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Acute Abdomen Radiological Approach Prof Dr. Haney A Sami
Acute Abdomen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definition ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Causes
Imaging techniques ,[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging techniques ,[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Value of CT
 
 
Common causes of acute pain in an abdominal quadrant ,[object Object],[object Object],[object Object],[object Object],[object Object]
Common causes of acute pain in an abdominal quadrant ,[object Object],[object Object],[object Object],[object Object],[object Object]
Common causes of acute pain in an abdominal quadrant ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Common causes of acute pain in an abdominal quadrant ,[object Object],[object Object],[object Object]
Pancreatitis Ulcer Diverticulitis Cholecystitis Appendicitis
What to Examine by  Plain X-ray ,[object Object],[object Object],[object Object],[object Object],[object Object]
Key to densities in AXRs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Normal Gas Pattern ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gas in stomach Gas in a few loops of small bowel Gas in rectum or sigmoid Normal Gas Pattern
Normal Fluid Levels ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Erect Abdomen Always air/fluid level in stomach A few air/fluid levels in small bowel
Large vs. Small Bowel ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Haustra films Faecal mottling
Complete Abdomen Obstruction Series ,[object Object],[object Object],[object Object],[object Object]
Complete Abdomen Supine ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complete Abdomen Erect ,[object Object],[object Object],[object Object],[object Object]
Complete Abdomen Erect Chest ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complete Abdomen Prone ,[object Object],[object Object],[object Object],[object Object]
Abnormal Gas Patterns ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],Localized Ileus  Key Features Sentinel Loops Supine Prone
Localized Ileus Pancreatitis Ulcer Diverticulitis Cholecystitis Appendicitis Sentinel Loops
Localized Ileus Pitfalls ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Generalized Ileus Key Features
Generalized Adynamic Ileus Supine Erect
Is It An Ileus? ,[object Object],[object Object]
Mechanical SBO Key Features ,[object Object],[object Object],[object Object],[object Object],SBO
Mechanical SBO Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],*Cause may be visible on plain film
Mechanical SBO Pitfalls ,[object Object]
Differentiation between SBO & ILEUS  ,[object Object],[object Object],[object Object]
Mechanical LBO Key Features ,[object Object],[object Object],[object Object],[object Object]
LBO
LBO Supine Prone
Mechanical LBO Causes ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Mechanical LBO Pitfalls ,[object Object],[object Object],[object Object],[object Object]
Carcinoma of Sigmoid – LBO – Decompressed into SB Prone Supine
 
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Air in biliary tree Gallstone Gallstone Ileus
Post-op C-section Adynamic Ileus
Mesenteric Occlusion
Abnormal Gas Patterns Ileus and Obstruction ,[object Object],[object Object],[object Object],[object Object]
Conditions causing extraluminal air ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chilaiditi’s syndrome ,[object Object],[object Object]
Extraluminal Air Free Intraperitoneal Air
Signs of Free Air ,[object Object],[object Object],[object Object],[object Object],Crescent sign Free Intraperitoneal Air
Free Air Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Extraperitoneal Air
Soft Tissue Masses
Soft Tissue Masses ,[object Object],[object Object],[object Object],[object Object]
Splenomegaly
Myomatous Uterus
Bladder Outlet Obstruction – pre- and post- cath Hours later
Right Renal Cyst
RLQ Abscess
Abdominal Calcifications
Normal structures that calcify ,[object Object],[object Object],[object Object],[object Object]
Abnormal structures that contain calcium ,[object Object],[object Object],[object Object],[object Object],[object Object]
Abnormal structures that contain calcium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Abdominal Calcifications Patterns ,[object Object],[object Object],[object Object],[object Object]
Rimlike Calcification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Renal Cyst Gallbladder Wall
Linear or Track-like ,[object Object],[object Object],[object Object],Atherosclerosis Calcification Vas Deferens
Lamellar or Laminar ,[object Object],[object Object],[object Object],[object Object],Stone in Ureterocoele Staghorn Calculi
Cloudlike, Amorphous, Popcorn ,[object Object],[object Object],[object Object],Nephrocalcinosis Myomatous Uterus
Visceral Inflammation Colitis Appendicitis Diverticulitis Bowel Inflammation Cholecystitis Pancreatitis
Inflammation -  Cholecystitis   ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Thickening of gallbladder wall  Cholelithiasis .
 
 
 
Pancreatitis   ,[object Object],[object Object],[object Object]
Notice the peripancreatic stranding  ( bars )  as well  as the fluid thickening of the interfascial space
[object Object],[object Object]
Pancreatic necrosis
Pancreatic pseudocyst
 
Appendicitis   ,[object Object],[object Object],[object Object]
This image of an acute abdomen  ( arrow )  displays periappendicial stranding and dilattion of its  terminal portion .
For comparison, this image of a normal appendix   can be visualized at the ileocecal junction .  Also notethe fat ventralcontaining heria
Inflammation -  Colitis   ,[object Object],[object Object],[object Object]
 
This example of colitis shows thickening of the colon and pericolonic stranding typical of inflammation .
Thickening of sigmoid colon due to pseudomembranous colitis
A case of diverticulitis showing a thickened sigmoid colon   and a diverticulum
Diverticulitis
Distal ureteral stone lead ing to right hyrdronephrosis in above image   Ureteral junctional stone Renal Colic
Renal stone right sided hydronephrosis Renal Colic
Aortic aneurysms
Case  give a diagnosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The End

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Acute abdomen