Textbook of Gastrointestinal Radiology, 5e

Front Matter
Copyright
List of Contributors
Preface
Contents
Video Contents
SECTION I: Abdominal Radiography
1 - Abdomen: Normal Anatomy and Examination Techniques
Technique
STANDARD PROJECTIONS
SUPPLEMENTAL PROJECTIONS
Normal Anatomy
PERITONEAL CAVITY
Liver
Gallbladder
Spleen
Stomach
Small Intestine
Colon
Potential Intraperitoneal Spaces
RETROPERITONEUM AND ABDOMINAL WALL
Perirenal Space: Kidneys and Adrenal Glands
Posterior Pararenal Space
Anterior Pararenal Space: Ascending and Descending Colon, Duodenum, and Pancreas
Psoas Muscle
Diaphragmatic Crura
PELVIS
Piriformis Muscle
Obturator Internus Muscle
Sacrospinous Ligament and Coccygeus Muscle
Ischiorectal Fossa
Gluteus Maximus Muscle
Pelvic Viscera
Acknowledgment
REFERENCES
2 - Abnormal Bowel Gas Patterns and Extraluminal Gas in Abdomen
Normal Bowel Gas Patterns
Abnormal Bowel Gas Patterns
GASTRIC OUTLET OBSTRUCTION
ADYNAMIC ILEUS
ACUTE COLONIC PSEUDO-OBSTRUCTION (OGILVIE’S SYNDROME)
SMALL BOWEL OBSTRUCTION
COLONIC OBSTRUCTION
CLOSED LOOP OBSTRUCTION
VOLVULUS
Sigmoid Volvulus
Cecal Volvulus
Transverse Colon Volvulus
Splenic Flexure Volvulus
Appendicitis
MAJOR SIGNS OF APPENDICITIS
Appendicolith.
Abnormal Bowel Gas Pattern.
Abnormal Cecum and Ascending Colon.
Extraluminal Soft Tissue Mass.
Gas in the Appendix.
Free Intraperitoneal Air.
Obliteration of Normal Fat Planes.
Scoliosis of the Lumbar Spine.
Toxic Megacolon
Pneumoperitoneum
MAJOR SIGNS OF FREE AIR ON SUPINE ABDOMINAL RADIOGRAPHS
Rigler’s Sign.
Increased Lucency in the Right Upper Quadrant.
Visualization of the Undersurface of the Diaphragm.
Air in Morison’s Pouch (Posterior Hepatorenal Space).
Outline of Normal Peritoneal Ligaments.
Football Sign.
Air in the Lesser Sac of the Peritoneal Cavity.
Pneumoretroperitoneum
Pneumobilia
Portal Venous Gas
Intramural Gas
Abscesses
ASCITES
REFERENCES
3 - Abdominal Calcifications
Physiology
Morphology
CONCRETIONS
CONDUIT WALL CALCIFICATION
CYSTIC CALCIFICATION
SOLID MASS CALCIFICATION
DIFFICULTY IN CLASSIFICATION
Location
Mobility
REFERENCES
SECTION II: Pharynx
4 - Pharynx: Normal Anatomy and Function and Examination Techniques
Anatomy
LOCATION
BASIC STRUCTURES AND MUCOSAL SURFACE PATTERNS
DIVISIONS
MUSCLES
NERVES
The Normal Swallow
FEEDING
ORAL PHASE
Bolus Control
Bolus Transfer into the Oropharynx
PHARYNGEAL PHASE
Nasopharyngeal Protection
Airway Protection
Bolus Transfer Through the Pharynx
Principles of Technique
PATIENT PREPARATION
COMPONENTS OF ROUTINE EXAMINATION
DOUBLE-CONTRAST INTERPRETATION
Mucosal Coating
Projections
Distention
MOTILITY EXAMINATION
POSITION OF THE PATIENT
WHAT IS EXAMINED
CHOICE OF CONTRAST AGENTS
THERAPEUTIC EXAMINATION
Compensatory Techniques
Therapeutic Techniques
REFERENCES
5 - Abnormalities of the Pharynx
Functional Abnormalities
AGING
NEUROMUSCULAR ABNORMALITIES
Pharyngeal Pouches and Diverticula
LATERAL PHARYNGEAL POUCHES AND DIVERTICULA
BRANCHIAL CLEFT CYSTS, BRANCHIAL CLEFT FISTULAS, AND BRANCHIAL POUCH SINUSES
ZENKER’S DIVERTICULUM
LATERAL CERVICAL ESOPHAGEAL POUCHES AND DIVERTICULA
Pharyngeal and Cervical Esophageal Webs
Inflammatory Lesions of the Pharynx
LYMPHOID HYPERPLASIA OF THE LINGUAL AND PALATINE TONSILS
Benign Tumors of the Pharynx
Malignant Tumors of the Pharynx
SQUAMOUS CELL CARCINOMA
Pathology
Radiographic Findings
Specific Sites
Palatine Tonsil.
Base of the Tongue.
Supraglottic Region.
Piriform Sinus.
Posterior Pharyngeal Wall.
Postcricoid Area.
LYMPHOMA
RARE MALIGNANT TUMORS
Carcinoma of the Minor Salivary Glands
Sarcoma
Cartilaginous Tumors
Kaposi’s Sarcoma
Pharyngeal Damage From Radiation
Postoperative Pharynx
TOTAL LARYNGECTOMY
PHARYNGOLARYNGECTOMY
NECK DISSECTION
VOICE CONSERVATION SURGERY
Horizontal (Supraglottic) Laryngectomy
Vertical Laryngectomy
SURGERY FOR TONGUE AND OROPHARYNGEAL CANCERS
Glossectomy
Malignant Oropharyngeal Lesions
TRACHEOSTOMY
SURGERY FOR ZENKER’S DIVERTICULUM
CRICOPHARYNGEAL MYOTOMY
REFERENCES
SECTION III: Esophagus
6 - Barium Studies of the Upper Gastrointestinal Tract
General Principles
Double-Contrast Upper GI Study
BARIUM SUSPENSIONS
EFFERVESCENT AGENTS
HYPOTONIC AGENTS
RADIOGRAPHIC EQUIPMENT
ROUTINE TECHNIQUE
Single-Contrast Upper GI Study
Anatomic Considerations
ESOPHAGUS
STOMACH
DUODENUM
Variations in Technique
POSSIBLE PERFORATION
PARTIAL GASTRECTOMY
GASTRIC OUTLET OBSTRUCTION
ESOPHAGEAL VARICES
REFERENCES
7 - Motility Disorders of the Esophagus
Normal Esophageal Anatomy
Normal Esophageal Physiology
Radiographic Evaluation
Esophageal Motility Disorders
PRIMARY MOTILITY DISORDERS
Achalasia
Diffuse Esophageal Spasm
NONSPECIFIC ESOPHAGEAL MOTILITY DISORDER
SECONDARY MOTILITY DISORDERS
Gastroesophageal Reflux Disease
Collagen Vascular Diseases
Other Secondary Motility Disorders
REFERENCES
8 - Gastroesophageal Reflux Disease
Reflux Esophagitis
PATHOGENESIS
RELATIONSHIP AMONG HIATAL HERNIA, GASTROESOPHAGEAL REFLUX, AND REFLUX ESOPHAGITIS
CLINICAL FINDINGS
DIAGNOSIS
Gastroesophageal Reflux
Reflux Esophagitis
RADIOGRAPHIC FINDINGS
Esophageal Dysmotility
Mucosal Granularity
Ulceration
Thickened Folds
Inflammatory Esophagogastric Polyps
Scarring and Strictures
DIFFERENTIAL DIAGNOSIS
Artifacts
Mucosal Granularity
Ulceration
Thickened Folds
Scarring and Strictures
Barrett’s Esophagus
CLINICAL FINDINGS
ENDOSCOPIC AND HISTOLOGIC FINDINGS
RADIOGRAPHIC FINDINGS
Long-Segment Barrett’s Esophagus
Short-Segment Barrett’s Esophagus
DIFFERENTIAL DIAGNOSIS
REFERENCES
9 - Infectious Esophagitis
Candida Esophagitis
PATHOGENESIS
CLINICAL FINDINGS
ENDOSCOPIC FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Herpes Esophagitis
PATHOGENESIS
CLINICAL FINDINGS
ENDOSCOPIC FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Cytomegalovirus Esophagitis
RADIOGRAPHIC FINDINGS
Human Immunodeficiency Virus Esophagitis
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Tuberculosis
RADIOGRAPHIC FINDINGS
Actinomycosis
Other Infections
REFERENCES
10 - Other Esophagitides
Drug-Induced Esophagitis
PATHOGENESIS
Causative Agents
Tetracycline and Doxycycline
Potassium Chloride
Quinidine
Nonsteroidal Anti-inflammatory Drugs
Alendronate
Other Drugs
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Radiation Esophagitis
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Caustic Esophagitis
PATHOGENESIS
CLINICAL FINDINGS
DIAGNOSIS AND TREATMENT
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Eosinophilic Esophagitis
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Crohn’s Disease
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Epidermolysis Bullosa Dystrophica
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Benign Mucous Membrane Pemphigoid
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Erythema Multiforme Major
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Lichen Planus
RADIOGRAPHIC FINDINGS
Nasogastric Intubation Esophagitis
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Alkaline Reflux Esophagitis
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Acute Alcohol-Induced Esophagitis
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Chronic Graft-Versus-Host Disease
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Glutaraldehyde-Induced Esophageal Injury
Behçet’s Disease
Esophageal Intramural Pseudodiverticulosis
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
REFERENCES
11 - Benign Tumors of the Esophagus
Mucosal Lesions
SQUAMOUS PAPILLOMA
Radiographic Findings
ADENOMA
Radiographic Findings
INFLAMMATORY ESOPHAGOGASTRIC POLYP
Radiographic Findings
GLYCOGENIC ACANTHOSIS
Radiographic Findings
Differential Diagnosis
LEUKOPLAKIA
ACANTHOSIS NIGRICANS
Submucosal Lesions
LEIOMYOMA
Clinical Findings
Radiographic Findings
Differential Diagnosis
GASTROINTESTINAL STROMAL TUMOR
Radiographic Findings
LEIOMYOMATOSIS AND IDIOPATHIC MUSCULAR HYPERTROPHY
Radiographic Findings
FIBROVASCULAR POLYP
Clinical Findings
Radiographic Findings
Differential Diagnosis
GRANULAR CELL TUMOR
Radiographic Findings
LIPOMA
HEMANGIOMA
HAMARTOMA
OTHER MESENCHYMAL TUMORS
CYSTS
Duplication Cyst
Radiographic Findings.
