Ultrasound of: Appendicitis Intussusception Pyloric Stenosis

Size: px
Start display at page:

Download "Ultrasound of: Appendicitis Intussusception Pyloric Stenosis"

Transcription

1 Ultrasound of: Appendicitis Intussusception Pyloric Stenosis Andrew Phelps MD Assistant Professor Pediatric Radiology UCSF Benioff Children s Hospital

2 No Disclosures

3 Take Home Message Appendicitis occurs at any age. Intussusception and Pyloric Stenosis have specific age ranges.

4 Outline 1) Appendicitis 2) Intussusception 3) Pyloric Stenosis

5 Outline 1) Appendicitis 2) Intussusception 3) Pyloric Stenosis

6 Appendicitis Age Range Any!

7 Scanning Technique

8 10 minutes to find Appendix

9 Start anterior to the iliac vessels. Most often this is where you will find the appendix.

10 Look from All Directions

11 Normal Appendix

12 Normal Appendix mobile tubular blind-ending no peristalsis < 6 mm diameter

13 Normal Appendix Donut Train Tracks Stool Free Fluid

14 Appendix Fakeouts

15 Ileum Mimicking Appendix Look for bumpy folds.

16 Ureter Mimicking Appendix Sagittal Transverse

17 Ovarian Vein Mimicking Appendix

18 Appendicitis

19 Appendicitis 11 mm, focally tender

20 Appendicitis Color flow sometimes helpful.

21 Appendicitis Look for inflamed echogenic fat.

22 Outline 1) Appendicitis 2) Intussusception 3) Pyloric Stenosis

23 Intussusception Age Range 4 months 4 years > 4 years: Worry about tumor.

24 Intussusception Technique

25 5 minutes to find intussusception Start in RLQ. Scan all 4 quadrants.

26 Normal Bowel

27 Normal Spine

28 Normal Psoas Muscles

29 Normal Small Bowel Marbelized mucosa

30 Normal Terminal Ileum AIR/ STOOL

31 Normal Ileocecal Valve resembles pylorus

32 Normal Ascending Colon Speckles from stool/gas.

33 Intussusception

34 2 year old with colicky pain.

35 Intussusception

36 7 year old, VPS, emesis.

37 Intussusception in 7 year old from lymphoma!

38 Small Bowel Small Bowel Intuss. Presumed clinically insignificant.

39 2yo abdominal pain. Central Abd

40 Inverted Meckel s Small Bowel Intussusception Small Bowel Obstruction

41 Intussusception Fakeouts

42 Normal Ileocecal Valve IC valve normally herniates slightly into cecum

43 Inflamed Ileocecal Valve Sagittal Transverse A real intussusception wouldn t be this short.

44 Ileum Edema after Intussusception Reduction

45 Colitis Mimicking Intussusception No Compression With Compression

46 Outline 1) Appendicitis 2) Intussusception 3) Pyloric Stenosis

47 Pylorus Stenosis Age Range 3 weeks 6 months

48 Pylorus Scanning Technique

49 Use liver as window to pylorus. Place patient right-side down if need to get gas out of the way.

50 Normal Pylorus

51 Normal Pylorus Muscular layer is hypoechoic. Py St Du

52 Normal Pylorus Gas in duodenal bulb confirms correct location. Du Py

53 Pyloric Stenosis

54 Pyloric Stenosis Pyloric Stenosis Normal Pylorus 4 mm thickness, 16 mm length 3 weeks 6 months

55 Pyloric Stenosis Longitudinal Transverse

56 Pyloric Stenosis Fakeouts

57 Incorrect Measurements

58 Incorrect Measurements 7 x 15 mm 3 mm

59 Correct Measurements 7 x 15 mm 3 mm

60 To exclude pylorospasm, wait for emptying.

61 Outline 1) Appendicitis 2) Intussusception 3) Pyloric Stenosis

62 Take Home Message Appendicitis: any age Intussusception: 4 mo 4 years Pyloric Stenosis: 3 wk 6 mo

63 Questions

64 Question 1 What is the appendix diameter cutoff for appendicitis? a. >5 mm b. >6 mm c. >7 mm d. >8 mm

65 Question 1 What is the appendix diameter cutoff for appendicitis? a. >5 mm b. >6 mm c. >7 mm d. >8 mm Ref: Trout AT, Sanchez R, Ladino-Torres MF, Pai DR, Strouse PJ. A critical evaluation of US for the diagnosis of pediatric acute appendicitis in a real-life setting: how can we improve the diagnostic value of sonography? Pediatr Radiol Jul;42(7):813-23

