GIT RADIOLOGY

GIT RADIOLOGY
ZENKER'S DIVERTICULUM
 False diverticulum
 Posterior midline outpouch
 Above cricopharyngeal muscle

KILLIAN JAMESON DIVERTICULUM

 Anterior
 Below cricopharyngeal muscle

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DIFFUSE ESOPHAGEAL SPASM
 Painful contraction of esophageal
 Cork screw appearance

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ESOPHAGEAL WEB

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  Upper part of esophagus
 Associated with Plummer Wilson syndrome
PLUMMER VINSON SYNDROME
 Cricopharyngeal web
 Iron deficiency anemia
 Dysphagia
 Premalignant condition, increase chance of squamous cell carcinoma of esophagus
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HIATUS HERNIA
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 Herniation of stomach into thorax through diaphragmatic opening

Sliding Rolling

 IOC - CT scan with oral contrast

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CONGENITAL DIAPHRAGMETIC HERNIA

DEFECT IT PLEUROPERITONEAL MEMBRANE

BOCH DALAK HERNIA MORGAGNI HERNIA

 Right anteromedial defect  Left posterolateral defect

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 ACHALASIA CARDIA

PRIMARY SECONDARY
 Contracted  Due to any other
 Carcinoma
 Stricture

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CONGENITAL HYPERTROPHIC PYTORIC STENOSIS (CHPS)

 At age of 3-12 week
 None billous vomitting
 IOC → USG
 See target sign

TARGET SIGN
 Antral nipple sign
 Protusion redurdent pyloric cad mucosa into gastric anteum
 Pyloric wall thickning >3mm
 Pyloric length >16 mm
 Barium - string sign
 mushroom sign

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 Single Bubble appearance – CHPS
 Double bubble appearance - Duodenal atresia
 Tripple Bubble appearance - Jejunal atresia
 Multiple air fluid level - ileal atresia

GASTRIC ULCER
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BENIGN MALIGNANT
 Mucosal rugae are reaching  Rugae do not reach ulcer base
Upto ucler base

 BARIUM - Hampon line collar

 Carman menioscase sign & Kirkin
corples
PNEUMOPERITONEUM
 IOC → CT Scan
 X-ray
 Best X- ray veiw
 X- ray chest erect
 Cupola sign →Absence of air anterior to central tendour of diaphragm
 Doges Capsign → Free air in Pouch of Morrison
 Rigler sign → Presence of air on either of bowel
 Football sign
 Inverted V sign → outling of lateral umbrical ligament
 Urachus sign → outling of median umblical ligament

IMAGES
AIR UNDER DIAPHRAGM
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RIGLER SIGN

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FOOTBALL SIGN
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INVERTED V -SIGN

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CHILADITI SYNDROME

 bowel between right dome of diaphragm and liver and it is called pseudo pneumo peritoneum)
BARIUM STUDIES
 Swallow - Esophagus upto GE junction
 Meal - AfraTafreeh.com
Stomach & decend
 Meal follow through - Small bowel upto Ileocecal junction
 Enema - Large intestine

COLON CARCINOMA
 APPLE CORE REGION

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 SIGMOID VOLCULES & CAECAL VOLCULES
 Bird Beak / Bird of Prey Sign
 Coffee Bean Sign

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MIDGUT VOLVULUS
 USG/CT - whirl pool sign

HIRSCHSPRUNG DISEASE
  Colonic aganlionosis
 Proximar → Dilation
 (N) part → dilatea
 Ab (N) → Aganglionic part → constricted

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PSEUDO-MEMBRANOUS COLITIS
 Accordian sign

ILEOCECAL TB
 Obtuse ileocaecal angle
 Pulled up caecium
 Goose neck deformity
 Retracted & fibrosed calcium
 Inverted umbrella sign/fleisher sign
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INTUSUCEPTION

 Red current jelly stool

 M/c site – ileocolic
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PSEUDO KIDNEY

 Barium - Claw sign / Meniscus sign

 Coiled spring sign
CHRONS ULCERATIVE COLITIS
 Skip areal AfraTafreeh.com  Continuous

 Transmural involvement  Superficial

 Back wash ilectis

EARLIEST FINDINGS
 Apathous ulcers  Mucossal granularity
 Cobble stone appearance
SIGNS
 Target sign  Lead pipe appearance
 Cornt sign  Mucosal granularity
 Creeping fat sign  Collar button ulcer
 String sign of kantor  Loss of hausteration

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 LIVER
MULTIPHASE /TRIPHASE CT

ARTERIAL PHASE PORTAVENOUS PHASE DELAYED

HEMANGIOMA
 M/C benign lesion liver
 CECT → Delayed centripetal enhancement Peripheral nodular enhancement
 MRI → T2WI
 Hyperintense foci
 Light bulb appearnce

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FOCAL NODULAR HYPERPLASIA (FNH)

 Hot uptake on Tc99 sulphur coloia
 Stellate scar apperance

LIVER - DUAL SUPPLY

PORTAL VEIN HEPATIC ARTERY

HCC HEPATIC CELL CARCINOMA

  Major blood supply – Hepatic artery
 Early arterial enhancement and rapid washow

HYDATID CYST

Endocyst Ectocyst Pericyst

WATER LILY/FLOATING MEMBRANE SIGN

 Membrane floating over cyst fluid
 Membrane is settled down → sunset sign

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ACUTE CHOLECYSTITIS
 Ioc – USG
 Most accurate investigation:
 HIDA Scan
 Destended lumen
 Pericholic fluid
 GB wall hickening

PORCELAIN GALL BLADDER

 Calcification of GB wall
 Premalignant condition

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 GALL STONE ILEUS
RIGLER TRIAD

 Pneumobilia – air in biliary tree

 Small bowel obstrucion
 Impacted ectopic gallstone
 ERCP – endoscopic retrograde cholengiopanceartography
 MRCP

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ACUTE PANCREATITIS
 Increase serum amylase
 Risk → alcohol
 IOC → CECT
 X-ray
 Colen cut off sign
 Sentinal loop sign AfraTafreeh.com

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CHRONIC PANCREATITIS
 ERCP/MRCP
 Beaded/tortuous appearance of pancreatic duct
 Chain of lake appearance
 IOC
 MRCP
 Gold standard
 ERCP
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CA HEAD OF PANCREAS
 Double duct sign or MRCP
 CECT –
 Helergrous enhanced was in head of pancreas
 Reverse 3 sign of frostber

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