Basal Cell Carcinoma Dan Ladd, D.O, Rick Lin, D.O., MPH Bill V. Way, D.O.
Rocky Saenz, D.O. Case 21 NOTES - Botsford Radiology · GI HOTSEAT: SAENZ 1 Rocky Saenz, D.O....
Transcript of Rocky Saenz, D.O. Case 21 NOTES - Botsford Radiology · GI HOTSEAT: SAENZ 1 Rocky Saenz, D.O....
2/19/2012
GI HOTSEAT: SAENZ 1
Rocky Saenz, D.O.
GASTROINTESTINALCase 21
Bile leak on ERCP
• Note the contrast pooling in the GB fossa
• Also a PIG is in place– Radiology too the rescue, we were already
draining the Pt.
• All ducts were normal in size, note their size in comparison to the scope.
Case 22
NOTES SAMPLE
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GI HOTSEAT: SAENZ 2
Type I Choledochal Cyst
• DDx:– Exophytic hepatic cyst
– Pancreatic pseudocyst
– Gallbladder OR enteric duplication
• Todani
Case 23
Free barium
• Note that the barium out lines the stomach and the colon– Be suspicious of linear barium
• Ask for cross-sectional to confirm!– See next slide, same pt.
NOTES SAMPLE
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GI HOTSEAT: SAENZ 3
Case 24
Met on Dynamic MR
• Note hepatic capsular retraction– This always means a neoplastic lesion!!!
– Mets or CholangioCA• No ductal dilatation, cholangio is out
Case 25
Omental Infarct
• Key radiographic findings– Focal stranding around clump of fat
• DDx– Epiploic appendagitis
– Omental Infarct
– Pancreatitis
– Fibrosing Sclerosing Mesenteritis
• *90% on R side!
NOTES SAMPLE
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GI HOTSEAT: SAENZ 5
FNH on Eovist (gadoxetate)
• Key radiographic findings– lesion ISO-INTENSE to liver on hepatocyte phase
(20min)• DDx
– FNH– Heptocellular Carcinoma – well differenciated
• Consider telling the examiner to check labs AFP– This avoids unneeded Biopsy
Case 28
AdenoCA Duodenum
• DDx is the same as Case #13– PUD
– Primary Duodenal Neoplasm• Adenocarcinoma
• Lymphoma
• GIST
– Inflammatory
END
NOTES SAMPLE