66 Question 2 What do you need to worry about in a 10 year old with intussusception? a. abuse b. infection c. inflammatory bowel disease d. tumor

67 Question 2 What do you need to worry about in a 10 year old with intussusception? a. abuse b. infection c. inflammatory bowel disease d. tumor Ref: Zhang Y, Dong Q, Li SX, Ren WD, Shi B, Bai YZ, Zhang SC, Zheng LQ. Clinical and Ultrasonographic Features of Secondary Intussusception in Children. Eur Radiol Apr 5

68 Thank you!

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

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

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

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

SIMPLE GUIDE FOR SONOLOGICAL EVALUATION OF APPENDICITIS

SIMPLE GUIDE FOR SONOLOGICAL EVALUATION OF APPENDICITIS SIMPLE GUIDE FOR SONOLOGICAL EVALUATION OF APPENDICITIS A Case Study by Dr. Avni K P Skandhan, India (Consultant Radio Diagnosis, Malabar Institute of Medical Science, Malappuram, Kerala) Email: avniskandhan@gmail.com

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

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

Emergent 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 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 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

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

Imaging Children with Acute Abdominal Pain -- Role/Protocols of US, CT, MR

Imaging Children with Acute Abdominal Pain -- Role/Protocols of US, CT, MR Imaging Children with Acute Abdominal Pain -- Role/Protocols of US, CT, MR Kimberly E. Applegate, MD, MS Emory University Financial disclosures: AIM (American Imaging Management) radiation protection advisory

More information

Infantile Hypertrophic Pyloric Stenosis

Infantile Hypertrophic Pyloric Stenosis A Sonographic walk-through: Infantile Hypertrophic Pyloric Stenosis Tara K. Cielma, RDMS, RDCS, RVT, RT(S) Anjum N. Bandarkar, MD, Adebunmi O. Adeyiga, MD, Diagnostic Imaging and Radiology, Children s

More information

A Perf-ect Differential

A 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 information

The Gastrointestinal Tract

The Gastrointestinal Tract CHAPTER 10 The Gastrointestinal Tract INTRODUCTION Although sonography may not always be the modality of choice for the detection of all gastrointestinal abnormalities, it does provide a noninvasive, nonionizing

More information

The Digestive System and Body Metabolism

The Digestive System and Body Metabolism 14 PART B The Digestive System and Body Metabolism PowerPoint Lecture Slide Presentation by Jerry L. Cook, Sam Houston University ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY EIGHTH EDITION ELAINE N. MARIEB

More information

THE ORAL CAVITY

THE ORAL CAVITY THE ORAL CAVITY WALL OF ABDOMEN (ANTERIOR) The paraumbilical vein drains into the portal vein and then through the liver. This is an important clinical connection. THE ABDOMINAL VISCERA The small

More information

Washington State Hospital Association Safe Table Webcast 100K Children Campaign Safe Imaging September 15, 2014

Washington State Hospital Association Safe Table Webcast 100K Children Campaign Safe Imaging September 15, 2014 Washington State Hospital Association Safe Table Webcast 100K Children Campaign Safe Imaging September 15, 2014 1 Presenters Becky DeMers, RN Director, Quality and Performance Improvement Washington State

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

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

Abdominal Assessment

Abdominal 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 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

- Digestion occurs during periods of low activity - Produces more energy than it uses. - Mucosa

- Digestion occurs during periods of low activity - Produces more energy than it uses. - Mucosa Introduction Digestive System Chapter 29 Provides processes to break down molecules into a state easily used by cells - A disassembly line: Starts at the mouth and ends at the anus Digestive functions

More information

Sonographycally guided hydrostatic reduction of childhood intussusception

Sonographycally guided hydrostatic reduction of childhood intussusception Sonographycally guided hydrostatic reduction of childhood intussusception Dubravka Vidmar, Alenka Višnar Perovič Clinical Radiology Institute, University Clinical Centre Ljubljana, Slovenia Background.

