Diverticulitis x ray: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
On [[abdominal]] x ray, diverticulitis is characterized by multiple air and fluid levels if there is an [[intestinal perforation]]. The chest x-ray is important to be done in patients with diverticulitis to investigate for the [[pneumoperitoneum]]; which is a harbinger to a critical [[illness]] and will lead to change in the management plan in the case. X ray can be used in case the CT scan is not available and in uncomplicated cases. | |||
==X Ray== | ==X Ray== | ||
| Line 16: | Line 16: | ||
**It may cause acute [[intestinal obstruction]]. | **It may cause acute [[intestinal obstruction]]. | ||
*The radiological findings in the abdominal x ray include the following: | *The radiological findings in the abdominal x ray include the following: | ||
**It shows intestinal obstruction | **It shows [[intestinal obstruction]]. | ||
**Multiple air-fluid levels in case [[perforation]] occur. | **Multiple air-fluid levels in case [[perforation]] occur. | ||
[[Image:866011f1abdb744127ddd20d04acff jumbo.jpeg|centre|500px]] | [[Image:866011f1abdb744127ddd20d04acff jumbo.jpeg|centre|500px]] | ||
| Line 22: | Line 22: | ||
*The single contrast technique may be preferred over the double contrast technique in the following cases: | *The single contrast technique may be preferred over the double contrast technique in the following cases: | ||
**The patient is unable to turn quickly/effectively | **The patient is unable to turn quickly/effectively. | ||
**Double contrast technique requires rapid changes in patient position | **Double contrast technique requires rapid changes in patient position. | ||
**When only the position and length of a structure is required | **When only the position and length of a structure is required. | ||
**Evaluation for acute diverticulitis when the CT is unavailable for whatever reason | **Evaluation for acute diverticulitis when the CT is unavailable for whatever reason. | ||
**Evaluating for a colonic [[fistula]] | **Evaluating for a colonic [[fistula]]. | ||
**Evaluation for postoperative leak after colon surgery | **Evaluation for postoperative leak after colon surgery. | ||
*Contraindications of the barium enema include the following:<ref name="pmid7122864">{{cite journal| author=Harned RK, Consigny PM, Cooper NB, Williams SM, Woltjen AJ| title=Barium enema examination following biopsy of the rectum or colon. | journal=Radiology | year= 1982 | volume= 145 | issue= 1 | pages= 11-6 | pmid=7122864 | doi=10.1148/radiology.145.1.7122864 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7122864 }} </ref> | *Contraindications of the barium enema include the following:<ref name="pmid7122864">{{cite journal| author=Harned RK, Consigny PM, Cooper NB, Williams SM, Woltjen AJ| title=Barium enema examination following biopsy of the rectum or colon. | journal=Radiology | year= 1982 | volume= 145 | issue= 1 | pages= 11-6 | pmid=7122864 | doi=10.1148/radiology.145.1.7122864 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7122864 }} </ref> | ||
| Line 36: | Line 36: | ||
===Chest X ray=== | ===Chest X ray=== | ||
*In small percentage (about 27-33%) of the [[acute abdomen]] patients, including diverticulitis, they may have a respiratory abnormality. Hence, chest x ray is recommended in patients suspected with diverticulitis. | *In a small percentage (about 27-33%) of the [[acute abdomen]] patients, including diverticulitis, they may have a [[respiratory]] abnormality. Hence, chest x ray is recommended in patients suspected with diverticulitis. | ||
*Chest X ray in cases of diverticulitis could show [[pneumoperitoneum]] which is a gas within the [[peritoneal cavity]] | *Chest X ray in cases of diverticulitis could show [[pneumoperitoneum]] which is a gas within the [[peritoneal cavity]] and is often the harbinger of a critical [[illness]]. Discovering this abnormality will lead to change in the case management and the chest X ray is the best radiological-modality which can show the [[pneumoperitoneum]].<ref name="pmid3924315">{{cite journal| author=Field S, Guy PJ, Upsdell SM, Scourfield AE| title=The erect abdominal radiograph in the acute abdomen: should its routine use be abandoned? | journal=Br Med J (Clin Res Ed) | year= 1985 | volume= 290 | issue= 6486 | pages= 1934-6 | pmid=3924315 | doi= | pmc=1416036 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3924315 }} </ref> | ||
[[Image:Pneumoperitoneum-1.jpg|centre|500px]] | [[Image:Pneumoperitoneum-1.jpg|centre|500px]] | ||
Revision as of 19:04, 31 July 2017
|
Diverticulitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Diverticulitis x ray On the Web |
|
American Roentgen Ray Society Images of Diverticulitis x ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
On abdominal x ray, diverticulitis is characterized by multiple air and fluid levels if there is an intestinal perforation. The chest x-ray is important to be done in patients with diverticulitis to investigate for the pneumoperitoneum; which is a harbinger to a critical illness and will lead to change in the management plan in the case. X ray can be used in case the CT scan is not available and in uncomplicated cases.