Retention Cyst
REFERENCES
12 - Carcinoma of the Esophagus
Squamous Cell Carcinoma
EPIDEMIOLOGY
PREDISPOSING CONDITIONS
Achalasia
Lye Strictures
Head and Neck Tumors
Celiac Disease
Plummer-Vinson Syndrome
Radiation
Tylosis
PATHOLOGY
Gross Features
Histologic Features
Distribution
ROUTES OF SPREAD
Direct Extension
Lymphatic Spread
Hematogenous Metastases
CLINICAL ASPECTS
ENDOSCOPIC FINDINGS
RADIOGRAPHIC FINDINGS
Early Esophageal Cancer
Advanced Carcinoma
Chest Radiography.
Barium Studies.
Associated Conditions
Achalasia.
Lye Strictures.
Tylosis.
Adenocarcinoma
EPIDEMIOLOGY AND PATHOGENESIS
Barrett’s Esophagus
Risk of Adenocarcinoma.
Dysplasia-Carcinoma Sequence.
Surveillance and Management of Barrett’s Esophagus.
Relationship Among Scleroderma, Barrett’s Esophagus, and Adenocarcinoma.
PATHOLOGY
Gross Features
ROUTES OF SPREAD
CLINICAL ASPECTS
RADIOGRAPHIC FINDINGS
Early Adenocarcinoma
Advanced Adenocarcinoma
Differential Diagnosis
EARLY ESOPHAGEAL CANCER
ADVANCED CARCINOMA
COMPUTED TOMOGRAPHY FINDINGS
Staging
COMPUTED TOMOGRAPHY
Technique
Staging Criteria
ENDOSCOPIC ULTRASOUND
Technique
Staging Criteria
POSITRON EMISSION TOMOGRAPHY
STAGING ALGORITHM
Treatment
SURGERY
RADIATION THERAPY
REFERENCES
13 - Other Malignant Tumors of the Esophagus
Metastases
SITES OF ORIGIN
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Direct Invasion
Contiguous Involvement by Mediastinal Lymph Nodes
Hematogenous Metastases
DIFFERENTIAL DIAGNOSIS
Secondary Achalasia
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Lymphoma
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Spindle Cell Carcinoma
PATHOLOGY
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Leiomyosarcoma
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Malignant Melanoma
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Kaposi’s Sarcoma
RADIOGRAPHIC FINDINGS
Small Cell Carcinoma
RADIOGRAPHIC FINDINGS
Leukemia
Miscellaneous Tumors
REFERENCES
14 - Miscellaneous Abnormalities of the Esophagus
Mallory-Weiss Tear
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Esophageal Hematoma
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Esophageal Perforation
PATHOGENESIS
Instrumentation
Foreign Bodies
Trauma
Spontaneous Esophageal Perforation (Boerhaave’s Syndrome)
CLINICAL FINDINGS
Cervical Esophageal Perforation
Thoracic Esophageal Perforation
RADIOGRAPHIC FINDINGS
Plain Radiographs
Cervical Esophageal Perforation.
Thoracic Esophageal Perforation.
Fluoroscopic Examinations
Computed Tomography
Foreign Body Impaction
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Plain Radiographs
Fluoroscopic Examinations
Fistulas
ESOPHAGEAL-AIRWAY FISTULA
ESOPHAGOPLEURAL FISTULA
AORTOESOPHAGEAL FISTULA
ESOPHAGOPERICARDIAL FISTULA
Diverticula
PULSION AND TRACTION DIVERTICULA
Radiographic Findings
EPIPHRENIC DIVERTICULUM
Radiographic Findings
Ectopic Gastric Mucosa
Congenital Esophageal Stenosis
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Extrinsic Impressions
NORMAL IMPRESSIONS
ABNORMAL IMPRESSIONS
ESOPHAGEAL RETRACTION
Varices
UPHILL VARICES
Pathophysiology
Clinical Findings
Radiographic Findings
Chest Radiographs.
Barium Studies.
Computed Tomography.
Angiography.
Differential Diagnosis
Treatment
Endoscopic Sclerotherapy.
Endoscopic Variceal Ligation.
DOWNHILL VARICES
Pathophysiology
Clinical Findings
Radiographic Findings
Differential Diagnosis
IDIOPATHIC VARICES
Radiographic Findings
REFERENCES
15 - Abnormalities of the Gastroesophageal Junction
Radiographic Technique
Normal Radiographic Appearances
CARDIA
Z LINE
MUCOSAL RING
MUSCULAR RING
Schatzki Ring
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Gastric Hernias
HIATAL HERNIA
Pathogenesis
Clinical Importance
Radiographic Diagnosis
PARAESOPHAGEAL HERNIA
Pathogenesis
Clinical Importance
Radiographic Diagnosis
Carcinoma of the Cardia
Prolapsed Esophagogastric Mucosa
Other Abnormalities
REFERENCES
16 - Postoperative Esophagus
General Principles
Gastroesophageal Reflux and Hiatal Hernia
NORMAL POSTOPERATIVE APPEARANCES
COMPLICATIONS
Obstruction
Recurrent Hiatal Hernia and Gastroesophageal Reflux
Benign Strictures
Carcinoma
ESOPHAGOGASTRECTOMY
Complications
COLONIC INTERPOSITION
PALLIATIVE INTUBATION
Achalasia
PNEUMATIC DILATION
CARDIOMYOTOMY
Varices
REFERENCES
SECTION IV: Stomach and Duodenum
17 - Peptic Ulcers
Epidemiology and Pathogenesis
HELICOBACTER PYLORI GASTRITIS
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
TOBACCO, ALCOHOL, AND COFFEE
STRESS
GASTRODUODENAL REFLUX OF BILE AND DELAYED GASTRIC EMPTYING
HEREDITARY FACTORS
Clinical Findings
Treatment
Radiographic Findings
GASTRIC ULCERS
Shape
Size
Location
Morphologic Features
Lesser Curvature Ulcers.
Greater Curvature Ulcers.
Posterior Wall Ulcers.
Anterior Wall Ulcers.
Multiplicity
Ulcer Healing and Scarring
Benign Versus Malignant Ulcers
DUODENAL ULCERS
Shape
Size
Location
Morphologic Features
Bulbar Ulcers.
Postbulbar Ulcers.
Giant Duodenal Ulcers.
Multiplicity
Ulcer Healing and Scarring
PYLORIC CHANNEL ULCERS
Differential Diagnosis
Complications
UPPER GASTROINTESTINAL BLEEDING
OBSTRUCTION
PERFORATION
Free Perforation
Confined Perforation
Fistulas
Gastroduodenal Fistulas (Double-Channel Pylorus).
Gastrocolic Fistulas.
Duodenocolic Fistulas.
Choledochoduodenal Fistulas.
Duodenorenal Fistulas.
Gastropericardial Fistulas.
Zollinger-Ellison Syndrome
PATHOLOGY
CLINICAL ASPECTS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
REFERENCES
18 - Inflammatory Conditions of the Stomach and Duodenum
Erosive Gastritis
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Antral Gastritis
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Helicobacter pylori Gastritis
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Hypertrophic Gastritis
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Ménétrier’s Disease
PATHOLOGY
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Atrophic Gastritis
PATHOLOGY AND PATHOGENESIS
CLINICAL FINDINGS
RELATIONSHIP TO GASTRIC CARCINOMA
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Granulomatous Conditions
CROHN’S DISEASE
Clinical Findings
Radiographic Findings
Gastric Involvement.
Duodenal Involvement.
Differential Diagnosis
Stomach.
Duodenum.