More information

The jejunum and the Ileum. Prof. Oluwadiya KS

The jejunum and the Ileum. Prof. Oluwadiya KS The jejunum and the Ileum Prof. Oluwadiya KS www.oluwadiya.siteled.com Introduction Introduction The small intestine (SI) comprises of the duodenum, jejunum and the ileum The jejunum is the second part

More information

Digestive System. In one end and out the other.

Digestive System. In one end and out the other. Digestive System In one end and out the other. Overview Every cell in the body needs nourishment, yet most cells cannot leave their position in the body and travel to a food source, so the food must be

More information

Adult Intussusception: A Complication of Metastatic Melanoma or Primary Malignancy?

Adult 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 information

- Digestion occurs during periods of low activity - Produces more energy than it uses. 3 Copyright 2016 by Elsevier Inc. All rights reserved.

- Digestion occurs during periods of low activity - Produces more energy than it uses. 3 Copyright 2016 by Elsevier Inc. All rights reserved. Introduction Digestive System Chapter 29 Provides processes to break down molecules into a state easily used by cells - A disassembly line: Starts at the mouth and ends at the anus Digestive functions

More information

Pediatric Abdominal Masses. Andrew Phelps MD Assistant Professor of Pediatric Radiology UCSF Benioff Children's Hospital

Pediatric Abdominal Masses. Andrew Phelps MD Assistant Professor of Pediatric Radiology UCSF Benioff Children's Hospital Pediatric Abdominal Masses Andrew Phelps MD Assistant Professor of Pediatric Radiology UCSF Benioff Children's Hospital No Disclosures Take Home Message All you need to remember are the 5 common masses

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

Anatomy of the Large Intestine

Anatomy of the Large Intestine Large intestine Anatomy of the Large Intestine 2 Large Intestine Extends from ileocecal valve to anus Length = 1.5-2.5m = 5 feet Regions Cecum = 2.5-3 inch Appendix= 3-5 inch Colon Ascending= 5 inch Transverse=

More information

TOP 10 LIST OF INCIDENTAL GI PET PEEVES ON MDCT

TOP 10 LIST OF INCIDENTAL GI PET PEEVES ON MDCT TOP 10 LIST OF INCIDENTAL GI PET PEEVES ON MDCT Richard M. Gore, MD North Shore University Medical Center University of Chicago Evanston, Illinois SCBT/MR 2011 Washington, DC October 23, 2011 4:30-4:40

More information

Emergency MDCT in case of right lower quadrant pain

Emergency 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 information

Topics for discussion. Pediatric General Surgery. Physiology. Surgical Newborns. Neonatal Intestinal Obstruction

Topics for discussion. Pediatric General Surgery. Physiology. Surgical Newborns. Neonatal Intestinal Obstruction Topics for discussion Pediatric General Surgery Professor General & Thoracic Surgery What makes Pediatric Surgery unique? Neonatal intestinal obstruction Abdominal wall defects Inguinal hernias Appendicitis

More information

L o o k L i s t e n F e e l S c a n. Your Pocus Cards For Your Every Day Scanning.

L o o k L i s t e n F e e l S c a n. Your Pocus Cards For Your Every Day Scanning. L o o k L i s t e n F e e l S c a n Your Pocus Cards For Your Every Day Scanning E-FAST Extended Focused Assessment by Sonography in Trauma Subcostal Heart View Pleural Sliding on M-mode (Sea-shore sign)

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

ANATOMY OF THE SMALL & LARGE INTESTINES. Semester 1, 2011 A. Mwakikunga

ANATOMY OF THE SMALL & LARGE INTESTINES. Semester 1, 2011 A. Mwakikunga ANATOMY OF THE SMALL & LARGE INTESTINES Semester 1, 2011 A. Mwakikunga LEARNING OBJECTIVES 1. List the parts and anatomical regions of the small and large intestines 2. State anatomical relations of the

