OCG (Oral cholecystogram) BY Akash Das
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Oral cholecystography is a radiographic examination of the gallbladder using oral contrast media. It was developed in 1924 but has now been largely replaced by ultrasound and MRCP. The exam involves patients consuming contrast media 14 hours prior to imaging. Radiographs are taken in various positions including before and after a fatty meal to visualize the gallbladder and assess for any abnormalities like inflammation, polyps, tumors or gallstones. Precautions must be taken to minimize radiation exposure to the patient and staff during the exam.
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Oral cholecystography
An oral cholecystography is a radiological investigation that involves administering contrast media orally to visualize the gallbladder. It was first described in 1925 but is now largely replaced by ultrasound and MRCP due to its low success rate. The document discusses the indications, contraindications, technique, additional techniques, complications of an oral cholecystography.
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This document discusses hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome. It provides details on the epidemiology, clinical presentation, risk factors, pathophysiology, prevention, and treatment of VOD. VOD is a serious complication of hematopoietic stem cell transplantation that results from liver cell necrosis and vascular congestion. It most commonly occurs within the first month after transplantation. Prevention strategies include heparin, ursodeoxycholic acid, defibrotide, and controlling risk factors. Treatment focuses on managing symptoms, with defibrotide showing promise for improving outcomes in severe cases. The prognosis depends on the severity of the VOD, with mild cases having low mortality
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This document presents a case report of a 6 day old female infant referred to the hospital with vomiting since the 5th day of life. On examination, the infant was found to have bilious vomiting but no other symptoms of obstruction. Initial investigations and a barium meal were unremarkable. However, over the course of her hospital stay her symptoms persisted and she was eventually found to have a duodenal web, which was surgically corrected. This case highlights some of the challenges in diagnosing intestinal obstruction in newborns, including the need for high clinical suspicion and the potential limitations of initial radiological investigations.
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The patient did not revieled the ingestion of foreign bodies.
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colonoscopy-ppt-190317111747.pptxpptxxxxxx
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1. Colonoscopy involves inserting a flexible endoscope into the large intestine to examine the colon and identify any abnormalities.
2. Proper preparation is required, including following a low-fiber diet before the procedure and taking laxatives to clear the colon.
3. Colonoscopy can be used to diagnose a variety of conditions like polyps, inflammatory bowel disease, and cancers by visualizing the colon and collecting tissue samples. Therapeutic procedures like polypectomy and treatment of bleeding lesions can also be performed.
Imaging of biliary tract
The document discusses various imaging techniques for the biliary tract, including oral cholecystograms, intravenous cholangiograms, and cholangiography. An oral cholecystogram involves taking contrast agent pills before an X-ray exam to visualize the gallbladder. Intravenous cholangiograms inject iodine dye intravenously, which is then excreted in bile ducts and gallbladder to image them. Both techniques are now rarely used due to availability of more accurate ultrasound, CT, and MRI exams. Cholangiography refers more broadly to X-ray imaging of the bile ducts.
Clinical features and diagnosis of malabsorption
The document provides an overview of malabsorption, including its causes, mechanisms, diagnosis, and laboratory tests used for evaluation. It discusses the three key steps required for normal nutrient absorption and lists factors that may damage the intestine and cause malabsorption. Common tests described include stool tests to measure fat, blood tests of vitamin/mineral levels, breath tests for lactose intolerance, imaging to detect structural abnormalities, and biopsy for abnormal cells. Carbohydrate and fat malabsorption are evaluated using tests like D-xylose absorption, lactose tolerance, breath hydrogen, and fecal fat determination. Specific disorders are investigated using antibodies for celiac disease and the Schilling test for pernicious anemia.
Cholelithiasis GB stone
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liz borders case study ppt
1) A 65-year-old man presented with spontaneous hemoperitoneum and required multiple surgeries including small bowel resection.
2) He developed complications including an ileus, myocardial infarction, and anastomotic leak, preventing enteral nutrition.
3) After 11 days without adequate nutrition, the patient was started on total parenteral nutrition (TPN) which was advanced cautiously due to his risk for refeeding syndrome.
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Pancreatic agenesis with congenital diabetes mellitus (case study).
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OCG (Oral cholecystogram) BY Akash Das
- 1. By, Akash Das Student Code- BWU/BRI/19/005 Paper Code- BMRIT-305 Oral Cholecystography (OCG)
- 2. • Definition: Oral Cholecystography or Oral Cholecystogram is the radiographic study of gallbladder by the oral administration contrast media. Oral Cholecystography (OCG) • It was developed in 1924 by American surgeons E.A Graham & W. H Cole. • But now days it is largely superseded by ultrasound and MRCP. • This is the initial examination for the investigation of biliary tract. Fig- 1: Gallbladder
- 3. • Inflammation of the organ. • Other abnormalities like polyps. • Tumors • Gallstones • To visualizing cystic duct and common bile. • To demonstrate suspected pathology in the gallbladder. Fig- 3: Gallstone Formation Fig- 2: Polyp Inside Gallbladder
- 4. • Pr severe hepatorenal disease. • Acute cholecysititis • Iodine sensitivity • Pregnancy • Dehydration • An IV cholecystography within the previous week evious cholecystectomy. Fig- 4: Acute Cholecysititis Fig- 5: Pregnancy
- 5. • Patient should take low residue diet for 2 days prior to examination. • A laxative 2 days prior to the examination. • The CM is taken with water 14 hours prior to the examination. • A fat-containing meal after preliminary film, if the gallbladder is not visualize by contrast media. • Food is forbidden until the examination is completed. Fig-6: Gall Stone Formation Fig-7: Radiographic Appearance of GB
- 6. 1. Biloptin 2. Telepaque 3. Cholebrin 4. Solu-Biloptin 1. Prone 20º LAO 2. Supine 20º RPO 3. Erect 20º LAO 4. Fatty meal provided. • Prone 20º LAO 30 minutes after a fatty meal. Fig- 9: Positioning of patient for OCG Fig- 8: Biloptin Capsules
- 7. • A night before the examination 6 tablet of Teleopaque or Biloptin is given orally. • After 12-16 hours a prone oblique view with right side raised to 20º is taken for gallbladder visualization. • After the preliminary film taken, the patient lie in the supine position and appropriate spot film of the gallbladder are taken. • Ask the patient to eat fatty meal. • After 30-40 min. films are taken to assess the contractibility of the gallbladder and small filling defect. (stones or polpyps) • Cystic and common bile duct also visualized in post fatty meal films. * If the GB not visualized a "double dose" OCG may have to be performed where the patient takes in all 12 tablets of CM.
- 8. • Mild gastrointestinal disturbances • Skin reactions • Uricosuric action • Impaired renal function • Psedoalbuminuria • Abnormal thyroid function tests • Increased effect of protein-bound drugs because of shared binding with albumen Fig- 11: Gastrointestinal Disturbances Fig- 10: Skin Reactions
- 9. There are many ways by which we can protect our self from scattered radiation, like- By using • Protective apron:0.5mmPb • Lead shield:0.5mm Pb • Lead protective gloves. • Film badge or TLD monitor. And also we should always the rule of TDS & ALARA principle We can also use beam limiting devices like cone to minimize the radiation dose. Fig- 14: Beam Limiting Device (Cone) Fig- 13: Cardinal’s principle (TDS) Fig- 12: Lead apron, shield, gloves & TLD
- 10. THANK YOU