digestive System Study Guide. Owensboro Community & Technical College: Anatomy & Physiology II. 11
12 Prior to reviewing CT findings of cecal volvulus, we will view an abdominal plain film from a companion patient and discuss the diagnostic utility of the plain film for cecal volvulus. 12
13 Companion Pt 1: Abdominal Plain Film Major findings: Focal loop of air distended bowel Prominent small bowel ( cm) Supine Abdominal Plain Film PACS, BIDMC 13
14 Plain Films: Diagnostic Utility In one large series, plain film suggested diagnosis of cecal volvulus <50% of the time. 1/3 of cases were thought to be small bowel obstruction. Why might this be? Let us briefly consider a differential diagnosis based on these plain film findings. 14
15 Partial Differential Diagnosis Suggested by Plain Film Findings Massively dilated loop of (large) bowel: Distal obstruction Functional obstruction Paralytic ileus (nonobstructive distention) Scleroderma, dermatomyositis Toxic megacolon Congenital / pediatric For distended small bowel, add: Drug effect Mesenteric ischemia Postvagotomy Celiac sprue Other malabsorptive syndromes In part because of this broad differential, plain films are of limited utility in diagnosing volvulus, and CT is preferable. 15
16 Important CT Findings of Volvulus Severe cecal distention (> 10 cm) Whirl sign, transition point(s) Dilation and fecalization of small bowel Decompression of colon Split wall sign 16
17 Pt LD: Whirl Sign on CT Whirl Sign / Hurricane Sign An important defining sign of volvulus Twisted loops of bowel and branching mesenteric vessels create swirling strands of soft tissue attenuation within a background of mesenteric fat attenuation. Khurana B, Radiology (2003); 226: C CT abdomen, sagittal view PACS, BIDMC 17
18 PACS, BIDMC Pt LD: Transition Points PACS, BIDMC Sequential axial C CT images showing transition points in small and large bowel. Left (arrow): proximal dilated cecum transitioning to narrowed, collapsed distal colon. Right: proximal small bowel (arrow) entering into twist (box) with large bowel. 18
19 Companion Pt 1: Whirl Sign (Axial View) Dilated cecum, seen here closer to midline Blue Box: Whirl Sign Our companion patient provides another example of the whirl sign. C CT abdomen, axial view PACS, BIDMC 19
20 Companion Pt 1: Whirl Sign (Coronal View) This coronal view of our companion patient clearly demonstrates the whirl sign, with distended large bowel entering into the twist. C CT abdomen, coronal view PACS, BIDMC 20
21 Important CT Findings of Volvulus: Progress Severe cecal distention (> 10 cm) Whirl sign, transition point(s) Dilation and fecalization of small bowel Decompression of colon Split wall sign 21
22 Companion Pt 1: Fecalized Small Bowel Fecalized Small Bowel, suggesting distal obstruction C CT abdomen, coronal view PACS, BIDMC 22
23 Companion Pt 2: Decompressed Colon Here, we see decompressed right colon distal to the point of volvulus. Oral contrast has not reached this loop, and it appears collapsed. Rosenblat JM, AM Rozenblit, EL Wolf, et al. Findings of Cecal Volvulus at CT. Radiology. 2010; 256:
24 Companion Pt 3: Split Wall Sign Split Wall Sign: Apparent splitting of colon wall by mesenteric fat. Caused by adjacent mesenteric fat invagination in a twisted loop of bowel. Rosenblat JM, AM Rozenblit, EL Wolf, et al. Findings of Cecal Volvulus at CT. Radiology. 2010; 256:
25 Important CT Findings of Volvulus: Complete Severe cecal distention (> 10 cm) Whirl sign, transition point(s) Dilation and fecalization of small bowel Decompression of colon Split wall sign 25
26 Our Patient LD: Clinical Outcome LD had an emergent exploratory laparotomy, with no signs of bowel ischemia Ileocolectomy was performed without complication LD recovered well and was discharged on postoperative day 4. Companion patient s surgical specimen Habre J, N Sautot Vial, C Marcotte et al. Caecal Volvulus. Am J Surg. 2008; 196:e48 e49. 26
