Peptic ulcer X ray: Difference between revisions
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Peptic ulcer Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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2017 ACG Guidelines for Peptic Ulcer Disease |
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Guidelines for the Indications to Test for, and to Treat, H. pylori Infection |
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Guidlines for factors that predict the successful eradication when treating H. pylori infection |
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Guidelines to document H. pylori antimicrobial resistance in the North America |
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Guidelines for evaluation and testing of H. pylori antibiotic resistance |
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Guidelines for when to test for treatment success after H. pylori eradication therapy |
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Guidelines for penicillin allergy in patients with H. pylori infection |
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Peptic ulcer X ray On the Web |
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American Roentgen Ray Society Images of Peptic ulcer X ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
If a peptic ulcer perforates, air will leak from the inside of the gastrointestinal tract (which always contains some air) to the peritoneal cavity (which normally never contains air). This leads to "free gas" within the peritoneal cavity. If the patient stands erect, as when having a chest X-ray, the gas will float to a position underneath the diaphragm. Therefore, gas in the peritoneal cavity, shown on an erect chest X-ray or supine lateral abdominal X-ray, is an omen of perforated peptic ulcer disease.
X Ray
There are no abdominal x-ray findings associated with peptic ulcer disease. However, an x-ray may be helpful in the diagnosing the complications of underlying disease. Findings of abdominal X-ray in perforated peptic ulcer include free air under the diaphragm called as pneumoperitoneum.[1][2]
Barium swallow
Various findings can be seen in barium swallow: The pocket of barium filling the ulcer crater round and linear
- Postbulbar ulcers should raise the possibility of Zollinger-Ellison syndrome especially if ulcers are multiple and gastric folds are thickened
- The oedematous collar of swollen mucosa (to be distinguished from the rolled edges of a malignant ulcer) radiating folds of mucosa away from the ulcer
Distinguish features between benign and malignant ulcer
Barium swallow helps to distinguish between benign and malignant ulcer
| Barium swallow
findings | |
|---|---|
| benign ulcer | malignant ulcer |
| Smooth rounded and deep ulcer crater | Irregular and shallow ulcer crater |
| Smooth ulcer mound | Nodular and angular ulcer mound |
| Smooth folds that reach the margin of the ulcer | Nodular gastric folds that do not reach the ulcer margin |
| Hampton's line[3] | Carman meniscus sign |
The filling defect that surrounds the ulcer, as a result of edema, is smooth and symmetrical and merges with the healthy mucosa. The mucosal folds radiate to the edge of the ulcer
References
- ↑ {{cite journal |vauthors=Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA |title=Perforated peptic ulcer |journal=Lancet |volume=386 |issue=10000 |pages=1288–1298 |year=2015 |pmid=26460663 |pmc=4618390 |doi=10.1016/S0140-6736(15)00276-7 |url
- ↑ Thorsen K, Glomsaker TB, von Meer A, Søreide K, Søreide JA (2011). "Trends in diagnosis and surgical management of patients with perforated peptic ulcer". J. Gastrointest. Surg. 15 (8): 1329–35. doi:10.1007/s11605-011-1482-1. PMC 3145078. PMID 21567292.
- ↑ Nawaz M, Jehanzaib M, Khan K, Zari M (2008). "Role of barium meal examination in diagnosis of peptic ulcer". J Ayub Med Coll Abbottabad. 20 (4): 59–61. PMID 19999206.