SARCOIDOSIS
Clinical Findings
Radiographic Findings
TUBERCULOSIS
Clinical Findings
Radiographic Findings
SYPHILIS
Radiographic Findings
FUNGAL DISEASES
STRONGYLOIDIASIS
Radiographic Findings
Eosinophilic Gastritis
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Emphysematous Gastritis
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Caustic Ingestion
RADIOGRAPHIC FINDINGS
Radiation
RADIOGRAPHIC FINDINGS
Floxuridine Toxicity
PATHOGENESIS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Duodenitis
RADIOGRAPHIC FINDINGS
REFERENCES
19 - Benign Tumors of the Stomach and Duodenum
Mucosal Lesions
HYPERPLASTIC POLYP
Pathology
Clinical Findings
Radiographic Findings
Differential Diagnosis
Treatment
ADENOMATOUS POLYP
Pathology
Clinical Findings
Radiographic Findings
Differential Diagnosis
Treatment
DUODENAL POLYP
Radiographic Findings
Differential Diagnosis
VILLOUS TUMOR
Pathology
Clinical Findings
Radiographic Findings
Differential Diagnosis
POLYPOSIS SYNDROMES
Submucosal Lesions
Gastrointestinal Stromal Tumor
Pathology
Clinical Findings
Radiographic Findings
Differential Diagnosis
Treatment
LEIOMYOBLASTOMA
Pathology
Clinical Findings
Radiographic Findings
LIPOMA
Pathology
Clinical Findings
Radiographic Findings
HEMANGIOMA
Radiographic Findings
LYMPHANGIOMA
Radiographic Findings
GLOMUS TUMOR
Radiographic Findings
NEURAL TUMOR
Radiographic Findings
GRANULAR CELL TUMOR
Radiographic Findings
INFLAMMATORY FIBROID POLYP
Clinical Findings
Radiographic Findings
ECTOPIC PANCREATIC REST
Pathology
Clinical Findings
Radiographic Findings
Differential Diagnosis
BRUNNER GLAND HYPERPLASIA OR HAMARTOMA
Pathology
Clinical Findings
Radiographic Findings
Differential Diagnosis
DUPLICATION CYST
Pathology
Clinical Findings
Radiographic Findings
Differential Diagnosis
REFERENCES
20 - Carcinoma of the Stomach and Duodenum
Gastric Carcinoma
EPIDEMIOLOGY
Dietary Factors
Helicobacter Pylori Gastritis
Atrophic Gastritis
Gastric Polyps
Partial Gastrectomy
Ménétrier’s Disease
PATHOLOGY
Gross Features
Histologic Features
Distribution
ROUTES OF SPREAD
Direct Extension
Lymphatic Spread
Intraperitoneal Seeding
Hematogenous Metastases
CLINICAL FINDINGS
ENDOSCOPIC FINDINGS
RADIOGRAPHIC FINDINGS
Early Gastric Cancer
Advanced Gastric Cancer
Abdominal Radiographs.
Barium Studies.
Scirrhous Carcinoma.
Carcinoma of the Cardia.
Computed Tomography.
DIFFERENTIAL DIAGNOSIS
Early Gastric Cancer
Advanced Carcinoma
STAGING
Computed Tomography
Endoscopic Ultrasonography
Technique.
Diagnostic Accuracy.
Other Imaging Modalities
Summary
TREATMENT AND PROGNOSIS
Duodenal Carcinoma
REFERENCES
21 - Other Malignant Tumors of the Stomach and Duodenum
Metastases
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Hematogenous Metastases
Lymphatic Spread
Direct Invasion
Esophageal Carcinoma.
Pancreatic Carcinoma.
Renal Cell Carcinoma.
Colonic Carcinoma.
Gallbladder Carcinoma.
Omental Metastases.
DIFFERENTIAL DIAGNOSIS
Lymphoma
PATHOLOGY
CLINICAL FINDINGS
ENDOSCOPIC FINDINGS
TREATMENT AND PROGNOSIS
RADIOGRAPHIC FINDINGS
Low-Grade Mucosa-Associated Lymphoid Tissue Lymphoma
Advanced Gastric Lymphoma
Barium Studies.
Computed Tomography.
Endoscopic Ultrasonography.
Positron Emission Tomography/Computed Tomography.
DIFFERENTIAL DIAGNOSIS
DUODENAL LYMPHOMA
Malignant Gastrointestinal Stromal Tumor
PATHOLOGY
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
MALIGNANT DUODENAL GASTROINTESTINAL STROMAL TUMOR
Carcinoid Tumors
PATHOLOGY
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
DUODENAL CARCINOIDS
Kaposi’s Sarcoma
CLINICAL FINDINGS
PATHOLOGIC AND ENDOSCOPIC FINDINGS
RADIOGRAPHIC FINDINGS
DIFFERENTIAL DIAGNOSIS
Miscellaneous Tumors
REFERENCES
22 - Miscellaneous Abnormalities of the Stomach and Duodenum
Gastric Varices
Pathophysiology
Portal Hypertension
Splenic Vein Obstruction
Clinical Findings
Radiographic Findings
Abdominal Radiographs
Barium Studies
Computed Tomography
Angiography
Differential Diagnosis
Treatment
Portal Hypertensive Gastropathy
RADIOGRAPHIC FINDINGS
Diverticula
GASTRIC DIVERTICULA
DUODENAL DIVERTICULA
True Diverticula
Pseudodiverticula
Intraluminal Diverticula
Webs
ANTRAL WEBS
DUODENAL WEBS
Adult Hypertrophic Pyloric Stenosis
Gastric Outlet Obstruction
Duodenal Obstruction
SUPERIOR MESENTERIC ROOT SYNDROME
OTHER CAUSES
Gastric Dilation Without Gastric Outlet Obstruction
ACUTE GASTRIC DILATION
CHRONIC GASTRIC DILATION AND GASTROPARESIS
Abnormal Extrinsic Masses
STOMACH
DUODENUM
Widening of the Duodenal Sweep
Pancreatic Diseases Affecting the Stomach and Duodenum
Unusual Filling Defects
BEZOARS
FOREIGN BODIES
HEMATOMAS
INTRAGASTRIC AND INTRADUODENAL GALLSTONES
Gastric Volvulus
Gastroduodenal and Duodenojejunal Intussusception
Fistulas
GASTROCOLIC AND DUODENOCOLIC FISTULAS
CHOLECYSTODUODENAL FISTULAS
AORTODUODENAL FISTULAS
Gastric and Duodenal Perforation
Gastric Emphysema
Amyloidosis
Cystic Fibrosis
REFERENCES
23 - Postoperative Stomach and Duodenum
Diagnostic Evaluation After Gastric and Duodenal Surgery
IMAGING STUDIES
Fluoroscopic Studies of the Upper Gastrointestinal Tract
Computed Tomography
Nuclear Medicine
Endoscopy
Surgical Considerations for Peptic Ulcer Disease
INDICATIONS FOR SURGERY
SURGICAL PROCEDURES FOR PEPTIC ULCER DISEASE
Vagotomy
Pyloroplasty
Antrectomy
Surgical Procedures for Gastric Resection
BILLROTH I PROCEDURE
BILLROTH II PROCEDURE
ROUX-EN-Y GASTROJEJUNOSTOMY
IDENTIFICATION OF POSTSURGICAL ANATOMY ON IMAGING STUDIES
COMPLICATIONS AFTER GASTRIC RESECTION
Metabolic Problems
Postoperative Leaks
Gastric Stasis
Roux Stasis Syndrome
Obstruction
Bezoar Formation
Dumping Syndrome
Marginal Ulcers
Jejunogastric Intussusception
Afferent Loop Syndrome
Bile Reflux Gastritis
Malignant Tumors After Partial Gastrectomy for Benign Disease
Surgical Considerations for Gastric and Duodenal Neoplasms
SURGERY FOR MALIGNANT GASTRIC NEOPLASMS
SURGERY FOR MALIGNANT DUODENAL NEOPLASMS
COMPLICATIONS AFTER GASTRIC AND DUODENAL SURGERY FOR MALIGNANT NEOPLASMS
Surgery for Weight Loss (Bariatric Surgery)
ROUX-EN-Y GASTRIC BYPASS
Imaging After Roux-en-Y Gastric Bypass
Upper Gastrointestinal Study.
Computed Tomography.
Complications
Extraluminal Leaks.
Communication with the Excluded Stomach.
Marginal Ulcers.
Small Bowel Obstruction
Acute Obstruction.
Late Obstruction.
Internal Hernias.
Anastomotic Stenosis.
Intussusception.
LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
Imaging After Laparoscopic Adjustable Gastric Banding
Radiography.
Upper Gastrointestinal Study.
Computed Tomography.
Band Adjustments.
Complications of Laparoscopic Adjustable Gastric Banding
Pouch Dilation.
Band Slippage.
Intragastric Band Erosion.
Device-Related Complications.
SLEEVE GASTRECTOMY
Imaging after Sleeve Gastrectomy
Upper Gastrointestinal Study.
Computed Tomography.