27 References Caplan, Geralyn M. Digestive System Study Guide. Owensboro Community & Technical College: Anatomy & Physiology II. uide%20k%20digestive%20anatomy.htm. Accessed 8/20/11. Habre J, N Sautot Vial, C Marcotte et al. Caecal Volvulus. Am J Surg. 2008; 196:e48 e49. Katz DS, B Yam, JJ Hines et al. Uncommon and Unusual Gastrointestinal Causes of the Acute Abdomen: Computed Tomographic Diagnosis. Seminars in Ultrasound CT and MRI. 2008; 29: Khurana B. The Whirl Sign. Radiology. 2003; 226: Moore CJ, F Corl, E Fishman. CT of Cecal Volvulus: Unraveling the Image. AJR. 2001; 177: Peterson C, J Anderson, AK Hara et al. Volvulus of the Gastrointestinal Tract: Appearance at Multi modality Imaging. RadioGraphics. 2009; 29: Reeder, Maurice M. Reeder and Felson s Gamuts in Radiology: Comprehensive Lists of Imaging Differential Diagnoses. Fourth edition. New York: Springer; Accessed 8/20/11. Rosenblat JM, AM Rozenblit, EL Wolf, et al. Findings of Cecal Volvulus at CT. Radiology. 2010; 256:
28 Acknowledgements Samir Shah, MD Emily Hanson 28
Christopher 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 informationA case of cecal volvulus in a cerebral palsy patient: Usefulness of multidetector computed tomography for preoperative diagnosis
Kawasaki Medical Journal 38(4):205-209,2012 205 A case of cecal volvulus in a cerebral palsy patient: Usefulness of multidetector computed tomography for preoperative diagnosis Yusuke MATSUI 1), Munenori
More informationAbdominal Pain. Luke Donnelly, MD Emergency Medicine
Abdominal Pain Luke Donnelly, MD Emergency Medicine Objectives Approach to abdominal pain Evaluation Critical diagnoses and treatments Abdominal Pain Most Common ER Complaint Broad Differential Can often
More informationNordic Forum - Trauma & Emergency Radiology. Bowel Obstruction: Imaging Update
Nordic Forum - Trauma & Emergency Radiology Bowel Obstruction: Imaging Update Borut Marincek Institute of Diagnostic Radiology University Hospital Zurich, Switzerland Acute Abdomen Bowel Obstruction Bowel
More informationCystic liver lesion and eosinophilia
November, 2005 Cystic liver lesion and eosinophilia Jakob Begun, Harvard medical School Year III Patient Presentation 55 year old Cape Verde female presented to her PCP with 6 month history of variable
More informationThe "whirl sign". Diagnostic accuracy for intestinal volvulus.
The "whirl sign". Diagnostic accuracy for intestinal volvulus. Poster No.: C-0670 Congress: ECR 2014 Type: Scientific Exhibit Authors: M. Pire, M. Marti, A. Borobia, A. Verón; Madrid/ES Keywords: Abdomen,
More informationU Lecture Objectives. U Nordic Forum Trauma & Emergency Radiology. Bowel obstruction. U Bowel Obstruction: Etiologies
Nordic Forum Trauma & Emergency Radiology Lecture Objectives Bowel Obstruction To illustrate the spectrum of acute obstruction of the small and the large bowel To explain how these bowel obstructions may
More informationGeneral 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 informationAlways keep it in the differential
Acute Appendicitis Lissa C. Sakata and Lindsey Perea 2 Always keep it in the differential Learning Objectives 1. The learner should be able to describe the etiology of acute appendicitis. 2. The learner
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 informationWorld Journal of Colorectal Surgery
World Journal of Colorectal Surgery Volume 3, Issue 4 2013 Article 6 Case report: Intussusception of the colon through a colostomy: A rare presentation of colonic intussusception. Dr. Nora Trabulsi Dr.
More informationACUTE ABDOMEN. Dr. M Asadi. Surgical Oncology Research Center MUMS. Assistant Professor of General Surgery
ACUTE ABDOMEN Dr. M Asadi Assistant Professor of General Surgery Surgical Oncology Research Center MUMS Definition I. The term Acute Abdomen refers to signs & symptoms of abdominal pain and tenderness,
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 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 informationPerforation of a Duodenal Diverticulum. Elective Student S. C.
