Gastrointestinal Imaging Diagnosis

Update on Gastrointestinal Imaging

Appendicitis:
CT is best for diagnosis of appendicitis, particularly when performed with oral contrast to differentiate distal ileum from inflamed appendix and IV contrast  to increase the conspicuity of inflamed hyperemic tissue.  One limitation is that in patients with little intraabdominal fat, the appendix may be difficult to identify due to the immediate proximity of adjacent loops of bowel.  Despite this, we are able to definitively identify the normal or abnormal appendix and differentiate it from adjacent small bowel loops in the vast majority of patients.

New diagnostic techniques:
Along with more long-standing methods of fluoroscopic barium exams, CT, ultrasonography, and nuclear medicine, relatively recent developments include MRCP and Virtual Colonoscopy (CT Colonography).

Terminology in ordering Barium studies:

    Barium Swallow = Esophagram
        Exam includes a focused study of the esophagus, often with the use of upright
        and prone positioning, a barium tablet, and dual-contrast technique.

    Upper GI Series (UGI)
        Study includes esophagus, stomach, and duodenum

    Small Bowel Series
        Study of the small bowel using single contrast technique

    Upper GI and Small Bowel Follow Through
        Study includes esophagus, stomach, duodenum, and remainder of small bowel.