Colonic Polyps

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Colonic Polyps

 Best radiographic alternative to optical colonoscopy  Proper technique critical, including utilization of colon cleansing agent, stool “tagging” agent, electronic CO₂ insufflator, and separate supine and prone acquisitions  Polyps appear as…

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Gastric Volvulus

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Gastric Volvulus

 Most common type; “upside-down stomach”  Occurs in setting of large paraesophageal hernia  Stomach rotates upward, with greater curvature lying above lesser curve • Mesenteroaxial volvulus: Rotation of stomach about its short…

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Opportunistic Intestinal Infections

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Opportunistic Intestinal Infections

 Favors distal small bowel (SB) and colon  Mucosal hyper- or hypoenhancement; submucosal edema  Infiltration of mesenteric fat  Lymphadenopathy is very uncommon • Mycobacterial  Mycobacterium avium-intracellulare  (MAI): Thickened SB folds with relatively…

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Acalculous Cholecystitis

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Acalculous Cholecystitis

 Findings identical to calculous cholecystitis (except gallstones)  Thickening of gallbladder wall > 3 mm  Positive sonographic Murphy sign – May be absent or impossible to elicit in critically ill patients at…

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Primary Sclerosing Cholangitis

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Primary Sclerosing Cholangitis

 Pruned appearance of biliary tree develops over time • CT/MR  Thickening and hyperenhancement of bile duct wall suggests active inflammation  Visualization of greater than expected number of peripheral ducts on MRCP…

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Portal Vein Occlusion

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Portal Vein Occlusion

 Color Doppler US initially: Highly accurate and cost effective  CT or MR: Complete evaluation and to search for cause TOP DIFFERENTIAL DIAGNOSES • Streaming artifact • Extrinsic compression • Budd-Chiari syndrome PATHOLOGY • Most…

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Epithelioid Hemangioendothelioma

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Epithelioid Hemangioendothelioma

 Enhancing (hyperemic) peripheral inner rim (increased vascularity)  Nonenhancing peripheral outer rim or “halo” (avascular rim)  Delayed or nonenhancing central part of tumor (myxoid and hyalinized stroma) • Imaging protocol: Multiphasic CT…

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Sickle Cell Anemia

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Sickle Cell Anemia

 Splenic autoinfarction: Absent or small calcified spleen  Massive splenic infarction: Rare complication defined as when > 50% of spleen is infarcted  Splenic sequestration: Massive splenomegaly  Splenic abscess: Usually due to…

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Celiac-Sprue Disease

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Celiac-Sprue Disease

 Mucosal hyperenhancement accompanies active ulceration  Reversal of jejunoileal fold patterns (atrophied jejunal, thickened ileal)  Submucosal edema, fat, or gas  Small bowel intussusception  Eccentric soft tissue density mass in bowel wall…

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Peripheral (Intrahepatic) Cholangiocarcinoma

Nov 16, 2016 by in GASTROINTESTINAL IMAGING Comments Off on Peripheral (Intrahepatic) Cholangiocarcinoma

 Most common type of CCA  Well circumscribed, large, with lobulated margins  Multicentricity, especially around main tumor • Periductal-infiltrating CCA  Grows along bile ducts and is elongated, spiculated, or branch-like • Progressive, gradual,…

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