Complications of Sleeve Gastrectomy
BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH
REFERENCES
SECTION V: Small Bowel
24 - Barium Studies of the Small Bowel
Normal Small Intestine
Principles for Performing and Interpreting Small Bowel Studies
Small Bowel Follow-Through
Peroral Pneumocolon
Enteroclysis
Hypotonic Duodenography
Small Bowel Studies Using Water-Soluble Contrast Agents
Retrograde Examinations of the Small Bowel
BARIUM ENEMA
ILEOSTOMY ENEMA
Choice of Barium Study Versus Other Diagnostic Tests
CHRONIC DIARRHEA
SMALL BOWEL OBSTRUCTION
ABDOMINAL PAIN
SUSPECTED PERFORATION
MALABSORPTION
UNEXPLAINED GASTROINTESTINAL BLEEDING
REFERENCES
25 - Computed Tomography Enterography
Computed Tomography Enterography: How It Differs From Routine Abdominal Computed Tomography
Indications
Technique
Interpretation of Computed Tomography Enterography Images
SUSPECTED CROHN’S DISEASE
GASTROINTESTINAL BLEEDING
LOW-GRADE OBSTRUCTION
Integration With Other Tests
REFERENCES
26 - Magnetic Resonance Enterography
Technical Considerations
ENTERAL CONTRAST AGENTS FOR MAGNETIC RESONANCE IMAGING
TECHNIQUE
MAGNETIC RESONANCE IMAGING PROTOCOL AND PULSE SEQUENCES
Image Interpretation
Clinical Applications
CROHN’S DISEASE
SMALL BOWEL NEOPLASMS
CELIAC DISEASE
BOWEL ISCHEMIA AND VASCULITIS
INFECTIONS
SMALL BOWEL OBSTRUCTION
Summary
REFERENCES
27 - Crohn’s Disease of the Small Bowel
Clinical Considerations
Classification and Therapy
Diagnostic Tools
BARIUM CONTRAST EXAMINATIONS
Early Radiographic Active Inflammatory Disease
Intermediate Radiographic Active Inflammatory Disease
Advanced Radiographic Active Inflammatory Disease
Quiescent or Inactive Disease
Fibrostenotic Disease
Fistulizing or Penetrating Disease
ULTRASOUND
MAGNETIC RESONANCE IMAGING
COMPUTED TOMOGRAPHY
Nomenclature for Computed Tomography and Magnetic Resonance Enterography Findings
COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE ENTEROGRAPHY FINDINGS OF SMALL BOWEL CROHN’S DISEASE
Wall Findings
Hyperenhancement.
Thickening.
Luminal Narrowing, Stricture Formation, and Upstream Dilation.
Ulcer and Sinus Tract.
Simple and Complex Fistulae.
Mesenteric Findings
Vasa Recta Distention.
Fibrofatty Proliferation.
Perienteric Edema and Inflammation.
Inflammatory Mass and Abscess
Adenopathy.
Extraintestinal Findings
Active Inflammatory Small Bowel Crohn’s Disease
Quiescent or Inactive Small Bowel Crohn’s Disease
Mixed Fibrostenotic and Active Inflammatory Small Bowel Crohn’s Disease
Penetrating Crohn’s Disease
Fibrostenotic Small Bowel Crohn’s Disease
ASSESSMENT OF DISEASE ACTIVITY
Magnetic Resonance Imaging–Derived Disease Activity Indices
Additional Imaging Considerations
Acknowledgment
REFERENCES
28 - Other Inflammatory Conditions of the Small Bowel
Parasitic Infestations
ASCARIASIS
HOOKWORM INFESTATION (ANCYLOSTOMIASIS)
STRONGYLOIDIASIS
ANISAKIASIS
TAPEWORM (CESTODE) INFESTATION
TREMATODE (FLUKES) INFESTATION
GIARDIASIS
TRYPANOSOMIASIS
Bacterial Infections
TUBERCULOSIS
YERSINIOSIS
SALMONELLOSIS
CAMPYLOBACTERIOSIS
Fungal Infections
HISTOPLASMOSIS
Viral Infections
Drug-Induced Disorders
ULCERS AND STENOSES RELATED TO NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
FLUORINATED ANTIPYRIMIDINES
Inflammatory Disease in Immunocompromised States
SELECTIVE IMMUNOGLOBULIN A AND COMMON VARIABLE IMMUNODEFICIENCY
GRAFT-VERSUS-HOST DISEASE
TYPHLITIS
GASTROINTESTINAL INFECTIONS IN AIDS
HUMAN IMMUNODEFICIENCY VIRUS ENTERITIS
CYTOMEGALOVIRUS INFECTION
CRYPTOSPORIDIOSIS
ISOSPORIASIS AND OTHER INTRACELLULAR PROTOZOANS
MYCOBACTERIUM AVIUM-INTRACELLULARE COMPLEX
ACTINOMYCOSIS
CANDIDIASIS
REFERENCES
29 - Malabsorption
Anatomic Classification of Malabsorption
HEPATOBILIARY AND PANCREATIC DISORDERS
GASTRIC DISORDERS
SMALL BOWEL DISORDERS
Intraluminal Stasis with Bacterial Overgrowth
Brush Border Disease
Mucosal Damage
Postmucosal Disease
Diseases with Multifactorial Causes
Small Bowel Hypomotility
JEJUNOILEAL DIVERTICULOSIS
PROGRESSIVE SYSTEMIC SCLEROSIS, VISCERAL NEUROPATHIES, AND MYOPATHIES
Epithelial Cell Damage
CELIAC DISEASE
Radiographic Findings
Complications
TROPICAL SPRUE
WHIPPLE’S DISEASE
EOSINOPHILIC GASTROENTERITIS
AMYLOIDOSIS
SHORT BOWEL SYNDROME
Nonformation of Chylomicrons
ABETALIPOPROTEINEMIA
Lymphatic Obstruction and Lymphangiectasia
Multifactorial Diseases
DIABETES MELLITUS
CYSTIC FIBROSIS
Differential Diagnosis of Thickened Folds in Malabsorption
REFERENCES
30 - Benign Tumors of the Small Bowel
Clinical Considerations
Imaging Considerations
Specific Tumors
ADENOMA
GASTROINTESTINAL STROMAL TUMOR
LIPOMA
HEMANGIOMA
UNCOMMON TUMORS
Polyposis Syndromes
FAMILIAL ADENOMATOUS POLYPOSIS SYNDROME
PEUTZ-JEGHERS SYNDROME
COWDEN’S DISEASE
CRONKHITE-CANADA SYNDROME
REFERENCES
31 - Malignant Tumors of the Small Bowel
Imaging of Small Bowel Neoplasm
Neuroendocrine Tumor
Adenocarcinoma
Gastrointestinal Stromal Tumor
Lymphoma
Metastasis
Conclusion
REFERENCES
32 - Small Bowel Obstruction
Terms Used in Describing Small Bowel Obstruction and Adynamic Ileus
Radiologic Imaging
PLAIN RADIOGRAPHY OF THE ABDOMEN
COMPUTED TOMOGRAPHY
BARIUM STUDIES
Classification of Small Bowel Obstruction
EXTRINSIC LESIONS
Adhesions
Closed Loop Obstruction and Strangulation
Hernias
Extrinsic Tumors in Mesentery or Retroperitoneum
INTRAMURAL LESIONS
Primary Tumors
Inflammatory Conditions
Vascular Diseases
Radiation Enteropathy.
INTRALUMINAL CAUSES
INTUSSUSCEPTION
REFERENCES
33 - Vascular Disorders of the Small Intestine
Mesenteric Ischemia
ACUTE MESENTERIC ISCHEMIA
Computed Tomography Findings
Bowel Dilation.
Bowel Wall Thickening.
Bowel Wall Attenuation and Abnormal Enhancement.
Stranding and Ascites.
Pneumatosis and Portomesenteric Venous Air.
Patterns of Ischemia: Arterial Occlusive Ischemia Versus Venous Occlusive Ischemia.
CHRONIC MESENTERIC ISCHEMIA
Vasculitis
LARGE VESSEL VASCULITIS
MEDIUM VESSEL VASCULITIS
SMALL VESSEL VASCULITIS
Henoch-Schönlein Purpura
Systemic Lupus Erythematosus
Behçet’s Disease
Acute Small Bowel Bleeding
Computed Tomography in the Diagnosis of Gastrointestinal Bleeding.
