Learning objectives
- Recognize the most common X-ray signs associated with the abdominal tract diseases;
- Alphabetical sorting of the abdominal x-ray signs;
- Describe the pathophysiologic characteristics associated with the radiologic findings;
- Discuss the pertinent features related to each sign with emphasis on the cause of the appearance of these signs and the differential diagnoses to be considered
Background
There is a significant role for plain radiographs and contrast studies of the abdomen in the evaluation of the patients.
The radiographs of the abdomen are a reasonable way to start the imaging evaluation especially with acute abdomen.
The radiologic signs in general are recognizable characteristic patterns used to describe abnormalities visualized on imaging modalities that ultimately aid in the diagnosis and subsequent treatment of disease.
When a classic sign is invoked,
it immediately brings an image to mind and add confidence to the diagnosis...
Findings and procedure details
“A”
Apple Core Sign
Definition: it is a radiologic manifestation of a focal stricture in the bowel,
on contrast studies.
Underlying Diseases:
-carcinoma of the colon (stenosing annular colorectal carcinoma) – the most frequent cause (1,2)
-lymphoma
-Crohn's disease
- chronic ulcerative colitis,
- ischaemic colitis,
- Chlamydia infection,
- tuberculosis,
- Helminthoma,
- Amoebiasis,
- Cytomegalovirus,
- villous adenoma,
- radiosurgery (2).
Radiographic features:
- The stricture shows shouldered margins and resembles an apple bite (1);
- The characteristics that suggest a colon carcinoma...
Conclusion
The knowledge and familiarity with these signs helps in arriving at a diagnosis in day-to-day practice.
The newer imaging modalities may render some signs obsolete,
but they do not change the basic pathophysiology on which the signs are based.
References
(1) Roche CJ,
O'Keeffe DP,
Lee WK,
Duddalwar VA,
Torreggiani WC,
Curtis JM.
Selections from the buffet of food signs in radiology.
Radiographics.
2002 Nov-Dec;22(6):1369-84.
(2) Alzaraa A,
Krzysztof K,
Uwechue R.
Apple-core lesion of the colon: a case report.
Cases J.
2009;2 (1): 7275.
(3) Carrott,
Philip W.,
MD; Mann,
James A.,
MD; Kozower,
Benjamin D.,
MD,
MPH,
FACS.
Esophageal Function Testing.
Current Surgical Therapy.
2014.
Pages 1-9.
(4) Achkar E: Achalasia.
Gastroenterologist.
1995;3:273-288.
(5) Burrell HC,
Baker DM,
Wardrop P,
Evans AJ.
Clin...