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

Role of Ultrasound in Acute Non Traumatic Abdominal Emergencies

Role of Ultrasound in Acute Non Traumatic Abdominal Emergencies ORIGINALARTICLE Role of Ultrasound in Acute Non Traumatic Abdominal Emergencies Kamlesh Gupta, Ramesh Chander, Arvinder Singh, Sohan Singh, Sandeep Singh Abstract The current study was undertaken to access

More information

Complicated 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 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 information

In children 3 months to 3 years of age intussusception is

In children 3 months to 3 years of age intussusception is Baird Mallory, MD, 1 and Yale Popowich, MD 2 In children 3 months to 3 years of age intussusception is one of the most common causes of a distal small bowel obstruction. It is often associated with intermittent

More information

Good morning! July 24, 2014

Good morning! July 24, 2014 Good morning! July 24, 2014 Prep #1 A 2-year-old boy presents to your office with a 2-day history of swelling of the right eye. He has been otherwise well. There are scattered insect bites on his body,

More information

CT Evaluation of Bowel Wall Thickening. Dr: Adel El Badrawy; M.D. Lecturer of Radio Diagnosis Faculty of Medicine Mansoura University.

CT Evaluation of Bowel Wall Thickening. Dr: Adel El Badrawy; M.D. Lecturer of Radio Diagnosis Faculty of Medicine Mansoura University. CT Evaluation of Bowel Wall Thickening By Dr: Adel El Badrawy; M.D. Lecturer of Radio Diagnosis Faculty of Medicine Mansoura University. The CT findings of bowel wall thickening includes 1 Degree of thickening.

More information

Duodenum retroperitoneal

Duodenum retroperitoneal Duodenum retroperitoneal C shaped Initial region out of stomach into small intestine RETROperitoneal viscus Superior 1 st part duodenal cap ; moves upwards and backwards to lie on the R crura medial to

More information

Anatomy of the SMALL INTESTINE. Dr. Noman Ullah Wazir PMC

Anatomy of the SMALL INTESTINE. Dr. Noman Ullah Wazir PMC Anatomy of the SMALL INTESTINE Dr. Noman Ullah Wazir PMC SMALL INTESTINE The small intestine, consists of the duodenum, jejunum, and illium. It extends from the pylorus to the ileocecal junction were the

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

Pediatric Bowel Obstruction

Pediatric Bowel Obstruction Pediatric Bowel Obstruction Matt Zerden, Harvard Medical School III Patient 1 16 year old presents with severe, episodic abdominal pain, nausea and vomiting. Questionable abdominal mass in RLQ Previous

More information

Radiology of GI system diseases

Radiology of GI system diseases GI Cycle - Lecture 12 436 Teams Radiology of GI system diseases Objectives 1. 2. 3. To know common GIT Pathologies presentation. To understand step wise approach in requesting GIT Radiology Investigations.

More information

Emergent Pediatric US: What Every Radiologist Should Know 1

Emergent Pediatric US: What Every Radiologist Should Know 1 Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. PEDIATRIC IMAGING

More information

Uncommon conditions in surgical oncology: acute abdomen caused by ileocolic intussusception

Uncommon conditions in surgical oncology: acute abdomen caused by ileocolic intussusception Case Report Uncommon conditions in surgical oncology: acute abdomen caused by ileocolic intussusception Karl Mrak Department of Surgery, Brothers of Mercy Hospital, St. Veit, Glan, Austria Correspondence

More information

Diagnostic Imaging of Pediatric Gastrointestinal Abnormalities. Learning Objectives

Diagnostic Imaging of Pediatric Gastrointestinal Abnormalities. Learning Objectives Diagnostic Imaging of Pediatric Gastrointestinal Abnormalities Tess Chapman, MD Associate Professor of Radiology, University of Washington School of Medicine Staff Radiologist, Seattle Children s Hospital

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

Document Title: Non-Traumatic Abdominal Pain/Abdominal Emergencies. Author(s): Joseph House (University of Michigan), MD 2012

