Al-Hakim Ramsey

Preliminary Diagnosis: Cholelithiasis I. What imaging technique is first-line for this diagnosis? Transabdominal right upper quadrant ultrasound. Ideally, patient is NPO for 8 hours to distend the gallbaldder and optimize imaging of the gallbladder wall and contents. II. Describe the advantages and disadvantages of this technique for diagnosis of cholelithiasis. Advantages Very high sensitivity and…

Preliminary Diagnosis: Hydronephrosis I. What imaging technique is first-line for this diagnosis Renal ultrasound with Doppler II. Describe the advantages and disadvantages of this technique for diagnosis of hydronephrosis. Advantages Ultrasound is safe, cheap, and fast. Early in obstruction prior to collecting system dilatation, Doppler may show increased renal vascular resistance from obstruction compared to…

Preliminary Diagnosis: Volvulus I. What imaging technique is first-line for this diagnosis? CT abdomen/pelvis with IV and PO contrast with multiplanar reconstructions. A volvulus is best demonstrated when the imaging axis is perpendicular to the axis of rotation, and therefore multiplanar reconstructions increases the sensitivity of volvulus detection. If a complete or high grade obstruction…

Preliminary Diagnosis: Small Bowel Obstruction I. What imaging technique is first-line for this diagnosis? CT with IV and PO contrast. If a complete or high-grade obstruction is suspected, then PO contrast should not be given. II. Describe the advantages and disadvantages of this technique for diagnosing small bowel obstruction. Advantages High sensitivity and specificity for…

Preliminary Diagnosis: Large Bowel Obstruction I. What imaging technique is first-line for this diagnosis CT with IV and PO contrast II. Describe the advantages and disadvantages of this technique for diagnosis of large bowel obstruction. Advantages High sensitivity and specificity for large bowel obstruction Identifies transition point of obstruction Identifies degree of obstruction (low grade,…

Preliminary Diagnosis: Choledocholithiasis I. What imaging technique is first-line for this diagnosis? Transabdominal right upper quadrant ultrasound. Ideally, patient is NPO for 8 hours to empty the duodenum/stomach and optimize visualization of the distal common bile duct. II. Describe the advantages and disadvantages of this technique for diagnosis of choledocholithiasis. Advantages Ultrasound is safe, fast,…