Learn Barium Meal & Follow Through for the beginners from a Radiology Resident.For some image description please go through the text book "David Sutton" because i have described these image during my presentation Verbally..There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
Abdominal TB can involve any part of GIT from mouth to anus, the peritoneum and pancreato-billiary system.
Total EP TB accounts for about 10-12% of total no. of TB cases, out of which 11-16% are abdominal koch.
Sixth most frequent EP TB after lymphatics, genitourinary, bone & joint, milliary & meningeal TB.
Caused by M. tuberculosis, M. bovis & NTM.
Age group 20-40 most commonly affected & slight female preponderance has been described.
Before era of HIV infection > 80% TB was confined to lung
Extrapulmonary TB increases with HIV
40 –60% TB in HIV+ pt are extrapulmonary
Globally, proportion of co-infected pt > 8 %
~ 0.4 million people in India are co-infected.
In one study, 16.6% abdominal TB pt in Bombay was HIV +.
Mechanisms by which M. tuberculosis reach the GIT:
Hematogenous spread from primary lung focus
Ingestion of bacilli in sputum from active pulmonary focus.
Direct spread from adjacent organs.
Via lymph channels from infected LN
Rare Mechanism:
Contiguous spread of infection from a fallopian tube
TB peritonitis as complication of peritoneal dialysis
Ileum > caecum > ascending colon > jejunum
>appendix > sigmoid > rectum > duodenum
> stomach > oesophagus
More than one site may be involved
Ileum > caecum > ascending colon > jejunum
>appendix > sigmoid > rectum > duodenum
> stomach > oesophagus
More than one site may be involved
Ileum > caecum > ascending colon > jejunum
>appendix > sigmoid > rectum > duodenum
> stomach > oesophagus
More than one site may be involved
LOWER GI HEMORRHAGE- PLAYLIST OF 6 VIDEOS
Dear Viewers,
Greetings from “Surgical Educator”.
I have made a playlist for Lower GI Hemorrhage which consists of six videos on various causes of Lower GI Hemorrhage. They are Introduction, diverticular disease, haemorrhoids, fissure-in-ano, colorectal carcinoma and inflammatory bowel disease. If you watch all these videos together you will become confident to tackle the clinical problem of Lower GI Hemorrhage. You can watch these videos in the following link: https://www.youtube.com/playlist…
Thank you for watching the videos.
Ulcerative colitis explanation, management and therapyYuliaDjatiwardani2
A chronic, inflammatory bowel disease that causes inflammation in the digestive tract.
Ulcerative colitis is usually only in the innermost lining of the large intestine (colon) and rectum. Forms range from mild to severe. Having ulcerative colitis puts a patient at increased risk of developing colon cancer.
Symptoms include rectal bleeding, bloody diarrhoea, abdominal cramps and pain.
Treatment includes medication and surgery.
This is a presentation detailing facts about abdominal tuberculosis. Intended for healthcare professionals and medical students
Dr Manoj K Ghoda
Gujarat Gastro Group
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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1. IMAGING IN INFLAMMATORY
BOWEL DISEASE
DR.KHYATI VADERA REFERENCES: RADIOGRAPHICS
RESIDENT DOCTOR RUMACK
M.D RADIODIAGNOSIS RADIOLOGY ASSISTANT
MEDICAL COLLEGE BARODA
SSG HOSPITAL
2. • INTRODUCTION
• DEFINATIONS
• IMAGING MODALITIES
• DIFFERENCE BETWEEN CHRON’S AND UC
• DIFFERENTIAL DIAGNOSIS
• CONCLUSION
PROTOCOLS
3. Group of chronic disorders that cause inflammation
and ulceration in small and large bowel.
Mainly two most common diseases are –chron’s
disease and ulcerative colitis
INTRODUCTION
4.
5. Idiopathic, chronic, transmural inflammatory process
of bowel - affect whole GI system starting from
mouth to anus.
Most commonly involved- terminal ileum, ileocaecal
valve and caecum with regional enteritis.
SKIP LESIONS ARE PATHOGNOMIC
Diagnosed typically between 15-25 years of age group.
No gender predilection, runs in families.
Smokers - more affected.
CHRON’S DISEASE
6. • Chron’s disease can be –Stricturing,Penetrating,Inflammatory
• Etiology – idiopathic, genetic(DR5 DQ1 alleles), immunologic, microbial,
psychosocial
• Clinical presentation- diarrhoea, abdominal pain, weight loss
• Intermittent attacks of active disease followed by periods of remission.
• Disease re-activation by triggers like stress, dietary factors, smoking.
