Abdominal Imaging
The abdominal radiograph
Why do we see any structure on a normal abdominal radiograph?
• It has to be surrounded by tissue of different attenuation (x-ray stopping power).
• we therefore see margins delineated by air (the mucosal surface of air filled bowel)
• Things outlined by fat (usually the kidneys. the psoas margins ,the bladder and the abdominal wall).
We can only see
• gas
• soft tissue (effectively water density)-viscera, bowel and bowel wall, bladder.
• bone and calcium-stones, calcified lymph nodes,stones(90% renal, 10% gallstones)
• Fat
Properitoneal fat
Transversus abdominis
A FEW INTERESTING RADIOGRAPHS
Gas outside the bowel .
Outling both the inside and outside of the bowel.
Free gas
DILATED LARGE BOWEL WITH NO BOWEL WALL THICKENING
Turned out to be a sigmoid tumour.
Gross large bowel wall thickening.
Secondary to ulcerative colitis
Causes of colitis
• Inflammatory bowel disease
• Ischaemic colitis
• Pseudomembranous colitis
• Amoebic,schistosoma etc
Gas outside the bowel .
Outling both the inside and outside of the bowel.
Free gas
Aortic aneurysm
Basic CT Anatomy
mhv
rhv
IVC
anterior
posterior
right left
gb
rk
ra
cl (1)
stomach
anterior
posterior
right left
spleen
pv
ha
anterior
posterior
rightleft
rk
lk
pancreas
svd
cd
Fluid in lesser sac
gallbladder
Renal pelvisRenal artery
Renal vein
uu
anterior
posterior
rightleft
uu
anterior
posterior
Right left
anterior
posterior
rightleft
u u
bladder
nav
Left gastric A
Gastroduodenal A
Common Hepatic A
Splenic A
Pancreaticoduodenal A
Right gastric –small, from proper hepatic or Lt gastric
Image of an aneurysm to discuss suitability