Document Title: Non-Traumatic Abdominal Pain/Abdominal Emergencies. Author(s): Joseph House (University of Michigan), MD 2012 Project: Ghana Emergency Medicine Collaborative Document Title: Non-Traumatic Abdominal Pain/Abdominal Emergencies Author(s): Joseph House (University of Michigan), MD 2012 License: Unless otherwise noted,

More information

Dr. Zahiri. In the name of God

Dr. Zahiri. In the name of God Dr. Zahiri In the name of God small intestine = small bowel is the part of the gastrointestinal tract Boundaries: Pylorus Ileosecal junction Function: digestion and absorption of food It receives bile

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

Pediatric Surgical Emergencies Veronica Victorian, PA-C

Pediatric Surgical Emergencies Veronica Victorian, PA-C Pediatric Surgical Emergencies Veronica Victorian, PA-C Texas Children s Hospital Division of Pediatric General Surgery Assistant Professor, Baylor College of Medicine Objectives 1. Define Pediatric Surgical

More information

The Digestive System

The Digestive System The Digestive System Identify the Structure and Function. Mesentery of the Large Intestine The mesentery functions to connect the visceral organs to the abdominal wall. Identify the Structure. Nasal Cavity

More information

The nontraumatic acute abdomen

The 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 information

PEDIATRIC GI EMERGENCIES. AGE-RELATED DIAGNOSIS Early Infancy EXAMINATION TIPS PEDIATRIC ABDOMINAL PAIN. How Common Is It?

PEDIATRIC GI EMERGENCIES. AGE-RELATED DIAGNOSIS Early Infancy EXAMINATION TIPS PEDIATRIC ABDOMINAL PAIN. How Common Is It? PEDIATRIC ABDOMINAL PAIN How Common Is It? PEDIATRIC GI EMERGENCIES Ghazala Q. Sharieff, MD 5% of unscheduled visits 2% of patients are admitted 1% need operative intervention EXAMINATION TIPS Palpate

More information

BELLWORK DEFINE: PERISTALSIS CHYME RUGAE Remember the structures of the digestive system 1

BELLWORK DEFINE: PERISTALSIS CHYME RUGAE Remember the structures of the digestive system 1 BELLWORK DEFINE: PERISTALSIS CHYME RUGAE 2.07 Remember the structures of the digestive system 1 STANDARD 8) Outline basic concepts of normal structure and function of all body systems, and explain how

More information

GI POTPOURRI. What is the best diagnostic test? Presentation #1: Vomiting. I have no disclosures

GI POTPOURRI. What is the best diagnostic test? Presentation #1: Vomiting. I have no disclosures I have no disclosures GI POTPOURRI Andi Marmor, MD Associate Professor, Pediatrics UCSF, San Francisco General Hospital Presentation #1: Vomiting Caraway, a 3 week old boy, is brought to your walk-in clinic

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

JMSCR Vol 3 Issue 11 Page November 2015

JMSCR Vol 3 Issue 11 Page November 2015 www.jmscr.igmpublication.org Impact Factor 3.79 Index Copernicus Value: 5.88 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: http://dx.doi.org/10.18535/jmscr/v3i11.52 Ultrasonographic Evaluation of Acute Abdomen

More information

Gastrointestinal Emergencies CEN REVIEW 2017 MARY RALEY, BSN, RN, CEN, TCRN, TNSCC

Gastrointestinal Emergencies CEN REVIEW 2017 MARY RALEY, BSN, RN, CEN, TCRN, TNSCC Gastrointestinal Emergencies CEN REVIEW 2017 MARY RALEY, BSN, RN, CEN, TCRN, TNSCC Gastrointestinal Emergencies is 7% of the CEN A. Acute abdomen B. Bleeding C. Cholecystitis D. Cirrhosis E. Diverticulitis

More information

Contrast-enhanced small bowel ultrasound in the assessment of the small bowel in patients with Crohn s Disease

Contrast-enhanced small bowel ultrasound in the assessment of the small bowel in patients with Crohn s Disease Contrast-enhanced small bowel ultrasound in the assessment of the small bowel in patients with Crohn s Disease C.F. Healy 1, D. Ferguson 1, S. Jepson 1, B. Salh 2, F. Donnellan 2, N. Chatur 2, A. C. Harris

More information

Pelvic Pain in the Pediatric Patient Susan D. John, M.D.

