New PDF release: Mayo Clinic Gastrointestinal Imaging Review

By C. Daniel Johnson

Supplying 4 instances the quantity of imaging circumstances provided by way of competing texts, this reference stands because the most desirable advisor to universal ailments and radiographic displays came upon in the gastrointestinal tract-authoritatively protecting the total diversity of gastrointestinal ailments to incorporate stipulations affecting the esophagus, belly, duodenum, small bowel, colon, liver, biliary tree, gallbladder, pancreas, spleen, peritoneum, and mesentery.

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The spread of adenocarcinoma resembles that of squamous cell carcinoma, except there is a higher likelihood of involvement of the gastric cardia or fundus. Radiographic features that suggest an adenocarcinoma rather than a squamous carcinoma include distal location, gastric invasion, and evidence for chronic reflux esophagitis. CT can be used to identify mediastinal invasion and subdiaphragmatic extent of tumor. If extensive metastases are identified, the patient often receives radiation therapy rather than surgery.

A. Multiple thin, transverse folds are present in the lower esophagus. B. An exposure taken a few seconds later is normal, without evidence of the previously seen folds. Differential Diagnosis 1. Feline esophagus 2. Transverse folds of chronic reflux esophagitis Diagnosis Feline esophagus Discussion Feline esophagus can be recognized by the presence of multiple transverse folds that are present transiently as the esophagus begins to collapse. The folds are fine and delicate, numerous, and symmetric.

Differential Diagnosis 1. Tertiary contractions 2. Vigorous achalasia Diagnosis Nonspecific motor incoordination, tertiary esophageal contractions Discussion Esophageal contractions can be categorized as three separate types: primary, secondary, or tertiary. Primary esophageal peristalsis is initiated by a swallow and propagates a smooth, continuous contraction the length of the esophagus. Secondary esophageal peristalsis appears fluoroscopically identical to a primary wave, except it is not initiated by a swallow but rather by a bolus within the esophagus or by intraesophageal distention.

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