Miscellaneous Disorders
SUPERIOR MESENTERIC ARTERY DISSECTION
TRAUMA
RADIATION ENTERITIS
SPLANCHNIC ARTERY ANEURYSMS
DRUG-INDUCED SMALL BOWEL ANGIOEDEMA
MEDIAN ARCUATE LIGAMENT SYNDROME
Summary
REFERENCES
34 - Postoperative Small Bowel
Small Bowel After Gastric Surgery
AFFERENT LOOP OBSTRUCTION
Enterectomy and Anastomosis
POSTOPERATIVE BLIND POUCH AND LOOP
Enterostomy
JEJUNOSTOMY
ILEOSTOMY
Ileal Reservoir
CONTINENT ILEOSTOMY RESERVOIR
ILEAL POUCH WITH ILEOANAL ANASTOMOSIS
Small Bowel Transplantation
REFERENCES
35 - Miscellaneous Abnormalities of the Small Bowel
Abnormalities of Small Bowel Development in Adults
MECKEL’S DIVERTICULUM
MIDGUT DUPLICATIONS
HETEROTOPIC TISSUE
ILEAL DYSGENESIS (SEGMENTAL DILATION)
INTESTINAL MALROTATION
PARADUODENAL (MESOCOLIC) HERNIAS
Endometriosis
Bezoars and Enteroliths
REFERENCES
SECTION VI: Colon
36 - Barium Studies of the Colon
Single- Versus Double-Contrast Technique
Double-Contrast Barium Enema
PATIENT PREPARATION
MATERIALS AND EQUIPMENT
ADMINISTRATION OF GLUCAGON
INSERTION OF ENEMA TIP
ROUTINE EXAMINATION
NORMAL APPEARANCES
Single-Contrast Barium Enema
Technical Problems
POOR PREPARATION
DIVERTICULOSIS
INCONTINENCE
FILLING OF ENTIRE COLON
Complications
Variations in Technique
SUSPECTED PERFORATION
PERORAL PNEUMOCOLON
COLOSTOMY ENEMA
REFERENCES
37 - Functional Imaging of Anorectal and Pelvic Floor Dysfunction
Normal Anatomy
Assessment of Pelvic Floor
PREPROCEDURE PREPARATION
IMAGING TECHNIQUE
Measurements
ANORECTAL ANGLE
ANAL CANAL LENGTH
LEVEL OF ANORECTAL JUNCTION
Pathology
ENTEROCELE AND SIGMOIDOCELE
ANTERIOR MUCOSAL WALL PROLAPSE AND RECTOCELE
RECTAL INTUSSUSCEPTION
Solitary Rectal Ulcer Syndrome
POSTERIOR-LATERAL RECTAL POUCHES
PELVIC FLOOR DYSSYNERGY (ANISMUS)
DESCENDING PERINEUM SYNDROME
ANTERIOR MUCOSAL PROLAPSE
UTERINE AND VAGINAL VAULT PROLAPSE
CYSTOCELE
CONSTIPATION AND INCONTINENCE
Comparison With Other Methods of Examining the Pelvic Floor
Normal Variations
Summary
REFERENCES
38 - Computed Tomography Colonography and Evaluation of the Colon
Indications and Use
SCREENING FOR COLORECTAL CANCER
DIAGNOSTIC INDICATIONS
STAGING AND SURVEILLANCE
History of Computed Tomography Colonography Trial Results and Supporting Evidence
Computed Tomography Colonography Exam
TECHNICAL COMPONENTS
Bowel Preparation
Alternative Protocols.
Colonic Distention
Image Acquisition
INTERPRETATION
Detection
Characterization
Polyp Differential
REPORTING
Specific Issues/Topics in Computed Tomography Colonography
COMPLICATIONS
RADIATION
EXTRACOLONIC FINDINGS
Summary
REFERENCES
39 - Diverticular Disease of the Colon
Diverticulosis
RADIOLOGIC FINDINGS
Plain Radiographic Studies
Barium Studies
Computed Tomography
Diverticulitis
RADIOLOGIC FINDINGS
Plain Radiographic Studies
Contrast Enema Examination
Ultrasonography
Magnetic Resonance Imaging
Computed Tomography
SURGICAL AND COMPUTED TOMOGRAPHY STAGING
DIFFERENTIATION OF DIVERTICULITIS FROM CARCINOMA
CHRONIC DIVERTICULITIS
DIFFERENTIAL DIAGNOSIS
Epiploic Appendagitis
Cecal Diverticulitis
COMPLICATIONS
Fistulas and Sinus Tracts
Free Intraperitoneal Perforation
Bowel Obstruction
Pylephlebitis and Liver Abscess
Diverticular Hemorrhage
Giant Sigmoid Diverticulum
REFERENCES
40 - Diseases of the Appendix
Anatomy
Acute Appendicitis
EPIDEMIOLOGY
CAUSES
PATHOPHYSIOLOGY
CLINICAL AND RADIOLOGIC ASSESSMENT
FINDINGS
Clinical Findings
Imaging
Plain Radiographs and Barium Enema.
Computed Tomography.
Computed Tomography Protocols.
Ultrasonography.
Magnetic Resonance Imaging.
DIFFERENTIAL DIAGNOSIS
Mesenteric Adenitis
Infectious Enterocolitis
Epiploic Appendagitis
Omental Infarction
Right-Sided and Ileal Diverticulitis
Meckel’s Diverticulum
Neutropenic Colitis (Typhlitis)
Ischemia
Cecal Carcinoma
Crohn’s Disease
Ulcerative Colitis
Endometriosis
Appendiceal Diverticulitis
Appendiceal Intussusception
Appendiceal Neoplasms
MUCOCELE
Epidemiology, Cause, and Pathology
Clinical Findings
Imaging Findings
Barium Enema.
Cross-Sectional Imaging.
MUCINOUS CYSTADENOMA AND CYSTADENOCARCINOMA
NONMUCINOUS ADENOCARCINOMA
CARCINOID
LYMPHOMA
Metastases
REFERENCES
41 - Ulcerative and Granulomatous Colitis: Idiopathic Inflammatory Bowel Disease
Ulcerative Colitis
FINDINGS
Radiologic Findings
Plain Abdominal Radiographs.
Colonic Fecal Residue.
Mucosa.
Haustration.
Colon Diameter.
Mural Thickness.
Barium Enema
Granular Pattern.
Mucosal Stippling.
“Collar Button” Ulcers.
Polyps.
Inflammatory Pseudopolyps.
Postinflammatory Pseudopolyps.
Backwash Ileitis.
Blunting and Lost Haustra.
Widened Presacral Space.
Rectal Valve Abnormalities.
Strictures.
Distribution.
Computed Tomography
Ultrasonography
Magnetic Resonance Imaging
Scintigraphy
Crohn’s Disease
FINDINGS
Radiologic Findings
Radiography.
Barium Enema
Lymphoid Hyperplasia.
Aphthoid Ulcerations.
Cobblestoning.
Deep Ulcerations.
Sinus Tracts, Fissures, and Fistulas.
Mural Thickening.
Luminal Narrowing and Strictures.
Sacculations.
Anorectal Disease.
Distribution.
Computed Tomography
Mesenteric Involvement.
Fibrofatty Proliferation of the Mesentery.
Phlegmon.
Abscess.
Transrectal Ultrasonography
Transabdominal Ultrasonography
Magnetic Resonance Imaging
Intestinal Complications of Inflammatory Bowel Disease
CARCINOMA
TOXIC MEGACOLON
Radiologic Findings
Differential Diagnosis of Colitis
Summary
REFERENCES
42 - Other Inflammatory Conditions of the Colon
Bacterial Infections
SALMONELLOSIS
SHIGELLOSIS
CAMPYLOBACTERIOSIS
YERSINIA ENTEROCOLITIS
COLITIS CAUSED BY ESCHERICHIA COLI O157:H7
TUBERCULOSIS
ACTINOMYCOSIS
Viral Infections
Parasitic Infections
AMEBIASIS
SCHISTOSOMIASIS
Fungal Infections
HISTOPLASMOSIS
MUCORMYCOSIS
Noninfectious Colitis
GRAFT-VERSUS-HOST DISEASE
Exogenous Causes of Colitis
TYPHLITIS (NEUTROPENIC COLITIS)
CLOSTRIDIUM DIFFICILE COLITIS
REFERENCES
43 - Polyps and Colon Cancer
Epidemiology
Factors Involved
DIETARY FACTORS
HEREDITARY FACTORS
RISK FACTORS
Clinical Aspects
Radiology and Diagnostic Methods
Benign Epithelial Polyps
INCIDENCE
PATHOLOGY
POLYP DETECTION
Barium Enema
Cross-Sectional Imaging
Adenocarcinoma
BARIUM ENEMA
Early Cancer
Advanced Cancer
Complications
COMPUTED TOMOGRAPHY
Primary Colorectal Carcinoma
Preoperative Staging by Computed Tomography
MAGNETIC RESONANCE IMAGING
Preoperative Staging by Magnetic Resonance Imaging
TRANSRECTAL ULTRASOUND
Primary Tumor
Preoperative Staging by Endoluminal Ultrasound
IMMUNOSCINTIGRAPHY WITH MONOCLONAL ANTIBODIES
Detection of Primary Colorectal Neoplasm
Preoperative Staging of Primary Colorectal Neoplasm
POSITRON EMISSION TOMOGRAPHY
Primary Colorectal Neoplasm
Staging of Primary Colorectal Neoplasm
Conclusions for Cross-Sectional Imaging in Primary Colorectal Neoplasm
