Regarding GIT radiology
Must describe the part of the tract we examine Ba swallow , meal , follow through & enema
If the film is chest XR with upper abdomen must exclude
2 things
1.Pnemoperitonium if it is crescent shape
2. Sub phrinic abscess if there is straight air fluid level
In KUB film of abdomen
Once see dilated bowel loops 2 things must verified
The film is erect or supine
a.The dilated bowel loops if being central small
numerous in no. cross the midline with valvula
convents (it is small bowel obstruction ).
b.If the dilated bowel loops is peripheral large few in
no. (it is large bowel obstruction ) .
Once see dilated esophagus in Ba swallow 3 things have
to exclude
1.If the stricture is long length it is being benign stricture
of the esophagus
2.If it is short length & below diaphragm it is achalasia
3.If the length is variable have missing part with
meniscus sign it is being malignant
In ba- meal examination concentrate on lesser & greater
curvature
a. Any projection from the lesser curvature in profile
view it is ulcer unless proven other wise .
b. Any irregularity in the greater curvature or distal
pyloric antrum of stomach , filling defect , irregular
narrowing +/- meniscus sign or what is called apple
core sign it is Ca stomach
Examination of duodenum is also called ba-meal
examination
Must exclude 2 things
a.Ulcer
b. Duodenal diverticulm ( which is well defined oval
or rounded shape smooth wall out pouching from
the second part of duodenum )
any In ba-enema examination must look carefully to
area of narrowing & constriction & any constriction
looks like apple core sign
( meniscus sign ) it is infiltrative ca colon
Regarding the KUB + IVU films
a. Must looks carefully to KUB film for any radio opaque
shadow ( so it is stone )
important pitfall in stage horn calculous
the calcified large stone take the shape renal pelvis
could be unilateral or bilateral so not to be confused
with hydronephrosis by looking to the pelvis in which
cystogram is not seen
b. In IVU films
Once we see hydro nephrosis & hydro ureter looks to the
distal ureteric obstruction & exclude the followings
obstructed causes
1.Stone ( unilateral or bilateral )
2.VUR ( uniulatral or bilateral )
3.Uretrocele ( there is unilateral or bilateral HN +HN
although the distal ureter is rounded cobra head shape ) so
it is being big trick !!!!!!!!!!!!! must not to fall in it !!!!!!!!
although the distal ureteric end rounded but the it is
orifice is being narrow )
In IVU film interpretation must look to for
important thing
a. Renal pelvis & ureter for any duplication
b. The inferior pole of the renal pelvis directed
outward parallel always to psoas muscle any
medial inward direction with fusion of the lower
pole calyx it is being horse shoe kidney
In US examination of the kidney 3 important
integral findings being almost the hallmark of the
kidney sono graphic examination request
*Stone ( echogenic white ) with reflection .
*Renal cyst ( echolucent black rounded ) with
enhancement .
*Centraly dilated renal pelvis with dilated major &
minor calyx ( hydro nephrosis ) .
In CT scan films
We can solve the film easily !!!!!! By comparison
Always compare the 2 sided aspect
1.The stone always in CT scan is white hyper dense even
if it is of low ca .
2.The tumor in CT scan is cause heterogeneous mass
destructed the whole kidney & renal pelvis & the
lesion could enhance heterogeneously or cause over all
necrotic non enhancing mass lesion .
3.The absent kidney easily excluded in CT scan although
the CT scan being of high radiation dose but indicated
in certain cases .