A tutorial of diagnostic radiology

1. OUTLINE
• PNEUMOPERITONEUM
• PNEUMATOSIS INTESTINALIS
• PNEUMOBILIA
ULTRASOUND: NORMAL & ABNORMAL
FINDINGS
 BILIARY SYSTEM
 RENAL & URETERIC STONES
 HYDRONEPHROSIS & PYONEPHROSIS
 PERITONITIS

2. OUTLINE
• APPENDICITIS
• PREGNANCY
• FIBROADENOMA
• BREAST CA

3. PNEUMOPERITONEUM: aka aeroperitoneum
It describes gas within the peritoneal cavity,
often due to critical illness.
• Etiology:
Perforated hollow viscus
Post op free intraperitoneal air
Peritoneal dialysis
Penetrating abdominal injury etc

4. Fig. 1: Normal plain abdominal x-ray(supine)

5. Fig. 2: PA chest & supine plain abdominal radiographs
depicting pneumoperitoneum

6. Fig. 3:Coronal CE CT Abdomen showing
pneumoperitoneum

7. PNEUMATOSIS INTESTINALIS: aka intramural
bowel gas, refers to the clinical or radiological
findings of gas within the wall of the bowel.
 Etiology:
Benign causes: pulmonary dx, systemic
dxs(scleroderma, lupus, AIDS), intestinal
inflammation, iatrogenic/procedures,
medications(steroids, lactulose, sorbitol) &
organ transplantation.
Life threatening: intestinal ischemia,
obstruction, enteritis/colitis, toxic caustic
ingestion, toxic megacolon, collagen vasc. dx

8. Fig. 4: Plain Abdominal x-ray (AP) & coronal CT
Abdomen showing pneumatosis intestinalis

9. PNEUMOBILIA: aka aerobilia, is the
accumulation of gas in the biliary tree.
 Etiology:
Recent biliary instrumentation e.g ERCP
Incompetent sphincter of Oddi
Biliary-enteric surgical anastomosis e.g
cholecystoenterostomy
Spontaneous biliary-enteric fistula
Infection- cholangitis, emphysematous
cholecystits

10. Fig. 5: Plain abdominal x-ray & Axial Abdominal CT
illustrating pneumobilia

11. Fig. 6: Diagram of hepatobiliary system

12. Fig. 7: Normal uss of the GB, CBD & PV

13. Fig. 8: Uss image of the liver showing
choledocholithiasis with dilated biliary tree

14. Fig. 9: Uss of GB showing acute cholecystitis

15. Fig. 10: Uss images of normal kidneys

16. Fig. 11: Uss images of renal calculus

17. Fig. 12: Plain abdominal x-ray & NCE Abdominal CT
showing ureteric stone

18. Fig. 13: Uss images depicting hydronephrosis

19. Fig. 14: Uss images showing pyonephrosis

20. Fig. 15: Uss images showing turbid & complex
extraluminal fluid collection in peritonitis

21. Fig. 16: Axial CE Abdominal CT images showing
peritonitis

22. Fig. 17: Uss images of normal appendix

23. Fig. 18: Uss images of acute appendicitis &
perforated appendix

24. Fig. 19: Uss images of normal 1st trimester cyesis

25. Fig. 20: Uss images showing anembryonic
gestation

26. Fig. 21: Uss images

27. Fig. 22: Uss images of placenta previa & fetus with
hydrocephalus

28. Fig. 23: Normal breast uss

29. Fig. 24: Normal breast mammograms

30. Fig. 25: Breast mammograms depicting fibroadenoma

31. Fig. 26: Breast Uss images of fibroadenoma

32. Fig. 27: Breast Mammograms showing
malignant calcifications

33. Fig. 28: Breast mammogram showing DCIS

34. Fig. 29 : Breast Uss images showing breast ca

35. THANK YOU FOR LISTENING