Understanding Imaging of Gastric and Intestinal Surgery

Transcription

1 Understanding Imaging of Gastric and Intestinal Surgery Poster No.: C-2605 Congress: ECR 2013 Type: Educational Exhibit Authors: R. E. Ochoa Albíztegui, S. E. Vazquez ; Mexico, D.F./MX, Mexico, DF/MX Keywords: Education and training, Surgery, Complications, Fluoroscopy, CT, Gastrointestinal tract DOI: /ecr2013/C-2605 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 21

2 Learning objectives To review and illustrate the common surgical procedures of gastrointestinal tract. To identify in Computed Tomography and/or Fluoroscopy the surgical procedures reviewed. To know their indications, localization (stomach, small intestine or colon) and recognize possible complications. Background There is a wide variety of surgical procedures in gastrointestinal tract. Because of the increasing number of imaging studies being performed, it is very common to find variations of normal gastrointestinal tract anatomy, many of them, related to previous surgical procedures. Patients are frequently not familiarized with the surgical procedure that they have undergone. The Radiologist may be asked to demonstrate complications in early postoperative period or to define anatomy and detect disease years later, even of old surgical procedures that were preformed over the past several decades, some of which may no longer be commonly used. These findings can be assessed in Computed Tomography and Fluoroscopy Imaging. Imaging findings OR Procedure details Post-Surgery normal findings of surgical procedures such as Billroth 1, Billroth 2, Roux en-y, Whipple, Gastric Bypass, Gastric Sleeve, Hartmann's Procedure, Fundoplication, Ostomies (Gastrostomy, Ileostomy, Colonostomy), end-to-end, side-to-end, or side-toside surgical procedures are assessed in Computed Tomography and Fluoroscopy. Indications - When are these surgical procedures indicated? Localization - Stomach, Small Intestine orcolon Complication Findings - Hemorrhage, Perforation, Obstruction or Malignancy Page 2 of 21

3 In this review, it will be shown how to recognize them and evaluate their localization and know their complications. Images for this section: Fig. 1: Illustration taken from Schwartz, et al. Schwartz's Principles of Surgery. United States of America: The McGraw-Hill Companies, Inc, ISBN Page 3 of 21

4 Fig. 2: Illustration taken from reference (5). Page 4 of 21

5 Fig. 3: Illustration taken from Schwartz, et al. Schwartz's Principles of Surgery. United States of America: The McGraw-Hill Companies, Inc, ISBN Page 5 of 21

6 Fig. 4 Page 6 of 21

7 Fig. 5 Page 7 of 21

8 Fig. 6: Illustration taken from reference (8). Page 8 of 21

9 Fig. 7 Page 9 of 21

10 Fig. 8: Illustration taken from reference (12). Page 10 of 21

11 Fig. 9 Page 11 of 21

12 Fig. 10: Illustration taken from Schwartz, et al. Schwartz's Principles of Surgery. United States of America: The McGraw-Hill Companies, Inc, ISBN Page 12 of 21

13 Fig. 11: Illustration taken from reference (10). Page 13 of 21

14 Fig. 12: Illustration taken from reference (10). Page 14 of 21

15 Fig. 13 Page 15 of 21

16 Fig. 14: Illustration taken from reference (15, 16). Page 16 of 21

17 Fig. 17: Illustration Taken from Schwartz, et al. Schwartz's Principles of Surgery. United States of America: The McGraw-Hill Companies, Inc, ISBN Page 17 of 21

18 Fig. 16: Illustration Taken from Schwartz, et al. Schwartz's Principles of Surgery. United States of America: The McGraw-Hill Companies, Inc, ISBN Page 18 of 21

19 Fig. 15: Illustration Taken from Schwartz, et al. Schwartz's Principles of Surgery. United States of America: The McGraw-Hill Companies, Inc, ISBN Page 19 of 21

20 Conclusion Understanding the anatomic modifications after a surgical procedure is simpler when radiologists are familiar with surgical techniques. Complications such as hemorrhage, perforation, obstruction or malignancy will be identified sooner. Patients who have undergone gastrointestinal surgery present challenging problems for posterior imaging studies and surgical interventions to their physicians. Radiologic studies aid in following and complications of these patients. References 1. Schwartz, et al. Schwartz's Principles of Surgery. United States of America : The McGraw-Hill Companies, Inc, ISBN Evaluation of the Postoperative Stomach and Duodenum. Claire Smith, Daniel J. Deziel, Robert A. Kubicka. 1994, Radiographics, págs. 14: Whipple's operation, The American Heritage Medical Dictionary. [En línea] [Citado el: 10 de 01 de 2013.] +operation. 4. Billroth I operation, McGraw-Hill Concise Dictionary of Modern Medicine. The Free Dictionary. [En línea] [Citado el: 20 de 01 de 2013.] 5. [En línea] [Citado el: 22 de 01 de 2013.] 6. gastrojejunostomy, Mosby's Medical Dictionary 8th edition. The Free Dictionary. [En línea] [Citado el: 19 de 01 de 2013.] 7. Roux-en-Y, Mosby's Medical Dictionary, 8th edition. The Free Dictionary. [En línea] [Citado el: 23 de 01 de 2013.] Roux-en-y. 8. Port Huron Hospital. [En línea] [Citado el: 24 de 01 de 2013.] Sleeve gastrectomy, TheFreeDictionary.com. [En línea] [Citado el: 28 de 01 de 2013.] Page 20 of 21

21 10. [En línea] [Citado el: 10 de 01 de 2013.] allpages/g-treatmentsprognosis/crukmig_1000img jpg. 11. Hartmann's operation, TheFreeDictionary.com. The Free Dictionary. [En línea] [Citado el: 29 de 01 de 2013.] +operation. 12. WeightLoss Solutions Australia. [En línea] [Citado el: 22 de 01 de 2013.] Gray, James P. The Free Dictionary. [En línea] [Citado el: 9 de 01 de 2013.] %2F&name=NISSEN_FUNDOPLICATION.jpg. 14. fundoplication, TheFreeDictionary.com. [En línea] [Citado el: 27 de 01 de 2013.] Mahnke, Daus. Aurora Health Care. Nucleus Medical Media, Inc. [En línea] 09 de 11 de [Citado el: 27 de 01 de 2013.] healthgate/getcontent.asp?urlhealthgate=% html% The University of California, San Francisco, CA. [En línea] [Citado el: 14 de 01 de 2013.] Personal Information nochoa85@gmail.com Page 21 of 21