بسم الله الرحمن الرحيم

يشأ من و يضلله الله يشأ منمستقيم صراط على يجعله

صدق الله العظيم

ByDr.Samar Shehata

lecturer of radiodiagnosis

Corkscrew esophagus Esophagitis and Barrett’s

esophegus Stricture:Malignant,corrosive,achale

sia Varices TOF Esophageal neoplasm Hernia

Tertiary esophageal waves Non-propulsive Corkscrew or beaded appearance

Barium swallow double contrast shows

Thickened mucosal folds(more than 3)

Multiple ulcers stricture Hiatus hernia

with reflux esophagitis

Barium swallow single contrast shows irregular stricture of the lower esophagus with more than 3 thickened mucosal fold

Diffuse mucosal nodularity & ulceration

Barium swallow single contrast shows Smooth, tapered distal esophagus with obstruction level below the diaphragm and proximal dilatation

Barium swallow double contrast shows multiple sausage shaped Serpiginous filling defects

Barium swallow double contrast shows short segment stricture with mucosal irregularity and shouldering in the thoracic esophagus

Smooth submucosal mass

Barium meal double contrast shows wide GE junction which seen above the diaphragm

Sliding hiatal hernia

Barium meal shows normal GE junction and herniated gastric fundus above the diaphragm

Ulcers Tumors others

Barium meal double contrast shows localizes collection of barium in ulcer crater with smooth thickened mucosal folds reaching ulcer edge

Barium meal single contrast shows localizes collection of barium centerally with surrounding edema in the 1st part of duodenum

Round filling defect with surface ulceration

Barium meal single contrast shows focal constricting lesion involving gastric outlet with mucosal destruction >> Malignant stricture

-Barium meal and follow through single contrast shows tumor invasion of the

gastric wall - diffuse irregular narrowing and rigidity of the stomach

Air filled fundus

Barium filled antrum

Duodenal bulb

Narrowed pyloric channel

Barium meal single contrast shows Narrowed pyloric channel With distended stomach no mucosal destruction >>CHPS)

Mesentroaxial gastric volvulusOrganoaxial gastric volvulus

X-ray radiography of abd A_P erect view>>>free gas under the diaphragm>>>Pneumoperitoneum(DD: Rupture vesicus, perforated ulcer, post operative )

Perforated viscus

Corkscrew appaearance

Large bowel Small Bowel•Peripheral ( diameter 8 cm max)•Presence of haustration

•Central ( diameter 5 cm max)•Vulvulae coniventae•Ileum: may appear tubeless

X-ray of abd. A-p view erect shows dilated small bowel with collapsed colon and multiple air fluid levels >>>Small bowel obstruction ( DD: adhesions, tumor, polyp)

Small bowel obstruction

Volvulus sigmoid

X-ray of abd. A-p view erect shows dilated large bowel with loss of haustra and inverted U shap and triple midline sign >>>large bowel obstruction sigmoid volvulus)

Volvulus sigmoid

Ace spade appearance

X-ray of abd. A-p view erect shows distended abdomen with dilated small and large bowels>>>Paralytic ileus (Postoperative)

Paralytic ileus

Barium enema single contrast show irregular stricture with shouldering (Core apple appearance)

Loss of haustration of pipe stem appaearnce

Barium Enema, Double ContrastBarium Enema, Double ContrastLoss of Haustrations

LEAD PIPE SIGN

Terminal Ilium

Cecum

Ulcerative Colitis (Pancolitis)

barium meal double contrast shows multiple filling defects involving transeverse and descening colling with loss of hausra and smooth wall of the deascending colon

Barium enema double contrast shows Narrowed distil ileum(string sign) due to chronic inflammation is typical for Crohn’s disease.

normal

Barium enema (single /double cntrast)Multiple round or oval outpouchings of barium projecting beyond the lumen>>>Diverticulosis(LT colon/LT and transverse colon)

. Criss-crossing ridges of thickened circular muscle (sawtooth configuration) (arrow

DIVERTICULITIS with cancer sigmoid

Barium enema double contrast show Annular constriction with shouldering and multiple out pouching of the descending and sigmoid colon

COLON POLYP

barium meal double contrast Polyp on wall without stalk is coated and outlined by barium >>>SESSILE POLYP

PEDUNCULATED POLYP

stalk on polyp--pedunculated

barium meal double contrast Polyp on wall with stalk is coated and outlined by barium

Barium enema single contrast show smooth narrowing of the distal sigmoid with proximal dilatation and narrow zone of transition

X-ray of abd inverto grame (coin test) gas collumen seen extended below /above the pubo-coccygeal line >>Imperforate anus(low/high)

costal cartilage phlebolithCalcifiied mesentric LN

DD of calcification

X-ray of abd A-p view shows multiple radio opaque shadows at the Rt hypochondrium)

ERCP

multiple filling defects in the GB and cystic duct with no intrahepatic billiary radicle dilatation

( crecent sign) and proximal dilatation >>Multiple CBD stones

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