Perforation of a Duodenal Diverticulum 2008 4 Elective Student S. C. Case History An elderly male presented to the Emergency Department with abdominal pain. Chief Complaint: Worsening, diffuse abdominal
More informationResidents Section Pattern of the Month
Residents Section Pattern of the Month Krajewski et al. olonic Dilation Residents Section Pattern of the Month Residents inradiology Katherine Krajewski 1 ettina Siewert Ronald L. Eisenberg Krajewski K,
More informationVolvulus characterization in radiology: A review
Volvulus characterization in radiology: A review Poster No.: C-1677 Congress: ECR 2010 Type: Topic: Educational Exhibit GI Tract Authors: C. Antunes, M. Seco, A. Canelas, C. Ruivo, C. Paulino, F. Cruz,
More informationFlouroscopy CT. Principal Modality (2): Case Report # [] Date accepted: 14 May 2015
Radiological Category: Emergency Principal Modality (1): Principal Modality (2): Flouroscopy CT Case Report # [] Submitted by: Haider Virani, M.D. Faculty reviewer: Naga Chinapuvvula, MD Date accepted:
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 informationPitfalls 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 informationelical 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 informationManagement of Small Bowel Obstruction: An Update. Case Presentation
Management of Small Bowel Obstruction: An Update The Postgraduate Course in General Surgery March 20-23, 2011 Jonathan Carter, MD Assistant Professor of Surgery Case Presentation 67 year old otherwise
More information3/21/2011. Case Presentation. Management of Small Bowel Obstruction: An Update. CT abdomen and pelvis. Abdominal plain films
Case Presentation 67 year old otherwise healthy woman presents to the ED with a chief complaint of abdominal pain, nausea and vomiting for five days. Management of Small Bowel Obstruction: An Update The
More informationVolvulus of the Gastrointestinal Tract: x-ray and CT imaging
Volvulus of the Gastrointestinal Tract: x-ray and CT imaging Poster No.: C-0076 Congress: ECR 2013 Type: Educational Exhibit Authors: E. Papadaki, S. Paschalidou, S. GIANNOU ; Rethymno, CR/ 1 2 2 3 1 3
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 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 informationAdult bowel obstruction with acute abdomen: spectrum of CT findings
Adult bowel obstruction with acute abdomen: spectrum of CT findings Poster No.: C-1571 Congress: ECR 2013 Type: Educational Exhibit Authors: L. Turturici, G. Gherarducci, F. Bianchi, R. Pascale, M. Tonerini,
More informationFive Views of Transitional Cell Carcinoma: One Man s Journey
September 2006 Five Views of Transitional Cell Carcinoma: One Man s Journey Amsalu Dabela, Harvard Medical School III Outline Overview: Renal Anatomy Our Patient s Story Diagnostic Imaging Studies Appearance
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 informationX-ray Corner. Imaging of The Colon. Pantongrag-Brown L
110 Imaging of The Colon X-ray Corner Imaging of The Colon Pantongrag-Brown L Imaging modalities used in colon include plain radiographs, barium enema, US, CT, PET CT and MRI. Barium enema (BE) is declining
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 2/5/2011 Radiology Quiz of the Week # 6 Page 1 CLINICAL PRESENTATION AND RADIOLOGY QUIZ
More informationComputed tomography (CT) imaging review of small bowel obstruction
Computed tomography (CT) imaging review of small bowel obstruction Poster No.: C-1602 Congress: ECR 2010 Type: Educational Exhibit Topic: GI Tract - Small Bowel Authors: A. Vousough, D. S. Prasad ; Aberdeen/UK,
More informationFHS 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 informationEmergent Pediatric Ultrasound. Katharine Dennis, RDMS/RVT Tiffany Schultz, RDMS UNC Health Care Dept of General Ultrasound
Emergent Pediatric Ultrasound Katharine Dennis, RDMS/RVT Tiffany Schultz, RDMS UNC Health Care Dept of General Ultrasound Introduction Learning Objectives Review common pediatric emergent ultrasound exams
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 informationAbdominal Assessment
Abdominal Assessment Mary Marian, MS,RD,CSO University of AZ, Tucson, AZ Neha Parekh, MS,RD,LD,CNSC Cleveland Clinic, Cleveland, OH Objectives: 1. Outline the steps in performing an abdominal examination.
