Week 5 highlights

Question 1

What are the 4 abnormal bowel gas patterns?

Answer 1

Local ileus
Generalized adynamic ileus
SBO
LBO

Question 2

___________ is also called “pseudo-obstruction”

Answer 2

Ileus

Question 3

Blockage:
Where is the transition point? How can you see it?

Answer 3

Distal loop(s) become decompressed/ suddenly gets small; seen on CT

Question 4

What is a localized functional ileus typically caused by?

Answer 4

Adjacent inflammation

Question 5

Localized functional ileus:
1) What point to underlying pathology?
2) Some air still gets through (i.e. not a complete obstruction); therefore, air still present in _________ or __________ (important)

Answer 5

1) Sentinel loops
2) rectum or sigmoid colon

Question 6

Localized Functional Ileus: List some key imaging features

Answer 6

1) 1 or 2 persistently dilated loops of bowel
2) Usually small bowel

Question 7

Generalized Functional Ileus:
1) In generalized ileus the ________ bowel is aperistaltic
2) ___________ bowel becomes dilated
3) Most often the result of _____________ and the manipulation of the bowel that occurs during

Answer 7

1) entire
2) Entire
3) abd surgery

Question 8

SBOs are very frequently caused by _____________

Answer 8

adhesions

(Another important reason you ask about prior abdominal surgeries as a part of your history)

Question 9

Loops may stack up on one another, causing a step-ladder appearance

This describes what pathology?

Answer 9

SBO

Question 10

What is the key feature of SBO on imaging?

Answer 10

The key feature on imaging is transition point which is only discoverable on CT

Question 11

What is a common cause of LBO (large bowel obstruction)?

Answer 11

Tumor

Question 12

LBO: What is a special case?

Answer 12

Volvulus

Question 13

Describe the 4 abnormal gas patterns

Answer 13

Question 14

Ogilvie Syndrome:
1) What is it?
2) Who does it occur in?
3) Why does it occur in them?

Answer 14

1) Acute intestinal pseudo-obstruction
2) Occurs in elderly patients
3) Hx of drugs with anticholinergic effects

Question 15

What can you NOT miss?

Answer 15

Air beneath the diaphragm
(easier to see on the right side)

Question 16

Streaky, linear appearance (outline structures) describes?

Answer 16

Retroperitoneal air

Question 17

1) Name a Harbinger of bowel death
2) What is it a sign of in infants?
3) What abt in adults?

Answer 17

1) Pneumatosis
2) Necrotizing enterocolitis in infants
3) Ischemic bowel disease in adults

Question 18

What is the triad for cholangitis?

Answer 18

RUQ pain, fever, jaundice