• Risk of colonic adenocarcinoma is increased in long standing cases.
7. • on X-ray- plain radiograph of abdomen is usually helpful in cases of
obstruction secondary to chron’s or extraintestinal manifestations
8. MUCOSAL ULCERS
APHTHOUS ULCERS initially
deeper transmural ulcers typically either longitudinal or circumferential in
orientation
when severe leads to COBBLESTONE APPEARANCE
may lead to sinus tracts and fistulae
thickened folds due to oedema
pseudodiverticula formation: due to contraction at the site of ulcer with
ballooning of the opposite site
STRING SIGN: tubular narrowing due to spasm or stricture depending on
chronicity partial obstruction
Barium small bowel follow-through
14. ULTRASOUND
limited role, it has been evaluated as an initial screening tool
Typically examination is limited to the small bowel and wall
thickness assessed:
Bowel wall thickness should be <3 mm, normally
thickness < 3 mm helps exclude the disease in a low risk patient.
thickness > 4 mm helps establish the diagnosis in a high risk patient.
Ultrasound in the assessment of extraintestinal manifestations.
15.
16. US image - stricture in a patient with active
Crohn's disease
18. Fat halo sign in chron’s disease
Transverse CT scan shows the central fatty
submucosal layer of low attenuation (*)
surrounded by higher-attenuation inner (long
arrow) and outer(short arrow) layers grossly
corresponding to the mucosa and muscularis
propria and serosa of the descending colon,
respectively.
19. COMB SIGN:Hypervascular appearance of the mesentery in active Crohn's disease.
Fibrofatty proliferation and perivascular inflammatory infiltration outline the
distended intestinal arcades. This forms linear densities on the mesenteric side of
the affected segments of small bowel, which give the appearance of the teeth of a
comb.
20.
21. CECT image, coronal section,
venous phase - enterocecal
fistula with secondary
traction of the cecum and
right psoas muscle abscess
22. CT AND MR ENTEROGRAPHY
Useful for both mural and extramural spread of
disease.
Inflammed bowel loops show thickening and contrast
enhancement.
Extramural spread: fibrofatty proliferation-thickening
of extramural fat
:vascular engorgement(comb sign)
Stenosis and strictures
23.
24. MRI enteroclysis - placement of a nasojejunal catheter
through which 1.5-2 L of contrast solution (e.g. water
with polyethylene glycol and electrolytes) are
injected.
When disease is transmural, with cobblestone
appearance, the abnormalities are evident as high T2
signal linear regions.
CT AND MR ENTEROCLYSIS
25. Introduction of the 12 to 14-F enteroclysis tube (under
fluoroscopy or through duodenoscope).
Contrast is administered either on the fluoroscopy table or after
transferring the the patient to the CT unit for commencement
of the CT scan (usually 1.5-2L of oral contrast).
In the CT unit, the position of the enteroclysis tube is checked in
the topogram.
In case negative oral contrast will be used, intravenous contrast
injection will be given (approximately 100-150ml).
CT ENTEROCLYSIS
26.
27. placement of a nasoduodenal tube under fluoroscopic guidance
the small-bowel is distended with 1-3L of methylcellulose (0.5%)
and water solution or isosmotic water solution through an
electric infusion pump infusion rate: 80-200 mL/min.
multislice HASTE(half-Fourier acquisition single-shot turbo spin-
echo) images with fat saturation and unenhanced and
enhanced (0.1 mmol/kg gadolinium) T1 coronal and axial fast
low-angle shot (FLASH) 2D images with fat saturation are
obtained 60 seconds after contrast injection
MR ENTEROCLYSIS
28.
29.
30. Perirectal phlegmon on axial T2 Single Shot TSE (left) and T1 contrast
enhanced (right) sequences. Rectal wall thickening with avid contrast
uptake due to active disease. Perirectal phlegmon surrounded by a
hyperenhancing perirectal fascia, displaces the rectum anteriorly.
32. Causes superficial ulceration of colon and rectum.
It starts from rectum and retrogradely involves whole colon
continuously.
In total colitis- back wash ileitis.
More common in DR2 related genes.
More female predilection, age group 30-40 yrs.
Clinical symtoms- diarrhoea, tenesmus, bleeding per rectum, passage
of mucus, crampy abdominal pain.
ULCERATIVE COLITIS
33. MILD DISEASE: fine granularity
MODERATE: marked erythema, coarse granularity, contact bleeding
and no ulceration.