More informationHirschprung s. Meconium plug R/S >1 R/S <1
NEONATAL ABDOMINAL EMERGENCIES LOW OBSTRUCTION HIGH OBSTRUCTION INTESTINAL OBSTRUCTION High obstruction - proximal to mid-ileumileum Few dilated, air filled bowel loops Complete obstruction diagnosed by
More informationA rare case of intestinal obstruction due to internal hernia. Dr. Jayanth 3 rd year PG Dept. Of General Surgery
A rare case of intestinal obstruction due to internal hernia Dr. Jayanth 3 rd year PG Dept. Of General Surgery One of the common cause of acute abdomen May lead to high morbidity and mortality if not treated
More informationAdult 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 informationComputed tomography (CT) imaging review of small bowel obstruction
Computed tomography (CT) imaging review of small bowel obstruction Poster No.: C-1602 Congress: ECR 2010 Type: Educational Exhibit Topic: GI Tract Authors: A. Vousough, D. S. Prasad ; Aberdeen/UK, Leeds/UK
More informationEmergency MDCT in case of right lower quadrant pain
Emergency MDCT in case of right lower quadrant pain Poster No.: C-0563 Congress: ECR 2015 Type: Educational Exhibit Authors: M. Lisitskaya, V. Sinitsyn; Moscow/RU Keywords: Abdomen, Emergency, Gastrointestinal
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 6/23/2012 Radiology Quiz of the Week # 78 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationGallstone ileus:diagnostic and therapeutic dilemma
Saurabh et al. 1 CASE SERIES OPEN ACCESS Gallstone ileus:diagnostic and therapeutic dilemma Shireesh Saurabh, Andrew Camerota, Jeffrey Zavotsky ABSTRACT Introduction: Gallstone ileus is a rare complication
More informationA Perf-ect Differential
A Perf-ect Differential Carolyn Marcus, MD Disclosure of Financial Relationships Husband works as in-house legal counsel at Sanofi Case Presentation 6 year old boy with a history of constipation presents
More informationIntussusception Secondary to a Meckel Diverticulum in an Adolescent
48) Intussusception Secondary to a Meckel Diverticulum in an Adolescent Yener O., Demir M., Yigitbaşı R. Department of Surgery, Göztepe Training and Research Hospital, Istanbul, Turkey Received March 28,
More information8/29/2016 DIVERTICULAR DISEASE: WHAT EVERY NURSE PRACTITIONER SHOULD KNOW. LENORE LAMANNA Ed.D, ANP-C LEARNING OBJECTIVES
DIVERTICULAR DISEASE: WHAT EVERY NURSE PRACTITIONER SHOULD KNOW LENORE LAMANNA Ed.D, ANP-C LEARNING OBJECTIVES Define Diverticular Disease Discuss Epidemiology and Pathophysiology of Diverticular disease
More informationCase Report Urachal Cyst Causing Small Bowel Obstruction in an Adult with a Virgin Abdomen
Case Reports in Surgery Volume 2016, Article ID 3247087, 4 pages http://dx.doi.org/10.1155/2016/3247087 Case Report Urachal Cyst Causing Small Bowel Obstruction in an Adult with a Virgin Abdomen Michael
More informationX-ray Corner. Imaging of the Small Bowel. Pantongrag-Brown L. Case 1. A 63-year-old man presented with abdominal pain, nausea and vomiting.
