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Radiology
Gastrointestinal Interventions
Built from Fundamentals of Diagnostic Radiology
What’s inside
5 sections · 110 slides
Overview
- Scope of gastrointestinal interventions
- Imaging tools in these procedures
Mesenteric Angiography and Intervention
Arterial anatomy, GI hemorrhage, ischemia, aneurysms, and trauma
- Arterial supply of the gut
- Mesenteric arterial supply
- Celiac artery and its branches
- Splenic and left gastric branches
- Celiac axis anatomy
- Superior mesenteric artery and its branches
- Right-sided branches of the SMA
- Superior mesenteric artery anatomy
- Inferior mesenteric artery and its branches
- Inferior mesenteric artery anatomy
- Collateral connections between mesenteric arteries
- Anastomotic connections of the mesenteric vasculature
- Common arterial variants
- Workup of GI bleeding
- Upper versus lower GI bleeding
- Detection thresholds for GI bleeding
- Upper GI bleeding: incidence and presentation
- Common causes of upper gastrointestinal hemorrhage
- Treatment of upper GI bleeding
- Angiographic signs of bleeding
- Gastroduodenal artery pseudoaneurysm embolization
- Embolization in the upper GI tract
- Prophylactic left gastric artery embolization
- Retrograde filling after embolization
- Gastroduodenal artery embolization and retrograde filling
- >90%
- Transpapillary hemorrhage
- Aortoenteric fistula
- Lower GI bleeding: incidence and presentation
- Causes of lower GI bleeding
- Indications for intervention in lower GI bleeding
- Imaging of lower GI bleeding
- Embolization for lower GI bleeding
- Ileocolic artery extravasation and coil embolization
- Angiographic appearance of angiodysplasia
- Angiodysplasia of the right colon
- Small bowel bleeding
- Overview of mesenteric ischemia
- Causes of acute mesenteric ischemia
- Presentation of acute mesenteric ischemia
- Arterial embolism versus thrombosis
- Treatment of acute mesenteric ischemia
- Nonocclusive mesenteric ischemia (NOMI)
- Chronic mesenteric ischemia
- Mesenteric artery stenosis treated with stenting
- Overview of mesenteric aneurysms
- Distribution of visceral arterial aneurysms
- Management of mesenteric aneurysms
- Mesenteric trauma findings
- Splenic pseudoaneurysm embolization after trauma
- Embolization after trauma
Biliary Interventions
Percutaneous biliary drainage and cholecystostomy
- Indications for percutaneous biliary drainage
- Examples of causes of biliary obstruction
- Presentation of biliary obstruction
- Symptoms of biliary obstruction
- Selecting percutaneous biliary drainage
- Right- versus left-sided access
- Crossing the biliary obstruction
- Two types of biliary drain
- Percutaneous biliary drainage access
- Biliary stents for malignant obstruction
- Metallic stents for internal biliary drainage
- Complications of biliary drainage
- Complications of biliary drainage
- Benign strictures and bile leaks
- Biliary drainage for suspected bile leak after liver transplant
- Indications for percutaneous cholecystostomy
- Preparation for cholecystostomy
- Gallbladder access routes
- Complications of percutaneous cholecystostomy
- Two techniques for catheter placement
- Gallbladder access under ultrasound guidance
- Catheter care and removal
- Cholecystostomy drain cholangiogram
Percutaneous Abscess Drainage
Draining abdominal and pelvic collections
- Overview of abscess drainage
- Contraindications to drainage
- Route and imaging selection
- US versus CT for percutaneous abscess drainage
- Two catheter placement techniques
- Drain size and method
- Abscess access with ultrasound guidance
- Perirenal collection drainage in a renal transplant
- Special routes for deep pelvic collections
- Transgluteal drainage of a deep pelvic abscess
- Transrectal drainage of a deep pelvic abscess in pregnancy
- Subphrenic collections
- Complications and follow-up
Enteric Access
Gastrostomy and gastrojejunostomy tube placement
- Indications for gastrostomy tube placement
- Contraindications to percutaneous gastrostomy tube placement
- Preparation for gastrostomy
- Push versus pull gastrostomy
- Push method steps
- Gastrostomy placement with T-fasteners
- Pull method steps
- Gastrostomy tube placement by pull method
- Gastrostomy complications
- Gastrojejunostomy tube placement
- Conversion of gastrostomy to gastrojejunostomy
- Conversion of gastrostomy to gastrojejunostomy
- Key takeaways
- References
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- References (continued)
- Brant and Helms' Fundamentals of Diagnostic Radiology