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Gastrointestinal Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Gareth Davies, Chris Black, Keeley Fairbrass
Toxic megacolon: Inflammation spreads to the muscularis mucosa and the colon dilates and may perforate. The patient deteriorates with tachycardia, fever and pain. The abdomen is distended and tender and there are no bowel sounds. Diagnosis is confirmed on abdominal radiography. Colectomy is usually required.
Abdominal and Chest Decubitus Radiography
Published in Russell L. Wilson, Chiropractic Radiography and Quality Assurance Handbook, 2020
A decubitus view is taken to evaluate air and fluid levels. In abdominal radiography, it is used as a substitute for the erect or upright view when the patient cannot stand. The side that the patient lies on is very important. The routine abdominal decubitus is the left lateral decubitus view. The patient lies on the left side. Any free abdominal air will pool above the liver near the right diaphragm. If the patient was on the right side, air in the stomach and colon could be misinterpreted as free air. The patient must remain on the left side for at least 10 minutes to allow the air to pool properly. When marking the decubitus view, mark the side that is up with an arrow and anatomical marker.
Animal Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Radiography can be used to assess if there is respiratory involvement. Changes may be variable and potentially not be specific or diagnostic for the disease. They may include tracheobronchial lymphadenopathy, interstitial to alveolar lung infiltration, lobar consolidation, and pleural effusion. Abdominal radiography or ultrasound may demonstrate hepatomegaly or splenomegaly, lymphadenopathy, mineralization of the mesenteric lymph nodes, or ascites. Assessment of bones by radiography may also reveal areas of bony lysis and sclerosis, osteoarthritis, discospondylitis, or periosteitis.
Perforation of the excluded segment without pneumoperitoneum following Roux-en-Y gastric bypass surgery: case report and literature review
Published in Acta Chirurgica Belgica, 2021
Maxime Peetermans, Jana Vellemans, Guido Jutten, Pieter D’hooge, Peter Delvaux, Frederik Huysentruyt, Anneleen Van Hootegem, Jos Callens, Olivier Peetermans
While abdominal radiography disclosed no abnormalities, abdominal computed tomography (CT) revealed a small amount of free fluid in the right upper quadrant and Douglas’ pouch (Figure 1(A)). Due to an unclear diagnosis, she was hospitalised for observation. Despite analgesics and supportive care, her pain continued to aggravate and she started having breathing difficulties the next morning. She had an oxygen saturation of 90% (normal range: 95–100%), requiring supplementary oxygen. Laboratory tests were repeated and showed an increased C-reactive protein (212.6 mg/L, normal range: <5.0 mg/L), decreased platelets (147 × 103/μL, normal range: 173–390 × 103/μL) and a further decrease in haemoglobin (9.9 g/dL, normal range: 11.9–14.6 g/dL). An arterial blood gas established a discrete metabolic acidosis and hypoxemia: pH = 7.34 (normal range: 7.35–7.45), pCO2 = 38.6 mmHg (normal range: 35–45 mmHg), bicarbonate = 20.5 mmol/L (normal range: 22–28 mmol/L), base excess = −4.7 mmol/L (normal range: −3 to 3) and pO2 = 55.8 mmHg (normal range: 70–98 mmHg). Subsequently, prior to perform an explorative laparoscopy under general anaesthesia, a CT thorax with contrast was performed which revealed no evidence of pulmonary embolism. There were some atypical infiltrates and pleural reactions at both lower lobes visible. Upper CT sections of the abdomen showed an increased amount of free fluid in the upper abdomen (Figure 1(B)) compared with the previous abdominal CT. A second abdominal radiography remained normal.
Comparison of low dose and standard dose abdominal CT scan in body stuffers
Published in Clinical Toxicology, 2018
Hooman Bahrami-Motlagh, Zahra Mahboubi-Fooladi, Babak Salevatipour, Hossein Hassanian-Moghaddam, Seyyed Hadi Mirhashemi
Diagnostic imaging has a key role in identifying ingested packages. Acceptability of plain abdominal radiography as a screening tool for suspected body packers is due to its simplicity, low cost and radiation dose [8]. However, conventional x-ray is an unhelpful investigation for body stuffers with significant false negative results because of limited contrast resolution, small number and size of pellets [3,5]. Ultrasound has low specificity for body packers [9] and its usefulness in body stuffers is unclear. Therefore, imaging diagnosis mostly relies on CT examination as a fast and relatively accurate diagnostic tool. It should be performed without contrast agents [10]. Scout CT view can be used as a substitute for plain X-ray [5] and packet detection rate is improved by reviewing in lung window setting, in addition to the usual window for abdomen [11]. Although high resolution CT scan has false negative results too [12,13], it has remained the best available imaging modality, considering the unreliable history presented by body stuffers [4,5,10].
Radiation-free flexible ureteroscopy for kidney stone treatment
Published in Arab Journal of Urology, 2019
Braulio O. Manzo, Edgard Lozada, Gildardo Manzo, Héctor M. Sánchez, Francisco Gomez, Alejandro Figueroa, Adrian Gonzalez
All patients diagnosed with renal stones are subjected to multiple diagnostic and therapeutic procedures (tomography, excretory urography, plain abdominal radiography, pyelography, and fluoroscopy) involving a cumulative large radiation load. Moreover, endourologists and urologists dedicated mainly to urolithiasis treatment, have significant exposure to the deleterious effects of radiation in their working life. Therefore, we believe it is essential, as a best practice, to avoid or to reduce to a minimum as much as possible the use of fluoroscopy during fURS for the kidney stones treatment.