IMAGENOLOGIA EN URGENCIAS ABDOMINALES.

Dr. Gerardo Sela Bayardo.

Generalidades

Radiology assistent

3

Ileo mecanico vs ileo adinamico

4

Neumoperitoneo y seudoneumo

Gas intestinal

Extraintestinal Neumoperitoneo

Intraintestinal Normal Aumentado

Generalizado localizado

Disminuido Abdomen vacio Preparacion Oclusion alta Trombosis mesenterica

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Obstruccion alta

7

Hernias diafragmaticas

Invaginacion

9

Volvulus

10

Perforacion de viscera hueca

Absceso hepatico

12

13

Patologia Vesicular

Vias biliares

14

15

Ascitis

Diverticulitis

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Enfermedad diverticular

Pancreatitis

Toracicos Derrame

Atelectasia

Elevacion diafragmatica

Abdominales. Abdomen vacio

Distencion gastrocolica

Ileo adinamico

Esqueleticos Infartos oseos

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Pancreatitis

Mayerle J et al. (2005) Current management of acute pancreatitisNat Clin Pract Gastroenterol Hepatol 2: 473–483 doi:10.1038/ncpgasthep0293

Figure 1 Axial contrast-enhanced CT scans of acute pancreatitis

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Apendicitis

Leonid Rogozov

Apendicitis epiploica

Inflamacionautolimitada

Fem, 20-50, obesas

Indistinguible otros

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Uropatia obstructiva

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Asbceso perirrenal

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Absceso psoas

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Escroto agudo

28

Embarazo ectopico

Bezoar

AA

31

Approximately…

FAST can detect between 100-250ml

0.5 cm in Morison's Pouch = 500ml

1 cm in Morison's Pouch = 1000ml

CT can detect volumes of free fluid as low as 100ml

Extended FAST (eFAST)

Evaluation of pneumo and hemothorax in addition to intraperitoneal injuries.

Hemothorax Ultrasound is much more

sensitive for detecting pleural fluid and can identify as little as 20mL in the pleural space

Pneumothorax Using ultrasound to

evaluate for a pneumothorax is a relatively new concept but it is easy to learn

Referencias TEXTBOOK OF RADIOLOGY AND IMAGING by DAVID SUTTON

Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging, 4th ed.

Imaging of Renal Trauma - RadioGraphics 2001; 21:557–574

Urethral Injuries after Pelvic Trauma - RadioGraphics 2008; 28:1631–1643

http://www.radiologyassistant.nl/en/466181ff61073

American College of Radiology - ACR Appropriateness Criteria

CT of the Acute Abdomen - Patrice Taourel

http://www.sonoguide.com/FAST.html