Abdomen Gastrointestinal tract 实习课.pptx

1. Achalasia
The very dilated oesophagus
containing food residues shows a
smooth narrowing at its lower end
Bird Beak
sign

2. Achalasia

3. Oesophageal carcinoma
an irregular stricture
(arrow) at the middle
esophagus

4. Oesophageal carcinoma
an irregular stricture
at the lower end

5. Oesophageal carcinoma
the lumen is not
distended freely by
barium

6. Contrast agent leaked into
the mediastinum because of
the esophageal rupture

7. +
+
Esophageal contrast agent leaks
into the trachea.There is a fistula
between the esophagus and trachea

8. There is a fistula between the esophagus and
trachea

9. • Extensive oesophageal cancer (black arrow) has eroded
into the posterior aspect of the carina (*) forming a
fistula.
• Enlarged lymph nodes are present in the anterior
mediastinum (white arrow).

10. Oesophageal carcinoma
There is thickening and enhancement of the
right lateral oesophageal wall
In this case, the left wall of the oesophagus is
relatively normal

11. Oesophageal carcinoma
nodule of soft tissue in the lumen and enhanced

12. There is thickening and enhancement of
oesophageal wall

13. Gastric carcinoma and metastatic
tumor
There is thickening of the
wall of the stomach，
Multiple low-density lesions
in the liver（ metastsis ）

14. Gastric carcinoma and metastatic
tumor
There are Several
lymph nodes

15. Gastric carcinoma and metastatic
tumor
There is diffuse thickening of
the wall of the stomach ，
Serosal surface invasion，
ascites，metastsis

16. Gastric carcinoma
There is diffuse thickening of the wall of
the stomach ， Serosal surface invasion

17. Gastric carcinoma
Metastsis in the lung from the
Gastric carcinoma

18. Gastric carcinoma
low-density lesions in the liver（ metastsis ）

19. Gastrointestinal stromal tumour
• There is a smooth ovoid mass arising from the anterior wall of the
stomach(arrow).
• This causes an indentation of the stomach. L, liver; P,pancreas; St,
stomach.

20. Appendicitis
CT showed enlarged appendix, thickened wall,
and inflammation of the periappendiceal fat

21. appendicitis
CT showed enlarged
appendix, thickened wall,
and inflammation of
the periappendiceal fat

22. Intestinal obstruction
The small intestine dilates and fluid
accumulates, Gas liquid level is visible

23. Perforation of hollow viscera
subphrenic free
air like crescent

24. Perforation of hollow viscera
Perihepatic free gas and exudation

25. Dot gas

26. intestinal obstruction
The small intestine dilates and
fluid accumulates, Gas liquid
level is visible

27. intestinal obstruction
The small intestine dilates and fluid
accumulates, Gas liquid level is
visible, gallbladder stone,
calculus of intrahepatic duct

28. Colon carcinoma
Thickening of the wall of the
sigmoid colon,markedly
enhanced

29. Colon carcinoma
Transverse colonic wall thickening
with marked enhancement

30. Colon carcinoma
The wall of the ascending
colon is thickened with marked
enhancement

31. Normal ileocecal bowel

32. Intussusception

35. Intussusception
• Intussusception causing small bowel obstruction:
Coronal contrast-enhanced CT demonstrates a
segmental jejunojejunal intussusception
(arrows),causing an early or partial proximal small
bowel obstruction.
• This was a case of metastatic melanoma

36. • While transient intussusceptions are a common
incidental finding, an intussusception causing
obstruction should raise suspicion for an
underlying lesion(tumor) and prompt surgery.

37. Crohn’s disease
• Narrowing. (a) There is a long stricture (arrows) in the ileum due to
Crohn’s disease and an abnormal mucosal pattern. There is also separation
of the abnormal segment from other loops of the bowel.
• (b) CT in the same patient demonstrating marked thickening of the
abnormal loop of small bowel, with a narrowed lumen (white arrows).
Several dilated loops of small bowel are also seen (blackarrows), due to
some obstruction at the level of the stricture.

38. Crohn’s disease
• It may cause disease in several different parts
of the small and large intestine, often leaving
normal intervening bowel, the affected parts
being known as skip lesions.

39. Lymphoma
• CT with the bowel opacified by contrast agent.
• The wall of all the bowel loops is considerably thickened.
• The arrows point to a portion of bowel which is particularly
involved by lymphoma.

40. Lymphoma
• Aneurysmal dilatation
• Obstruction is rarely seen

41. That’all,thank you!