Role of radiology and imaging in the daignosis of ... - Orion Group

Review Articleconcave defect in the head of the contrastcolumn. Sometimes contrast medium maypass beyond this, causing the well knowncoiled spring appearance.obstruction, the radiographic appearance maybe identical to those of a paralytic ileus.Paralytic ileus causes when intestinalperistalsis ceases and as a result fluid and gasaccumulates in the dilated bowel. It isfrequently found in cases of peritonitis and inthe post operative cases. Along with theradiological findings, history and clinicalsigns are helpful in differentiating betweenlarge bowel obstruction & paralytic ileus.Fig. no.10 (b)(iii) Large bowel obstruction:Usual causes are thea) Carcinoma -60% is situated in the sigmoidcolonb) Diverticular disease c)Volvulus of thecolon.Key to the radiological appearance of thelarge bowel obstructiondepends on the state of the competence of theIleocaecal valve. The obstructed coloninvariably contains large amounts of air andcan usually be identified by its location andby the presenc of haustral markings.When both small and large bowel dilatationare present in a case of large bowelThe ORION Vol. 9, May 2001Fig. no.10 (c)Fig. no.11. Shows hugelydilated large gut. Its a caseof sigmoid volvulus. Ahaustral loop of sigmoid isseen rising out the pelvis inthe shape of an inverted 'U'Dilated haustral colons arepresent on the two sides ofthe volvulus.Fig.no.12--Th/s filmshowsgeneralised dilatatlon of both small andlarge bowel and its acase of paralytic ileus.Acute pacreatitis: Clinical diagnosis may bedifficult in the initial stage .Other acuteabdominal conditions such as perforation,acute cholecystitis, acute peptic ulcer have tobe included in the differential diagnosis. Alarge number of radiological signs have beendescribed, most of them are non-specific.USGand CT are the diagnostic modality.Fig. no. 13- -Shows the transverse scan ofnormal pancreas and its duct.The normal pancreas has about the sameechogenecity as that of liver but itsechogenecity increase with age. When wescan the pancreas we usually identify thefollowing anatomical landmarks:1.Aorta2. Superior mesenteric artery3. Superior mesenteric vein4. Liver etc.Average diameter of the head of the pancreasis 2.8 cm. body 2 cm and tail 2.5cm, ductdiameter less than 2mm.In acute pancreatitis pancreas is diffuselyenlarged and oedematous which ishypoechogenic in comparison with the liverparenchyma. Diffusely enlarged irregularlyhypoechogenic pancreas may also seen inwww.orion-group.net/journals