Pelvic Pain in the Pediatric Patient Susan D. John, M.D. Pelvic Pain in the Pediatric Patient Susan D. John, M.D. RSNA 2012 Patients First Objectives After attending this presentation, participants will be able to: Understand the common congenital and acquired

More information

Amyand's Hernia: A Case Report

Amyand's Hernia: A Case Report Haris N. Shekhani 1*, Saurabh Rohatgi 1, Tarek Hanna 1, Jamlik-Omari Johnson 1 1. Division of Emergency Radiology, Emory University, Atlanta, GA 30308, USA * Correspondence: Haris Naseem Shekhani, Emory

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

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

Abdominal Exam. Winter Quarter Adapted from previous years by Amanda Kocoloski, OMS IV

Abdominal Exam. Winter Quarter Adapted from previous years by Amanda Kocoloski, OMS IV Abdominal Exam Winter Quarter 2010 Adapted from previous years by Amanda Kocoloski, OMS IV Agenda ó History ó Anatomy ó Physical ó Prac4ce cases ó 2 gastrointes4nal complaints ó Work on incorpora4ng GI

More information

GASTROINTESTINAL SYSTEM

GASTROINTESTINAL SYSTEM GASTROINTESTINAL SYSTEM Topographic Anatomy of the Abdomen Surface Landmarks Xiphoid process T9/T10 Inferior costal margin L2/L3 Iliac Crest L4 level ASIS L5/S1 level Pubic symphysis level of greater trochanter

More information

The Digestive System. Chapter

The Digestive System. Chapter The Digestive System Chapter 15.1 Functions: mechanical and chemical breakdown of food *absorption of nutrients Consists of alimentary canal and accessory organs Wall of the Alimentary Canal 15.2 Characteristics

More information

Abdominal Ultrasonography

Abdominal Ultrasonography Abdominal Ultrasonography David A. Masneri, DO, FACEP, FAAEM Assistant Professor of Emergency Medicine Assistant Director, Emergency Medicine Residency Medical Director, Operational Medicine Division Center

More information

Necrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability

Necrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability Necrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability Ricardo Faingold, MD. Department of Medical Imaging The Montreal Children s Hospital McGill University SPR Vancouver

More information

Khanal BR, Ansari MA, Pradhan S Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.

Khanal BR, Ansari MA, Pradhan S Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal. Kathmandu University Medical Journal (2008), Vol. 6, No. 1, Issue 21, 70-74 Original Article Accuracy of ultrasonography in the diagnosis of acute appendicitis Khanal BR, Ansari MA, Pradhan S Department

More information

UNDERSTANDING X-RAYS: ABDOMINAL IMAGING THE ABDOMEN

UNDERSTANDING 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 information

ד"ר דוד ירדני המכון לגסטרואנטרולוגיה ומחלות כבד מרכז רפואי סורוקה

דר דוד ירדני המכון לגסטרואנטרולוגיה ומחלות כבד מרכז רפואי סורוקה ד"ר דוד ירדני המכון לגסטרואנטרולוגיה ומחלות כבד מרכז רפואי סורוקה Presentaion: S.A is 38 years old. Referred for rectal bleeding investigation. Describes several occasions of bleeding and abdominal pain.

More information

Appendicitis USG vs CT

Appendicitis USG vs CT Appendicitis USG vs CT Dr Sateesh Kumar Kailasam MBBS Dip EM (RCGP, UK) MRCEM (UK) Group Head Maxcure Group of Hospitals National Treasurer Society for Emergency Medicine India (SEMI) My Talk includes

More information

Two main groups Alimentary canal continuous coiled hollow tube Accessory digestive organs

Two main groups Alimentary canal continuous coiled hollow tube Accessory digestive organs Digestion Breakdown of ingested food Absorption of nutrients into the blood Metabolism Production of cellular energy (ATP) Constructive and degradative cellular activities Two main groups Alimentary canal