THAI J 42 Imaging of the Small Bowel GASTROENTEROL 2015 X-ray Corner Imaging of the Small Bowel Pantongrag-Brown L Small bowel is the longest tubular organ in the body, about 18-22 feet. It is anchored
More informationGI Grand Rounds. A A Lifetime of Abdominal Pain 12/9/2004 Tim Edwards
GI Grand Rounds A A Lifetime of Abdominal Pain 12/9/2004 Tim Edwards PMH Aug 25, 1992 4 year old male presents to a pediatric gastroenterologist for primary complaint of anorexia, intermittent abdominal
More informationSurgical Education Series
Surgical Education Series The Acute Abdomen Ahmad kachooei, MD MPH Assistant Professor Division of General Surgery Department of Surgery University of Qom Outline Definitions What causes an acute abdomen
More informationEmergency radiology of the large-bowel: What radiologists should know
Emergency radiology of the large-bowel: What radiologists should know Poster No.: C-1659 Congress: ECR 2016 Type: Educational Exhibit Authors: A. Falkowski, D. Boll; Basle/CH Keywords: Colon, Emergency,
More informationSonographic 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 informationWorld Journal of Colorectal Surgery
World Journal of Colorectal Surgery Volume 3, Issue 1 2013 Article 14 ISSUE 1 Diffuse Intestinal Lipomatosis Presenting as Adult Intussusception Christopher W. Snyder Jamie A. Cannon University of Alabama
More informationPlain 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 informationHome FAQ Archives ABP Topics NeoReviews.org My Bookmarks CME Information Help. Print this Page Add to my Bookmarks Page 3 of 10
Welcome Kristin Ingstrup [ Logout ] SEARCH Home FAQ Archives ABP Topics NeoReviews.org My Bookmarks CME Information Help Overview Editorial Board My Learning Plan January February March May June July August
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 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 informationCase Report Ileocecal Intussusception due to a Lipoma in an Adult
Case Reports in Surgery Volume 2012, Article ID 684298, 4 pages doi:10.1155/2012/684298 Case Report Ileocecal Intussusception due to a Lipoma in an Adult Mehmet Bilgin, 1 Huseyin Toprak, 1 Issam Cheikh
More information: Abdominal Emergencies
INTRODUCTION Abdominal complaints are very common in emergency medicine. The specific cause of the abdominal pain can very rarely be determined in the pre-hospital environment, however performing a good
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 informationA Case of Pneumatosis Cystoides Intestinalis Mimicking Intestinal Perforation
Showa Univ J Med Sci 26 2, 169 173, June 2014 Case Report A Case of Pneumatosis Cystoides Intestinalis Mimicking Intestinal Perforation Takahiro UMEMOTO 1, Yoshikuni HARADA 1, Makiko SAKATA 1, Gaku KIGAWA
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 informationThe Value of Urgent Barium Enema and Computed Tomography in Acute Malignant Colonic Obstruction: Is Urgent Barium Enema Still Necessary?
J Radiol Sci 2012; 37: 105-110 The Value of Urgent Barium Enema and Computed Tomography in Acute Malignant Colonic Obstruction: Is Urgent Barium Enema Still Necessary? Chun-Chao Huang 1,2 Fei-Shih Yang
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 34 year old woman with Vomiting and abdominal pain
A 34 year old woman with Vomiting and abdominal pain The patient was a 34 y/o woman admitted because of epigastric pain developed from 2 months ago. It was a crampy pain without radiation that became better
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 8/27/2011 Radiology Quiz of the Week # 35 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationRadiologists' Guide to the Whirl Sign
Radiologists' Guide to the Whirl Sign Poster No.: C-1478 Congress: ECR 2015 Type: Educational Exhibit Authors: B. layton, R. magennis, V. Rudralingam, S. Sukumar; Manchester/ UK Keywords: Ischemia / Infarction,
More informationUSMLE and COMLEX II. CE / CK Review. General Surgery. 1. Northwestern Medical Review
USMLE and COMLEX II CE / CK Review General Surgery 1. Northwestern Medical Review Northwestern Medical Review www.northwesternmedicalreview.com Lansing, Michigan 2014-2015 Acute Abdomen 1. Your patient
More informationGastroschisis 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 informationNursing Principles & Skills II. Bowel Sounds Constipation Fecal Impaction
Nursing Principles & Skills II Bowel Sounds Constipation Fecal Impaction Bowel Sounds Definitionthe noise or sounds made by the peristaltic waves of the intestinal muscle contracting and relaxing Bowel
More informationMulti modality Imaging in Acute Pancreatitis. Marsha Lynch, HMS III Gillian Lieberman, MD BIDMC Core Clerkship in Radiology March 2009
Multi modality Imaging in Acute Pancreatitis Marsha Lynch, HMS III Gillian Lieberman, MD BIDMC Core Clerkship in Radiology March 2009 Our Patient R: Introduction 52M with 10d history of nausea, vomiting
More informationSmall Bowel Intussusception in an Adult due to Lipoma: a Rare Cause of Obstruction. Case report and Literature Review
ISPUB.COM The Internet Journal of Surgery Volume 25 Number 1 Small Bowel Intussusception in an Adult due to Lipoma: a Rare Cause of Obstruction. Case report and Literature Review Yashpal, M Bansal, A Kudva
More informationPatient Information. Age: 8 y/o Sex: Female. Date of Admission: Date of Discharge:
Patient Information Age: 8 y/o Sex: Female Date of Admission: 92-10-08 Date of Discharge: 92-10-18 Chief Complaint Severe admominal pain and vomiting with dysuria since last afternoon Present Illness Lower
More informationCase Internal herniation with bowel ischemia after Roux-en-Y gastric bypass surgery.