Postoperative Follow-Up
CONTRAST ENEMA
CROSS-SECTIONAL IMAGING
Computed Tomography
Magnetic Resonance Imaging
Transrectal Ultrasound
Immunoscintigraphy
Positron Emission Tomography
Conclusions for Cross-Sectional Imaging in Recurrent Colorectal Carcinoma
REFERENCES
44 - Other Tumors of the Colon
Lymphoma
PATHOLOGIC FINDINGS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS AND DIFFERENTIAL DIAGNOSIS
Vascular Lesions
HEMANGIOMA
Clinical and Pathologic Findings
Radiographic Findings and Differential Diagnosis
LYMPHANGIOMA
ANGIODYSPLASIA
Clinical and Pathologic Findings
Radiographic Findings
KAPOSI’S SARCOMA
Endocrine (Carcinoid) Tumors
PATHOLOGIC FINDINGS
ENDOCRINE CELL TUMORS OF THE RECTUM
ENDOCRINE TUMORS (EXCLUSIVE OF THE RECTUM)
Fatty Lesions
LIPOMA
Clinical Findings
Pathologic Findings
Radiographic Findings
FATTY INFILTRATION OF THE ILEOCECAL VALVE
Pathologic, Clinical, and Radiographic Findings
Differential Diagnosis
Stromal Tumors
PATHOLOGIC FINDINGS
SMALL STROMAL TUMORS
LARGE STROMAL TUMORS
Squamous Cell Carcinoma
Cloacogenic Carcinoma
Metastases
DIRECT INVASION FROM CONTIGUOUS PRIMARY TUMORS
DIRECT INVASION FROM NONCONTIGUOUS PRIMARY TUMORS
INTRAPERITONEAL SEEDING
Radiographic Findings
EMBOLIC METASTASES
REFERENCES
45 - Polyposis Syndromes
Familial Adenomatous Polyposis Syndrome
COLONIC MANIFESTATIONS
EXTRACOLONIC GASTROINTESTINAL MANIFESTATIONS
EXTRAINTESTINAL MANIFESTATIONS
Hamartomatous Polyposis Syndromes
PEUTZ-JEGHERS SYNDROME
JUVENILE POLYPOSIS SYNDROME
PTEN HAMARTOMA SYNDROMES
Multiple Hamartoma Syndrome (Cowden Syndrome)
Bannayan-Riley-Ruvalcaba Syndrome
CRONKHITE-CANADA SYNDROME
REFERENCES
46 - Miscellaneous Abnormalities of the Colon
Colonic Obstruction
PATHOPHYSIOLOGY
RADIOLOGIC APPROACH TO SUSPECTED LARGE BOWEL OBSTRUCTION
Radiography
Computed Tomography
Ultrasonography and Magnetic Resonance Imaging
MAJOR TYPES OF COLONIC OBSTRUCTION
Carcinoma of the Colon
Diverticulitis
Volvulus
Adult Intussusception
Adhesions
Hernias
Obturation Obstruction
Strictures
Extracolonic Diseases Involving the Colon
ENDOMETRIOSIS
MALIGNANT GYNECOLOGIC TUMORS
SEXUALLY TRANSMITTED DISEASES
PANCREATITIS
METASTASES
Colonic Ischemia
CLINICAL FINDINGS
RADIOLOGIC FINDINGS
Radiography
Computed Tomography, Ultrasonography, and Magnetic Resonance Imaging
Radiation Colitis
Internal Hemorrhoids
Rectal Mucosal Prolapse Syndromes
Irritable Bowel Syndrome
Nonobstructive Megacolon
Pneumatosis Intestinalis
PRIMARY INTESTINALIS
SECONDARY INTESTINALIS
REFERENCES
47 - Postoperative Colon
Segmental Resection
Colostomy
END COLOSTOMY
LOOP COLOSTOMY
DOUBLE-BARRELED COLOSTOMY
DIVIDED COLOSTOMY AND MUCOUS FISTULA
Cecostomy
Anterior Resection
LOW ANTERIOR RESECTION
Proctectomy and Coloanal Anastomoses
Hartmann Procedure
Abdominoperineal Resection
Ileal Pouch–Anal Anastomosis
Appendectomy
Colonic Stents
REFERENCES
SECTION VII: Gallbladder and Biliary Tract
48 - Magnetic Resonance Cholangiopancreatography
Technique
Clinical Applications
BILE DUCT CALCULI
NEOPLASMS
Pancreatic Carcinoma
Cholangiocarcinoma: Hilar and Distal Duct
Intraductal Papillary Mucinous Neoplasm of the Pancreas
CONGENITAL ANOMALIES
Choledochal or Bile Duct Cysts
Anatomic Variants of the Biliary Tract
Pancreas Divisum
Postoperative Alterations of the Pancreaticobiliary Tract and Gastrointestinal Tract
Primary Sclerosing Cholangitis
Pancreatitis
ACUTE PANCREATITIS
CHRONIC PANCREATITIS
Gallbladder Diseases
REFERENCES
49 - Cholelithiasis, Cholecystitis, Choledocholithiasis, and Hyperplastic Cholecystoses
Cholelithiasis
Abdominal Radiography
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Biliary Sludge
Acute Cholecystitis
Cholescintigraphy
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Acute Acalculous Cholecystitis
Ultrasound
Computed Tomography and Magnetic Resonance Imaging
Complications of Acute Cholecystitis
GANGRENOUS CHOLECYSTITIS
HEMORRHAGIC CHOLECYSTITIS
EMPHYSEMATOUS CHOLECYSTITIS
GALLBLADDER PERFORATION
Chronic Cholecystitis
CHRONIC ACALCULOUS CHOLECYSTITIS
XANTHOGRANULOMATOUS CHOLECYSTITIS
Choledocholithiasis
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Intrahepatic Biliary Calculi
RECURRENT PYOGENIC CHOLANGITIS
IMAGING
Other Conditions Related to Gallstones
SPILLED GALLSTONES AFTER LAPAROSCOPIC CHOLECYSTECTOMY
MIRIZZI SYNDROME
GALLSTONE ILEUS
Hyperplastic Cholecystoses
CHOLESTEROLOSIS
ADENOMYOMATOSIS
Ultrasound.
Computed Tomography.
Magnetic Resonance Imaging.
Milk of Calcium Bile
Gallbladder Hydrops
REFERENCES
50 - Neoplasms of the Gallbladder and Biliary Tract
Gallbladder Carcinoma
EPIDEMIOLOGY
ETIOLOGY
PATHOLOGIC FINDINGS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Radiologic Evaluation of the Primary Tumor
Carcinoma Manifesting as Mural Thickening.
Carcinoma Manifesting as a Polypoid Mass.
Carcinoma Manifesting as a Gallbladder Fossa Mass.
Differential Diagnosis
Pathways of Tumor Spread
TREATMENT AND PROGNOSIS
Intracholecystic Papillary Neoplasm
Benign Gallbladder Neoplasms
Cholangiocarcinoma
EPIDEMIOLOGY
PRECANCEROUS LESIONS
CLASSIFICATION
PATHOLOGIC FINDINGS
CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Intrahepatic CCA
Perihilar CCA
Distal CCA
Intraductal Growing CCA and IPNB
Differential Diagnosis
TREATMENT
Ampullary Carcinoma
Neuroendocrine Neoplasm of Biliary Tract
Mucinous Cystic Neoplasm of Biliary Tract
Other Malignant Neoplasms of Biliary Tract
Benign Bile Duct Neoplasms
REFERENCES
51 - Inflammatory Disorders of the Biliary Tract
Primary Sclerosing Cholangitis
EPIDEMIOLOGY AND CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
FLUOROSCOPIC CHOLANGIOGRAPHY
ULTRASOUND, COMPUTED TOMOGRAPHY, AND MAGNETIC RESONANCE IMAGING
DIFFERENTIAL DIAGNOSIS
Cholangiocarcinoma
Benign Ductal Diseases
Primary Biliary Cholangitis
EPIDEMIOLOGY AND CLINICAL FINDINGS
RADIOGRAPHIC FINDINGS
Obstructive Cholangitis
Recurrent Pyogenic Cholangitis (Oriental Cholangiohepatitis)
Parasitic Infestation
ASCARIASIS
CLONORCHIASIS
INFESTATION WITH OTHER LIVER FLUKES
ECHINOCOCCAL CHOLANGITIS
REFERENCES
52 - Postsurgical and Traumatic Lesions of the Biliary Tract
Laparoscopic Cholecystectomy
NORMAL IMAGING FINDINGS AFTER UNCOMPLICATED LAPAROSCOPIC CHOLECYSTECTOMY
GENERAL POSTSURGICAL COMPLICATIONS
BILIARY TRACT COMPLICATIONS
Bile Duct Injury and Bile Leak
Retained Biliary Stones
Bile Duct Strictures
Imaging of Postoperative Bile Duct Injuries
Ultrasound and Multidetector Computed Tomography.
Hepatobiliary Scintigraphy.
Percutaneous Transhepatic Cholangiography.
Endoscopic Retrograde Cholangiopancreatography.
Magnetic Resonance Cholangiopancreatography.
Spilled Gallstones
Imaging of Spilled Gallstones.