More information

Pictorial review of bowel ultrasound: Common and unsuspected pathologies

Pictorial review of bowel ultrasound: Common and unsuspected pathologies Pictorial review of bowel ultrasound: Common and unsuspected pathologies Poster No.: C-1668 Congress: ECR 2013 Type: Educational Exhibit Authors: A. Law, A. Ali, G. Hutchison; Bolton/UK Keywords: Ultrasound-Colour

More information

Meckel s Diverticulum

Meckel s Diverticulum January 2007 Meckel s Diverticulum Alex Herrera, Harvard Medical School Year III Meckel s Embryology Patent Duct Remnant of omphalomesenteric (vitelline) duct Complete obliteration normally occurs between

More information

The Physician as Medical Illustrator

The Physician as Medical Illustrator The Physician as Medical Illustrator Francois Luks Arlet Kurkchubasche Division of Pediatric Surgery Wednesday, December 9, 2015 Week 5 A good picture is worth a 1,000 bad ones How to illustrate an operation

More information

PEDIATRIC EMERGENCY DEPARTMENT CLINICAL GUIDELINE: GI SURGICAL EMERGENCIES: VOMITING

PEDIATRIC EMERGENCY DEPARTMENT CLINICAL GUIDELINE: GI SURGICAL EMERGENCIES: VOMITING GI SURGICAL EMERGENCIES: VOMITING PYLORIC STENOSIS Population: Infants: onset between 2-5 weeks of age 1 in 250 births Male: female ratio 4:1 Familial incidence History: No vomiting in the first few weeks

More information

Pelvic Pain? Cause Beyond the Ovary

Pelvic Pain? Cause Beyond the Ovary Pelvic Pain? Cause Beyond the Ovary Catherine Kirkpatrick Consultant Sonographer United Lincolnshire Hospitals Trust Aims Consider not all pelvic pain is ovary or uterus related Explore some non gynae

More information

Christopher Lau Kings County Hospital SUNY Downstate Medical Center February 24, 2011

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 information

US diagnosis of acute appendicitis

US diagnosis of acute appendicitis US diagnosis of acute appendicitis Poster No.: C-1496 Congress: ECR 2010 Type: Scientific Exhibit Topic: GI Tract Authors: A. Gligorievski; Skopje/MK Keywords: Ultrasound, Acute appendicitis, Diagnosis

More information

THE INS AND OUTS OF HERNIAS WHERE TO START? WHAT IS A HERNIA? CLINICAL INDICATIONS THE INGUINAL CANAL THE CLINICAL QUESTION 18/09/2018

THE INS AND OUTS OF HERNIAS WHERE TO START? WHAT IS A HERNIA? CLINICAL INDICATIONS THE INGUINAL CANAL THE CLINICAL QUESTION 18/09/2018 THE INS AND OUTS OF HERNIAS Cassandra Harrison BA/BSc, MMRU, AMS WHERE TO START? The Clinical Question Essential anatomy Inguinal hernia Scanning technique Variations WHAT IS A HERNIA? CLINICAL INDICATIONS

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

Evaluation of the of the sensitivity, accuracy and positive predictive value of ultrasonography in the diagnosis of Appendicitis.

Evaluation of the of the sensitivity, accuracy and positive predictive value of ultrasonography in the diagnosis of Appendicitis. West African Journal of Ultrasound Vol 17 Number 2 (2016) Evaluation of the of the sensitivity, accuracy and positive predictive value of ultrasonography in the diagnosis of Appendicitis. 1 2 3 Oguntola

More information

Always keep it in the differential

Always 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 information

Objectives. Hepatobiliary Ultrasound: Anatomy, Technique, Pathology. RUQ: Normal Anatomy. Emergency Ultrasound: Gallbladder Location

Objectives. Hepatobiliary Ultrasound: Anatomy, Technique, Pathology. RUQ: Normal Anatomy. Emergency Ultrasound: Gallbladder Location Hepatobiliary Ultrasound: Anatomy, Technique, Pathology Laleh Gharahbaghian, MD FAAEM Associate Director, EM Ultrasound Co-Director, EM Ultrasound Fellowship Stanford University Medical Center Seric Cusick,