Case 14127 Internal herniation with bowel ischemia after Roux-en-Y gastric bypass surgery. Peters B 1, 2, Waked K 3, Vanhoenacker FM 1, 2, 4, Ceulemans J 5, Mespreuve M 2, 4 University Hospital Antwerp,
More informationPROFESSIONAL SKILLS 1 3RD YEAR SEMESTER 6 RADIOGRAPHY. THE URINARY SYSTEM Uz. Fatema shmus aldeen Tel
PROFESSIONAL SKILLS 1 3RD YEAR SEMESTER 6 RADIOGRAPHY THE URINARY SYSTEM Uz. Fatema shmus aldeen Tel. 0925111552 Professional skills-2 THE URINARY SYSTEM The urinary system (review anatomy and physiology)
More informationRelationship Between Small Bowel Obstruction and Small Bowel Feces Sign: Four Cases Report
Case Report Elmer Press Relationship Between Small Bowel Obstruction and Small Bowel Feces Sign: Four Cases Report Altintoprak Fatih a, e, Gunduz Yasemin b, Yalkin Omer c, Gundugdu Kemal c, Serbulent Gokhan
More informationThe nontraumatic acute abdomen
CT features of acute appendicitis: pictorial review Marco ntonio Cura, MD The nontraumatic acute abdomen is one of the most common presentations to the emergency room, with appendicitis being one of the
More informationAdv Pathophysiology Unit 9: GI Page 1 of 10
Adv Pathophysiology Unit 9: GI Page 1 of 10 Learning objectives for this file: 1. Recognize positive physical and lab findings that point to the diagnosis 2. Appreciate the appearance of the affected organ
More informationAn Approach to Abdominal Pain
An Approach to Abdominal Pain objectives Should know the different types of abd pain Is acute or chronic? Hx taking skills with knowing the key questions Important abdominal pain signs A good differential
More informationAbdominal 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 informationPattern based approach for differential diagnosis of small bowel neoplasms using MDCT
Pattern based approach for differential diagnosis of small bowel neoplasms using MDCT Poster No.: C-1400 Congress: ECR 2014 Type: Educational Exhibit Authors: P. Bhari Thippeswamy, C. Anuradha, A. Polimood,
More informationChealon Miller, HMS IV Gillian Lieberman, MD. November Stress Fractures. Chealon Miller, Harvard Medical School Year IV Gillian Lieberman, MD
November 2005 Stress Fractures Chealon Miller, Harvard Medical School Year IV Our Patient G.F. 29 year old female runner c/o left shin pain and swelling Evaluated at OSH with MRI showing a mass Referred
More information12 Blueprints Q&A Step 2 Surgery
12 Blueprints Q&A Step 2 Surgery 34. A 40-year-old female has been referred to you for a recent ER and hospital admission, from which she was given a diagnosis of acute diverticulitis. Treatment at that
More informationAlison Douglass Gillian Lieberman, MD. November. Colon Cancer. Alison Douglass, Harvard Medical School Year III Gillian Lieberman, MD
November Colon Cancer Alison Douglass, Harvard Medical School Year III Our Patient Mr. K. is a 67 year old man with no prior medical problems other than hemorrhoids which have caused occasional rectal
More informationA 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 informationPelvic Pain. What you need to know. 139 Dumaresq Street Campbelltown Phone Fax
Pelvic Pain What you need to know 139 Dumaresq Street Campbelltown Phone 4628 5292 Fax 4628 0349 www.nureva.com.au September 2015 PELVIC PAIN This is a common problem and most women experience some form
More informationRad Lab 4 Unknowns: Genitourinary!