Biliary-Enteric Anastomosis
BACKGROUND, INDICATIONS, AND TECHNICAL CONSIDERATIONS
COMPLICATIONS
Biliary Leak
Biliary Stricture
Post-Traumatic Lesions of the Biliary Tree
IMAGING OF POST-TRAUMATIC LESIONS
REFERENCES
SECTION VIII: Liver
53 - Benign Tumors of the Liver
Hemangioma
PLAIN RADIOGRAPHIC FINDINGS
NUCLEAR MEDICINE
ULTRASOUND
COMPUTED TOMOGRAPHY
ANGIOGRAPHY
MAGNETIC RESONANCE IMAGING
DIAGNOSTIC WORKUP
Focal Nodular Hyperplasia
PLAIN RADIOGRAPHIC FINDINGS
NUCLEAR MEDICINE
ULTRASOUND
COMPUTED TOMOGRAPHY
ANGIOGRAPHY
MAGNETIC RESONANCE IMAGING
Hepatocellular Adenoma
PLAIN RADIOGRAPHIC FINDINGS
NUCLEAR MEDICINE
ULTRASOUND
COMPUTED TOMOGRAPHY
ANGIOGRAPHY
MAGNETIC RESONANCE IMAGING
MULTIPLE HEPATOCELLULAR ADENOMATOSIS
Nodular Regenerative Hyperplasia
INCIDENCE AND CLINICAL PRESENTATION
PLAIN RADIOGRAPHIC FINDINGS
NUCLEAR MEDICINE
ULTRASOUND
COMPUTED TOMOGRAPHY
ANGIOGRAPHY
MAGNETIC RESONANCE IMAGING
Lipomatous Tumors
PSEUDOLIPOMA
Cysts and Cystic Tumors
SIMPLE CYST
Radiologic Findings
BILE DUCT HAMARTOMAS (VON MEYENBERG COMPLEXES)
CONGENITAL HEPATIC FIBROSIS AND POLYCYSTIC LIVER DISEASE
Radiologic Findings
CYSTADENOMA
Infantile Hemangioendothelioma
PLAIN RADIOGRAPHIC FINDINGS
ULTRASOUND
COMPUTED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING
Mesenchymal Hamartoma
PLAIN RADIOGRAPHIC FINDINGS
ULTRASOUND
COMPUTED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING
Miscellaneous Benign Tumors
BILE DUCT ADENOMA
LYMPHANGIOMATOSIS
LEIOMYOMA
INFLAMMATORY PSEUDOTUMOR
REFERENCES
54 - Malignant Tumors of the Liver
Hepatocellular Carcinoma
RADIOLOGIC FINDINGS
Plain Radiography
Nuclear Medicine
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Fibrolamellar Carcinoma
RADIOLOGIC FINDINGS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Differential Diagnosis
Hepatoblastoma
PATHOLOGIC FINDINGS
RADIOLOGIC FINDINGS
Plain Radiography
Nuclear Medicine
Ultrasound
Computed Tomography
Angiography
Magnetic Resonance Imaging
Intrahepatic Cholangiocarcinoma
RADIOLOGIC FINDINGS
Plain Radiography
Nuclear Medicine
Ultrasound
Computed Tomography
Angiography
Magnetic Resonance Imaging
Cystadenoma and Cystadenocarcinoma
PATHOLOGIC FINDINGS
RADIOLOGIC FINDINGS
Angiosarcoma
PATHOLOGIC FINDINGS
RADIOLOGIC FINDINGS
Plain Radiography
Ultrasound
Computed Tomography
Angiography
Magnetic Resonance Imaging
Undifferentiated (Embryonal) Sarcoma
INCIDENCE AND CLINICAL PRESENTATION
RADIOLOGIC FINDINGS
Plain Radiography
Nuclear Medicine
Ultrasound
Computed Tomography
Angiography
Magnetic Resonance Imaging
Epithelial Hemangioendothelioma
PATHOLOGIC FINDINGS
INCIDENCE AND CLINICAL PRESENTATION
RADIOLOGIC FINDINGS
Other Mesenchymal Sarcomas (Leiomyosarcoma, Malignant Fibrous Histiocytoma)
Lymphoma
RADIOLOGIC FINDINGS
Nuclear Medicine
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Metastases
RADIOLOGIC FINDINGS
Plain Radiography
Nuclear Medicine
Ultrasound
Hyperechoic Metastases
Bull’s-Eye or Target Pattern
Hypoechoic Metastases
Cystic Metastases
Calcified Metastases
Diffuse Infiltration
Computed Tomography
Magnetic Resonance Imaging
Doughnut
Target
Amorphous
Halo
Light Bulb
Role of Magnetic Resonance Imaging
REFERENCES
55 - Focal Hepatic Infections
Bacterial (Pyogenic) Hepatic Abscesses
Amebic Abscesses
INCIDENCE
RADIOLOGIC FINDINGS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Hepatic Echinococcal Disease
RADIOLOGIC FINDINGS
Plain Radiographic Findings
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
COMPLICATIONS
Fasciola hepatica
Candidiasis and Fungal Infections
Schistosomiasis
Pneumocystis carinii (Pneumocystis jiroveci) Infection
Tuberculosis
REFERENCES
56 - Diffuse Liver Disease
Hepatic Steatosis
RADIOLOGIC FINDINGS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Hepatitis
VIRAL HEPATITIS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
ALCOHOLIC HEPATITIS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Toxin- and Drug-Induced Liver Disease
CHEMOTHERAPY TOXICITY
AMIODARONE TOXICITY
Radiation-Induced Liver Disease
Hemosiderosis and Hemochromatosis
RADIOLOGIC FINDINGS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Glycogen Storage Disease
RADIOLOGIC FINDINGS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Amyloidosis
Wilson’s Disease
Gaucher’s Disease
Sarcoidosis
Primary Biliary Cholangitis
Secondary Biliary Cholangitis
Cirrhosis
PORTAL HYPERTENSION
Varices
GENERAL RADIOLOGIC FINDINGS: CIRRHOSIS
Liver Morphology
Etiology of Specific Findings
ULTRASOUND: CIRRHOSIS
Liver Morphology
Vascular Changes
Extrahepatic Findings
COMPUTED TOMOGRAPHY: CIRRHOSIS
Liver Morphology
Vascular Findings
MAGNETIC RESONANCE IMAGING: CIRRHOSIS
Liver Morphology
ULTRASOUND: PORTAL HYPERTENSION
COMPUTED TOMOGRAPHY: PORTAL HYPERTENSION
MAGNETIC RESONANCE IMAGING: PORTAL HYPERTENSION
TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT
REFERENCES
57 - Vascular Disorders of the Liver and Splanchnic Circulation
Transient Hepatic Attenuation Differences (THADs) and Transient Hepatic Intensity Differences (THIDs)
THADs AND THIDs NOT ASSOCIATED WITH A MASS LESION
Budd-Chiari Syndrome and Sinusoidal Obstruction Syndrome
RADIOLOGIC FINDINGS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Nodular Regenerative Hyperplasia
Liver in Cardiac Disease
RADIOLOGIC FINDINGS
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Peliosis Hepatis
Portal Vein Thrombosis
RADIOLOGIC FINDINGS
Plain Radiography
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Cavernous Transformation of the Portal Vein
Superior Mesenteric Vein Thrombosis
Splenic Vein and Inferior Mesenteric Vein Thrombosis
Hepatic Infarction
Hemolysis, Elevated Liver Enzymes, Low Platelets (HELLP) Syndrome
Visceral Artery Aneurysms
CLINICAL FINDINGS
Splanchnic Vein Aneurysms
Osler-Weber-Rendu Disease
REFERENCES
58 - Hepatic Trauma and Surgery
Hepatic Trauma
CLASSIFICATION OF HEPATIC TRAUMA
PATHOPHYSIOLOGY
Blunt Trauma
Penetrating Injuries
Iatrogenic Injuries
Spontaneous Rupture
RADIOLOGIC FINDINGS
Computed Tomography of Hepatic Injuries
Ultrasound
Nuclear Scintigraphy
Magnetic Resonance Imaging
Angiography
Plain Radiographs
TREATMENT
COMPLICATIONS
Bleeding
Infection
Biliary Tract Complications
Hepatic Surgery
RADIOLOGY IN SURGICAL PLANNING
INTRAOPERATIVE ULTRASOUND
INDICATIONS
Benign Lesions
Malignant Lesions
Hepatic Resection for Liver Metastases
Selection of Patients for Resection
TYPES OF HEPATIC RESECTION
Wedge Excision
Subsegmentectomy
Right Hepatic Lobectomy
Right Trisegmentectomy
Left Hepatic Lobectomy
Left Lateral Segmentectomy
Left Trisegmentectomy
Right Posterior Segmentectomy
Minimally Invasive Hepatic Resection
REFERENCES
SECTION IX: Pancreatitis
59 - Pancreatitis
Classification of Pancreatitis
Acute Pancreatitis
ETIOLOGY
DEFINITIONS
CLINICAL FINDINGS
RADIOLOGIC FINDINGS
Ultrasonography
Computed Tomography and Magnetic Resonance Imaging
Diagnosis.
Diagnostic Sensitivity.
Staging.
Grading System.
Delineation of Necrosis.
Indications for Examination.
COMPLICATIONS
Acute Peripancreatic Fluid Collection
Pseudocyt
Acute Necrotic Colletion
Walled-off Necrosis
Hemorrhage
Chronic Pancreatitis
ETIOLOGY
CLINICAL FINDINGS
RADIOLOGIC FINDINGS
Plain Films
Ultrasonography
Endoscopic Ultrasound
Endoscopic Retrograde Cholangiopancreatography
Magnetic Resonance Cholangiopancreatography
Computed Tomography and Magnetic Resonance Imaging
Pancreaticopleural Fistula
Paraduodenal Pancreatitis
Autoimmune Pancreatitis
Summary
ACKNOWLEDGMENT
REFERENCES
60 - Pancreatic Neoplasms
Introduction
Ductal Adenocarcinoma
IMAGING
Goals of Imaging
Imaging Findings
Multidetector Computed Tomography.
