Date post: | 21-Jan-2018 |
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Health & Medicine |
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SPOTTERS-KEYSDR. ANISH CHOUDHARY, JR 3
30.05.16
1.
Zenker’s diverticulum
Findings:
Focal contrast collection along the posterior lateral proximal esophagus connecting by a thin neck
Found at the cricopharyngeus, the Killian’s dehiscence
ddx:
NONE!
This is an Aunt Minnie!
2.
Gastric carcinoma
Findings:
Large mass projecting into the fundus with a large central ulcer
loss of normal folds and wall contour
ddx:
leiomyosarcoma
lymphoma
metastasis
3.
Long esophageal stricture
Findings:
long segment of esophageal narrowing
loss of normal mucosal pattern
ddx:
Long-term nasogastric intubation
radiation
4.
Achalasia
Findings:
tight stenosis of the distal gastroesophageal junction = “bird’s beak” appearance
dilated proximal esophagus
ddx:
pseudoachalasia
Malignant stricture
Benign stricture
Chagas disease
5.
Pancreatitis
Findings:
diffuse narrowing of the duodenum
splaying of the “C-loop
loss of normal mucosal pattern
ddx:
large tumor
pseudocyst
hemorrhage
6.
Area gastrica
Findings:
Fine linear polygonal pattern of the gastric body seen on a double contrast study
This is a normal fold pattern
ddx:
NONE!
This is an Aunt Minnie!
7.
Ascariasis
Findings:
serpentine intraluminal foreign bodies = ascaris worms
thin ribbon of contrast = barium WITHIN worm GI tract
ddx:
NONE!
This is an Aunt Minnie!
8.
Barrett’s esophagus
Findings:
Segmental narrowing of the distal esophagus with smooth tapering margins, ulcerations, and loss of normal mucosal pattern
ddx:
GERD
radiation
malignancy
9.
Boerhaave’s syndrome
Findings:
focal horizontal contrast extravasation in the posterior distal esophagus
surrounding abnormal posterior mucosa
ddx:
Iatrogenic
Tumor
10.
Brunner’s gland hyperplasia
Findings:
multiple smooth and round filling defects up to 1cm involving the bulb and descending duodenum
due to increased acidity in the duodenal bulb
ddx:
Hyperplastic polyps
Familial polyposis syndromes
11.
Bezoar
Findings:
mass-like gastric luminal filling defect composed of undigested or partially digested food
may cause obstruction
ddx:
NONE!
This is an Aunt Minnie!
12.
Pseudomembranous colitis
Findings:
numerous thickened folds of the transverse and descending colon
sloughed mucosa or debris within the lumen
ddx:
Ischemic colitis
Ulcerative colitis
Crohn’s disease
Infectious colitis
13.
Candida esophagitis
Findings:
numerous plaque-like filling defects of the distal esophagus
no erosions or narrowing seen
may appear worse with disease severity
ddx:
NONE!
This is an Aunt Minnie!
14.
Caroli’s disease
Findings:
percutaneous cholangiogram shows marked dilated and beaded appearance of the intrahepatic biliary system
ddx:
NONE!
This is an Aunt Minnie!
15.
Cholangiocarcinoma
Findings:
percutaneous cholangiogram shows smooth narrowing of the biliary duct confluence and proximal common hepatic duct
ddx:
NONE!
This is an Aunt Minnie!
16.
Lye stricture & colonic interposition
Findings:
Long segmental distal esophageal narrowing
Anteriorly located bowel loop connecting mouth of stomach = interposed colonic loop
ddx:
NONE!
This is an Aunt Minnie!
17.
Apthous ulcers
Findings:
Numerous shallow mucosal defects with a surrounding mound of edema = “bull’s eye” or “target” lesions
do NOT penetrate beyond the muscularis mucosa
ddx:
Crohn’s disease
Infectious colitides
18.
Inflammatory polyps
Findings:
islands of normal or edematous mucosa seen during active inflammation
they protrude into the lumen because the surrounding mucosa is sloughed or deeply ulcerated
ddx:
ulcerative colitis
Infectious colitis
Crohn’s disease (“cobblestone pattern”)
19.
Crohn’s disease
Findings:
multiple loops of small bowel show segmental narrowing, loss of normal mucosal pattern (cobblestone), and fistula formation
striking involvement of the terminal ileum
ddx:
lymphoma
Tuberculosis
Yersinia (TI only)
20.
Duodenal adenocarcinoma
Findings:
eccentric sessile lesion with an irregular, ulcerated surface along the lateral wall of the descending duodenum
ddx:
sessile polyp
leiomyoma / leiomyosarcoma
metastasis
21.
Heterotopic gastric mucosaof the duodenal bulb
Findings:
numerous, slightly elevated lesions measuring a few millimeters clustered in a small segment of the duodenal bulb
may have angulated or plaque-like margins
occur in up to 20% of pts.
no clinical significance
ddx:
benign lymphoid hyperplasia (if 1-2mm smooth filling defects)
22.
Erosive gastritis
Findings:
numerous 3-4mm shallow mucosal defects with a surrounding mound of edema = “bull’s eye” or “target”
do NOT penetrate beyond the muscularis mucosa
ddx:
Idiopathic (50%)
NSAIDs (greater curve)
Crohn’s disease (apthous ulcers)
Alcohol ingestion
23. A 35 yo in a motor vehicle accident with severe injuries.
23. CT Hypotension ComplexShock Bowel
23.
24.
24. HISTOPLASMOSIS
25. 81 YEAR OLD WITH HISTORY OF NON VEG DIET.
25. Foreign Body (Chicken
Bone) Perforation of Bowel
25. Foreign Body (Chicken
Bone) Perforation of Bowel
THANK YOU