X Ray
Abdominal X ray
Barium enema
- X-ray barium enema is not the first diagnostic procedure to diagnose acute diverticulitis. However, it may be useful in case the CT scan is not available.[1][2][3][4]
- Barium enema was being used in the diagnosis of acute diverticulitis but it was not the best procedure to diagnose the disease. Enema has many disadvantages which include:[5]
- Enema rupture
- This rupture may cause cellulitis and peritonitis.
- If failed, it will lead to the delay of the other imaging procedures like CT scan, endoscopy and angiography to be held.
- It may cause acute intestinal obstruction.
- The radiological findings in the abdominal x ray include the following:
- It shows intestinal obstruction.
- Multiple air-fluid levels in case perforation occur.
- The single contrast technique may be preferred over the double contrast technique in the following cases:
- The patient is unable to turn quickly/effectively.
- Double contrast technique requires rapid changes in patient position.
- When only the position and length of a structure is required.
- Evaluation for acute diverticulitis when the CT is unavailable for whatever reason.
- Evaluating for a colonic fistula.
- Evaluation for postoperative leak after colon surgery.
- Contraindications of the barium enema include the following:[6]
- Patients with pneumoperitoneum shown in the chest X ray.
- Patients who did a recent deep rectal biopsy.
Chest X ray
- In a small percentage (about 27-33%) of the acute abdomen patients, including diverticulitis, they may have a respiratory abnormality. Hence, chest x ray is recommended in patients suspected with diverticulitis.
- Chest X ray in cases of diverticulitis could show pneumoperitoneum which is a gas within the peritoneal cavity and is often the harbinger of a critical illness. Discovering this abnormality will lead to change in the case management and the chest X ray is the best radiological-modality which can show the pneumoperitoneum.[7]
References
- ↑ Rafferty J, Shellito P, Hyman NH, Buie WD, Standards Committee of American Society of Colon and Rectal Surgeons (2006). "Practice parameters for sigmoid diverticulitis". Dis Colon Rectum. 49 (7): 939–44. doi:10.1007/s10350-006-0578-2. PMID 16741596.
- ↑ Doris PE, Strauss RW (1985). "The expanded role of the barium enema in the evaluation of patients presenting with acute abdominal pain". J Emerg Med. 3 (2): 93–100. PMID 4093571.
- ↑ McKee RF, Deignan RW, Krukowski ZH (1993). "Radiological investigation in acute diverticulitis". Br J Surg. 80 (5): 560–5. PMID 8518890.
- ↑ Hayward MW, Hayward C, Ennis WP, Roberts CJ (1984). "A pilot evaluation of radiography of the acute abdomen". Clin Radiol. 35 (4): 289–91. PMID 6734062.
- ↑ Gottesman L, Zevon SJ, Brabbee GW, Dailey T, Wichern WA (1984). "The use of water-soluble contrast enemas in the diagnosis of acute lower left quadrant peritonitis". Dis Colon Rectum. 27 (2): 84–8. PMID 6697835.
- ↑ Harned RK, Consigny PM, Cooper NB, Williams SM, Woltjen AJ (1982). "Barium enema examination following biopsy of the rectum or colon". Radiology. 145 (1): 11–6. doi:10.1148/radiology.145.1.7122864. PMID 7122864.
- ↑ Field S, Guy PJ, Upsdell SM, Scourfield AE (1985). "The erect abdominal radiograph in the acute abdomen: should its routine use be abandoned?". Br Med J (Clin Res Ed). 290 (6486): 1934–6. PMC 1416036. PMID 3924315.