GI Radiology. Imaging modalities in GI. Plain X-rays (Supine, Erect, Decubitus) Barium studies (Ba Swallow, Meal, Follow through, Enteroclysis, Enema) Ultrasound Abdomen CT Scan/MRI Abdomen ERCP, Cholangiography. Angiography and Nuclear Medicine. Plain Abdominal X-rays. Erect Chest
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Within the Lumen:
Dilated bowel ?Obstruction
Outside the Lumen:
In a cavity ?abscessNormal Vs Abnormal Gas shadows
Ionic (gastrografin) Can lead to pulmonary edema if aspirated.
Non- Ionic ( Low Osmolar) Relatively safer if aspirated.
Barium ( Non-water soluble)
Can cause sever peritonitis and fibrosis in perforation or leakage.Contrast Medium for GI
Upper abdominal mass
Assessment for perforation
Complete large bowel obstruction
NPO ---6 hrs
No smoking– increases GI motilityBarium Meal
Low residue diet
Bowel Prep (Dulcolax -2-4 Tab)Small Bowel Follow through/ Small bowel enema (Enteroclysis)
Change in bowel habits
Melaena / Anemia
Single contrast – Obstruction & Intussusception.
Rectal biopsy—5 days
Preparation: (Two days)
Low residue diet
Bowel prep (Dulcolax – 4 Tab)Barium Enema
Adequate visceral visualization
Best for GB
Indications:Acute Abdomen, Obstructive jaundice, abdominal masses, collections, Free fluid, follow up- tumors.
Poor in Obesity
Bones / CalcificationsUltrasoundAbdomen
Accurate & quick
Bowel/ gasses/ bones
Reformation and angio
Indications: Acute abdomen, Abdominal mass, tumor staging/follow up, Appendicitis/abscesses, Post op complications
Radiation (250 CXR)
Contrast reactionCT Scan Abdomen
Liver specific contrasts
Bowel motion/ contrast
Relatively long procedure time
EndoscopicRetrograde Cholangiopancreatography (ERCP)
MR Cholangiopancreatography (MRCP)
Percutaneous Transhepatic Cholangiography (PTC).Cholangiography