Rad Lab 4 Unknowns: Genitourinary! Peter Clarke MD! Don Di Salvo, MD! Clerkship Directors for Radiology! Harvard Medical School! Brigham and Women s Hospital! Dana Farber Cancer Institute! Case 1: 69 year
More informationCT Findings of Sigmoid Volvulus
Gastrointestinal Imaging Original Research Levsky et al. CT of Sigmoid Volvulus Gastrointestinal Imaging Original Research Jeffrey M. Levsky 1 Elana I. Den Ronelle A. DuBrow Ellen L. Wolf Alla M. Rozenblit
More informationComplicated Meckel`s diverticulum; to be considered as a differential diagnosis in the acute abdominal pain. Ultrasound and MDCT imaging finding
Complicated Meckel`s diverticulum; to be considered as a differential diagnosis in the acute abdominal pain. Ultrasound and MDCT imaging finding Poster No.: C-0174 Congress: ECR 2013 Type: Educational
More informationBackground. RUQ Ultrasound Normal, Recommend Clinical Correlation. Sohail R. Shah, MD, MSHA, FACS, FAAP Texas Children s Hosptial
RUQ Ultrasound Normal, Recommend Clinical Correlation Sohail R. Shah, MD, MSHA, FACS, FAAP Texas Children s Hosptial Background Incidence of pediatric gallbladder disease continues to rise U.S. Pediatric
More informationIntestinal obstruction key. What should we look for?
Intestinal obstruction key. What should we look for? Poster No.: C-1689 Congress: ECR 2013 Type: Educational Exhibit Authors: R. Carreño-Gonzalez, L. Renza, E. Navarro-Sanchis, M. D. 1 2 3 1 4 1 2 SÁNCHEZ
More informationWhich Blunt Trauma Patients Should Be Studied by Abdominal CT?
MDCT of Bowel and Mesenteric Injury: How Findings Influence Management 4 th Nordic Trauma Radiology Course 2006 4 th Nordic Trauma Radiology Course 2006 Stuart E. Mirvis, M.D., FACR Department of Radiology
More informationEvolving Gallstone Ileus. SUNY Downstate Case Conference January 12, 2012
Evolving Gallstone Ileus SUNY Downstate Case Conference January 12, 2012 Initial Presentation HPI: 90 yo F c 1wk h/o abdominal pain and N/V. Denied F/C. Passing flatus/bm. PMH: DM, HTN, CAD. PSH: C-sections
More informationCase 1307 Mesothelial cysts
Case 1307 Mesothelial cysts Vinhais S, Monteiro M, Cunha TM INSTITUTO PORTUGUÊS DE ONCOLOGIA de Francisco Gentil de LISBOA Section: Gastro-Intestinal Imaging Published: 2001, Nov. 23 Patient: 44 year(s),
More informationQuestion 1 History. Likely Diagnosis Differential. Further Investigation or Management. Requires Paediatric Surgical referral for laparotomy
Question 1 Male newborn spilling green tinged vomit day 1 of life Imaging Abdominal X-Rays performed on 03/05/2012 Upper and lower gastrointestinal contrast studies performed on 03/05/2012 Abdominal X-Rays
More informationADENOMYOSIS CHRONIC PELVIC PAIN IN WOMEN IMAGING CHRONIC PELVIC PAIN IN WOMEN CHRONIC PELVIC PAIN IN WOMEN ADENOMYOSIS: PATHOLOGY ADENOMYOSIS
CHRONIC PELVIC PAIN IN WOMEN IMAGING CHRONIC PELVIC PAIN IN WOMEN MOSTAFA ATRI, MD Dipl. Epid. UNIVERSITY OF TORONTO Non-menstrual pain of 6 months Prevalence 15%: 18-50 years of age 10-40% of gynecology
More informationCase Report Müllerian Remnant Cyst as a Cause of Acute Abdomen in a Female Patient with Müllerian Agenesis: Radiologic and Pathologic Findings
Volume 2016, Article ID 6581387, 4 pages http://dx.doi.org/10.1155/2016/6581387 Case Report üllerian Remnant Cyst as a Cause of Acute Abdomen in a Female Patient with üllerian Agenesis: Radiologic and
More informationAcute Abdomen in Pediatric Patients Admitted to the Pediatric Emergency Department
Pediatr Neonatol 2008;49(4):126 134 ORIGINAL ARTICLE Acute Abdomen in Pediatric Patients Admitted to the Pediatric Emergency Department Yu-Ching Tseng 1,2, Ming-Sheng Lee 2, Yu-Jun Chang 3, Han-Ping Wu
More informationPosterior Rectus Sheath Hernia Causing Intermittent Small Bowel Obstruction
Posterior Rectus Sheath Hernia Causing Intermittent Small Bowel Obstruction Scott Lenobel 1*, Robert Lenobel 2, Joseph Yu 1 1. Department of Radiology, The Ohio State University Wexner Medical Center,
More information