Magnetic Resonance Imaging.
Endoscopic Ultrasound.
Changes in the Main Pancreatic Duct
Accuracies of Multidetector Computed Tomography, Magnetic Resonance Imaging, and Endoscopic Ultrasound
Other Imaging Modalities
CURRENT TREATMENT OF PANCREATIC DUCTAL ADENOCARCINOMA
Cystic Neoplasms
SEROUS CYSTADENOMA
MUCINOUS CYSTIC TUMOR
INTRADUCTAL PAPILLARY MUCINOUS NEOPLASM
OTHER CYSTIC TUMORS
Pancreatic Neuroendocrine Tumors
INSULINOMA
GASTRINOMA
NONFUNCTIONING PANCREATIC NEUROENDOCRINE TUMOR
IMAGING
Secondary Pancreatic Neoplasms
REFERENCES
61 - Pancreatic Trauma and Surgery
Pancreatic Trauma
EPIDEMIOLOGY AND PATHOPHYSIOLOGY
CLINICAL FINDINGS
SURGICAL CLASSIFICATION
RADIOLOGIC FINDINGS
Computed Tomography
Ultrasound
Magnetic Resonance Pancreatography
Conventional Pancreatography
Gastrointestinal Studies
TREATMENT
Pancreatic Surgery
INDICATIONS FOR PANCREATIC SURGERY
Benign Disease
Malignant Disease
ROLE OF RADIOLOGY
Computed Tomography
FDG PET/CT
Magnetic Resonance Imaging
Intraoperative Ultrasound
TYPES OF PANCREATIC OPERATIONS AND POSTOPERATIVE RADIOLOGIC FINDINGS
Sphincterotomy
Puestow Procedure
Frey Procedure
Beger Procedure
Central Pancreatectomy
Whipple Operation
Bypass Procedures
POSTOPERATIVE COMPLICATIONS
REFERENCES
SECTION X: Spleen
62 - Benign and Malignant Lesions of the Spleen
Benign Lesions
DIFFERENTIAL DIAGNOSIS OF CYSTIC SPLENIC LESIONS
CONGENITAL CYSTS AND PSEUDOCYSTS
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
HEMANGIOMA
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
LYMPHANGIOMA
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
HAMARTOMA
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
INFLAMMATORY PSEUDOTUMOR
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
SCLEROSING NODULAR ANGIOMATOID TRANSFORMATION
SPLENIC INFECTION AND INFLAMMATORY DISEASE
Hydatid Disease
Epidemiology and Clinical Presentation.
Radiologic Imaging.
Pyogenic Abscess
Epidemiology and Clinical Presentation.
Radiologic Findings.
SPLENIC NODULAR DISEASE
Fungal Abscess and Microabscess
Epidemiology and Clinical Presentation.
Pathology.
Radiologic Findings.
Mycobacterial Infections
Pneumocystis jiroveci Infection
Bartonella Infection (Cat-Scratch Disease)
Sarcoidosis
SPLENIC INFARCTION
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
NONTRAUMATIC SPLENIC RUPTURE
SPLENOMEGALY
MISCELLANEOUS DISORDERS
Gamna-Gandy Bodies
Peliosis of the Spleen
Epidemiology and Clinical Presentation.
Pathology.
Radiologic Findings.
Sickle Cell Disease
Epidemiology and Clinical Presentation.
Gaucher’s Disease
Hemosiderosis
Thorotrast
Intermediate Lesions
LITTORAL CELL TUMORS
HEMANGIOENDOTHELIOMA AND HEMANGIOPERICYTOMA
Malignant Lesions
ANGIOSARCOMA
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
LYMPHOMA
Epidemiology and Clinical Presentation
Pathology
Radiologic Findings
Ultrasound.
Computed Tomography.
Magnetic Resonance Imaging.
Nuclear Imaging.
LEUKEMIA AND MYELOPROLIFERATIVE DISORDERS
METASTATIC DISEASE
Epidemiology and Clinical Presentation
Radiologic Findings
Ultrasound.
Computed Tomography.
Magnetic Resonance Imaging.
Nuclear Scintigraphy.
REFERENCES
63 - Splenic Trauma and Surgery
Splenic Trauma
RADIOLOGIC FINDINGS
Computed Tomography
Surgical and CT Classification of Splenic Injury.
Ultrasound
Other Techniques
COMPLICATIONS OF SPLENIC INJURY
TREATMENT AND OUTCOME
Splenic Surgery
REFERENCES
SECTION XI: Peritoneal Cavity
64 - Pathways of Abdominal and Pelvic Disease Spread
Hematogenous Spread
MALIGNANT DISEASE
Liver Metastases
Gut Metastases
INFECTION
Portal Vein
Systemic Arteries
Lymphatic Spread
Biliary Spread
INFECTION
MALIGNANT DISEASE
Peritoneal Spread
INTRAPERITONEAL FLOW OF FLUID
POUCH OF DOUGLAS
Malignant Disease
Infection
PERIHEPATIC SPACES
Malignant Disease
Infection
LEFT SUBPHRENIC SPACE
LOWER SMALL BOWEL MESENTERY
SIGMOID MESOCOLON
Retroperitoneal Spread
ANTERIOR PARARENAL SPACE
PERIRENAL SPACE
POSTERIOR PARARENAL SPACE
Subperitoneal Spread
TRANSVERSE MESOCOLON
GASTROCOLIC LIGAMENT AND GREATER OMENTUM
GASTROHEPATIC LIGAMENT
HEPATODUODENAL LIGAMENT
DUODENOCOLIC LIGAMENT
GASTROSPLENIC LIGAMENT
SPLENORENAL LIGAMENT
PHRENICOCOLIC LIGAMENT
SMALL BOWEL MESENTERY
SIGMOID MESOCOLON
BROAD LIGAMENT
FALCIFORM LIGAMENT AND LIGAMENTUM TERES
CORONARY LIGAMENT AND BARE AREA
Extraperitoneal Spread
ILIOPSOAS MUSCLE ROUTE
SACROSCIATIC NOTCH ROUTE
OBTURATOR FORAMEN ROUTE
ABDOMINAL WALL ROUTE
Conclusions
REFERENCES
65 - Ascites and Peritoneal Fluid Collections
Introduction
Types of Peritoneal Fluid Collections
Pathways of Fluid Distribution
Radiologic Findings
CHEST RADIOGRAPHY
PLAIN ABDOMINAL RADIOGRAPHY
BARIUM STUDIES
ULTRASONOGRAPHY
COMPUTED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING
REFERENCES
66 - Mesenteric and Omental Lesions
Primary Neoplasms
DESMOID TUMORS
MALIGNANT PERITONEAL MESOTHELIOMA
PRIMARY PERITONEAL SEROUS CARCINOMA
WELL-DIFFERENTIATED PAPILLARY MESOTHELIOMA
MULTICYSTIC PERITONEAL MESOTHELIOMA
DESMOPLASTIC SMALL ROUND CELL TUMOR
ADENOMATOID TUMOR
OTHER PRIMARY MESENCHYMAL TUMORS
Secondary Tumors
PERITONEAL CARCINOMATOSIS
CARCINOID TUMOR
LYMPHOMA
Inflammatory and Infiltrative Diseases
MESENTERIC PANNICULITIS OR SCLEROSING MESENTERITIS
TUBERCULOSIS
WHIPPLE’S DISEASE
AMYLOIDOSIS
EXTRAMEDULLARY HEMATOPOIESIS
TRAUMA AND HEMORRHAGE
MESENTERIC EDEMA
MESENTERIC CYSTS
Omentum
PRIMARY NEOPLASMS
METASTATIC DISEASE AND LYMPHOMA
INFLAMMATORY DISEASES
Pancreatitis
Tuberculosis
Panniculitis
MISCELLANEOUS CONDITIONS
REFERENCES
67 - Hernias and Abdominal Wall Pathology
Abdominal Hernias
Hernia Classification
Hernias
INTERNAL ABDOMINAL HERNIAS
Paraduodenal Hernia
Foramen of Winslow Hernia
Pericecal Hernia
Intersigmoid Hernia
Transmesenteric Hernia
Transomental Hernia
Retroanastomotic Hernia
ABDOMINAL WALL HERNIAS
Umbilical Hernia
Ventral Hernia
Spigelian Hernia
Lumbar Hernia
Incisional Hernia
PELVIC AND GROIN HERNIAS
Inguinal Hernia
Femoral Hernia
Obturator Hernia
Sciatic Hernia
Perineal Hernia
DIAPHRAGMATIC HERNIAS
Foramen of Morgagni Hernia
Foramen of Bochdalek Hernia
Traumatic Hernias
Anterior Abdominal Wall
ANATOMY
CONGENITAL LESIONS
Urachal Abnormalities
Omphalomesenteric Duct Abnormalities
Prune-Belly Syndrome
FLUID COLLECTIONS
Hematoma
Abscess and Cellulitis
NEOPLASMS
Primary Malignant Neoplasms
Metastatic Disease
Benign Lesions
Vascular Lesions
REFERENCES
Index