SEVERE: spontaneous bleeding,edematous and ulcerated
Long standing cases epithelial regeneration- pseudopolyps, pre
cancerous condition
Eventually shortening and narrowing of colon
FULMINANT DISEASE: toxic colitis/megacolon
PATHOGENESIS
34. Acute UC – descending colon
has irregular outline. No fecal
residue in colon S/O total colitis
35. Mucosal inflammation-granular appearance to the surface of
the bowel.
Mucosal ulcers are undermined -button-shaped ulcers
Islands of mucosa remain giving it a pseudo-polyp appearance
In chronic cases the bowel becomes featureless with loss of
normal haustral markings, luminal narrowing and bowel
shortening- lead pipe sign
BARIUM ENEMA
40. Back wash ileitis : patulous
IC valve and dilated granular
terminal ileum
41. CT FINDINGS
Inflammatory pseudopolyps
Inflamed and thickened bowel - target appearance, due concentric
rings of varying attenuation- mural stratification
In chronic cases, submucosal fat deposition is seen particularly in the
rectum fat halo sign
Extramural deposition of fat, leads to thickening of the perirectal
fat, widening of the presacral space
Marked muscularis mucosa hypertrophy-lead pipe sign.
45. Wall Thickening- median wall thickeness of colon
ranges from 4.7 to 9.8 mm, more severe the disease
more thicken the wall
Increased Enhancement- enhancement of the mucosa
with no or less enhancement of the submucosa
Loss of haustral markings
MRI
46. Mri image reveals thickening
of colon with loss of haustral
markings
47.
48. DIFFERENCE
CHRON’S DISEASE
70-80%Small bowel involvement
Skip lesions
Fat halo sign seen in 8%
Apthous ulcers are seen
Bowel wall more thicker
Irregular serosal surface
Perianal fistula/sinus/abscess
more common
Creeping fat and abscess are
very common in chronic cases
ULCERATIVE COLITIS
95% cases rectal involvement
Continuous spread from rectum
upwards
Fat halo sign is commonly seen
Collar button ulcers are seen.
Smooth serosal surface
Perianal disease rare
Mesenteric creeping fat and abscess
are uncommon.
Carcinoma is more common in long
standing cases.
59. • Lymph nodes with peripheral
rim enhancement giving
multilocular appearance
• Bowel wall thickening
60. TB CROHN’S
Involvement of
terminal ileum
shorter longer
Features Narrowed,
thickened, rigid
terminal ileum with
pulled up ceacum
Asymmetry and
cobblestoning
Longitudinal
Ulceration
absent present
TUBERCULOSIS VS CHRON’S
67. Acute diverticulitis
Pericolic stranding- disproportionate to the amount of bowel
wall thickening
segmental thickening of the bowel wall
enhancement of the colonic wall
diverticular perforation - air and fluid into the pelvis and
peritoneal cavity
abscess formation (seen in up to 30% of cases)
may contain fluid, gas or both
fistula formation-gas in the bladder/direct visualisation of
fistulous tract
70. Ischemic colitis
On CT:
segmental region of abnormality
submucosal oedema may produce low-density ring bordering
lumen (target sign)
intramural or portal venous gas
mesenteric oedema WITH NON ENHANCING BOWEL WALL
superior mesenteric artery or vein thrombus/occlusion may be
demonstrated
74. Pseudomembranous colitis
Pseudomembranous colitis-caused by the bacterium
Clostridium difficile due to bacterial overgrowth of
the colon in patients who are treated with broad-
spectrum antibiotics.
ascites and hyper enhancement of the bowel wall
with submucosal edema and edema in the
mesocolon.
76. Accordion sign
The sign is described as alternating edematous
haustral folds separated by mucosal ridges filled with
oral contrast material
77.
78. CONCLUSION
Inflammatory bowel diseases are chronic group of disorders which have a long
course of disease with intermittent periods of active disease and remission.
They can be easily diagnosed by multimodality approach combining clinical
symptoms , colonoscopy, and radiology.
Conventional radiological investigations like barium studies are still necessary for
diagnosis of characteristic intramural changes.
However the CT and MRI investigations are nowadays frequent and less
invasive, useful for detection of extraintestinal manifestations of IBD.
Colonoscopy at regular intervals is also must to look for progression of disease
and malignancy in long standing cases
Postcontraste axial image showing the presence of an acute fistula (arrows) between an inflamed ileum loop and the right psoas muscle.
Fibrotic stenosis. Axial T2 Single Shot (upper) and axial T1 post-contrast (lower) images of a patient with a history of recurrent Crohn's disease and episodes of partial bowel obstruction, show fibrotic stenosis. Thickening and stenosis of the distal ileum with homogeneous contrast enhancement are seen.
Note prominent right mesenteric fat wrapping displacing surrounding intraperitoneal structures