More information

LECTURE 11 & 12: ABDOMINAL VISCERA ABDOMINAL CONTENTS DIVISION. The location of abdominal viscera is divided into 4 quadrants:

LECTURE 11 & 12: ABDOMINAL VISCERA ABDOMINAL CONTENTS DIVISION. The location of abdominal viscera is divided into 4 quadrants: LECTURE 11 & 12: ABDOMINAL VISCERA ABDOMINAL CONTENTS DIVISION The location of abdominal viscera is divided into 4 quadrants: - horizontal line across the umbilicus divides the upper quadrants from the

More information

Fibrosing colonopathy is a newly described complication. Sonographic Evaluation of Bowel Wall Thickness in Patients With Cystic Fibrosis

Fibrosing colonopathy is a newly described complication. Sonographic Evaluation of Bowel Wall Thickness in Patients With Cystic Fibrosis J Clin Gastroenterol 2003;37(1):55 60. 2003 Lippincott Williams & Wilkins, Inc. Sonographic Evaluation of Bowel Wall Thickness in Patients With Cystic Fibrosis Irmela Dialer, MD, Cornelia Hundt, MD, Rose-Marie

More information

Accepted Article. Granulomatous appendicitis as an uncommon cause of abdominal pain. Description of a case

Accepted Article. Granulomatous appendicitis as an uncommon cause of abdominal pain. Description of a case Accepted Article Granulomatous appendicitis as an uncommon cause of abdominal pain. Description of a case Carmen Salvia López Ramos, Ana Fuentes Coronel, Santiago Rodríguez Gómez DOI: 10.17235/reed.2015.3763/2015

More information

Adult Intussception : A Case Report

Adult Intussception : A Case Report Article ID: ISSN 2046-1690 Adult Intussception : A Case Report Author(s):Dr. C Surendranath Singh, Prof. M.l. Prakash Corresponding Author: Dr. C Surendranath Singh, Senior Lecturer, Unit of Radiodiagnosis,

More information

ADENOMYOSIS CHRONIC PELVIC PAIN IN WOMEN IMAGING CHRONIC PELVIC PAIN IN WOMEN CHRONIC PELVIC PAIN IN WOMEN ADENOMYOSIS: PATHOLOGY ADENOMYOSIS

ADENOMYOSIS 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 information

Sonography-guided Gastrografin Enema for Meconium Plug Syndrome in Premature Newborns: Preliminary Results 1

Sonography-guided Gastrografin Enema for Meconium Plug Syndrome in Premature Newborns: Preliminary Results 1 Sonography-guided Gastrografin Enema for Meconium Plug Syndrome in Premature Newborns: Preliminary Results 1 Hyun Woo Goo, M.D., Ki Soo Kim, M.D. 2, Ellen Ai-Rhan Kim, M.D. 2, Soo Young Pi, M.D. 2, Chong

More information

Paediatric surgical emergencies. Mani Thyagarajan BWCH

Paediatric surgical emergencies. Mani Thyagarajan BWCH Paediatric surgical emergencies Mani Thyagarajan BWCH General points Always discuss Call consultant for help ASAP CT scan is a bad modality in paediatrics Ultrasound? Intussusception? Renal colic? UTI

More information

The Value of Ultrasound in Diagnosing Acute Appendicitis

The Value of Ultrasound in Diagnosing Acute Appendicitis The Value of Ultrasound in Diagnosing Acute Appendicitis *Dr. Baha'a Mushref Abdulsalam Department of Surgery, College of Medicine, University of Anbar, Anbar, Iraq Received 14/2/2012 Accepted 23/5/2012

More information

This lab activity is aligned with Visible Body s Human Anatomy Atlas app. Learn more at visiblebody.com/professors

This lab activity is aligned with Visible Body s Human Anatomy Atlas app. Learn more at visiblebody.com/professors 1 This lab activity is aligned with Visible Body s Human Anatomy Atlas app. Learn more at visiblebody.com/professors 2 A. Digestive System Overview To Start: Go to the Views menu and scroll down to the

More information

Objectives. Pediatric Mortality. Another belly pain. Gastroenteritis. Spewing & Pooing Child 4/18/16

Objectives. 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 information