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Radiology

Gastrointestinal Interventions

Built from Fundamentals of Diagnostic Radiology

The first 25 slides of Gastrointestinal Interventions
The first 25 slides, exactly as they appear. The full deck has 110 content slides.

What’s inside

5 sections · 110 slides

  1. 01

    Overview

    • Scope of gastrointestinal interventions
    • Imaging tools in these procedures

    2 slides

  2. 02

    Mesenteric Angiography and Intervention

    Arterial anatomy, GI hemorrhage, ischemia, aneurysms, and trauma

    • Arterial supply of the gut
    • Mesenteric arterial supply
    • Celiac artery and its branches
    • Splenic and left gastric branches
    • Celiac axis anatomy
    • Superior mesenteric artery and its branches
    • Right-sided branches of the SMA
    • Superior mesenteric artery anatomy
    • Inferior mesenteric artery and its branches
    • Inferior mesenteric artery anatomy
    • Collateral connections between mesenteric arteries
    • Anastomotic connections of the mesenteric vasculature
    • Common arterial variants
    • Workup of GI bleeding
    • Upper versus lower GI bleeding
    • Detection thresholds for GI bleeding
    • Upper GI bleeding: incidence and presentation
    • Common causes of upper gastrointestinal hemorrhage
    • Treatment of upper GI bleeding
    • Angiographic signs of bleeding
    • Gastroduodenal artery pseudoaneurysm embolization
    • Embolization in the upper GI tract
    • Prophylactic left gastric artery embolization
    • Retrograde filling after embolization
    • Gastroduodenal artery embolization and retrograde filling
    • >90%
    • Transpapillary hemorrhage
    • Aortoenteric fistula
    • Lower GI bleeding: incidence and presentation
    • Causes of lower GI bleeding
    • Indications for intervention in lower GI bleeding
    • Imaging of lower GI bleeding
    • Embolization for lower GI bleeding
    • Ileocolic artery extravasation and coil embolization
    • Angiographic appearance of angiodysplasia
    • Angiodysplasia of the right colon
    • Small bowel bleeding
    • Overview of mesenteric ischemia
    • Causes of acute mesenteric ischemia
    • Presentation of acute mesenteric ischemia
    • Arterial embolism versus thrombosis
    • Treatment of acute mesenteric ischemia
    • Nonocclusive mesenteric ischemia (NOMI)
    • Chronic mesenteric ischemia
    • Mesenteric artery stenosis treated with stenting
    • Overview of mesenteric aneurysms
    • Distribution of visceral arterial aneurysms
    • Management of mesenteric aneurysms
    • Mesenteric trauma findings
    • Splenic pseudoaneurysm embolization after trauma
    • Embolization after trauma

    51 slides

  3. 03

    Biliary Interventions

    Percutaneous biliary drainage and cholecystostomy

    • Indications for percutaneous biliary drainage
    • Examples of causes of biliary obstruction
    • Presentation of biliary obstruction
    • Symptoms of biliary obstruction
    • Selecting percutaneous biliary drainage
    • Right- versus left-sided access
    • Crossing the biliary obstruction
    • Two types of biliary drain
    • Percutaneous biliary drainage access
    • Biliary stents for malignant obstruction
    • Metallic stents for internal biliary drainage
    • Complications of biliary drainage
    • Complications of biliary drainage
    • Benign strictures and bile leaks
    • Biliary drainage for suspected bile leak after liver transplant
    • Indications for percutaneous cholecystostomy
    • Preparation for cholecystostomy
    • Gallbladder access routes
    • Complications of percutaneous cholecystostomy
    • Two techniques for catheter placement
    • Gallbladder access under ultrasound guidance
    • Catheter care and removal
    • Cholecystostomy drain cholangiogram

    23 slides

  4. 04

    Percutaneous Abscess Drainage

    Draining abdominal and pelvic collections

    • Overview of abscess drainage
    • Contraindications to drainage
    • Route and imaging selection
    • US versus CT for percutaneous abscess drainage
    • Two catheter placement techniques
    • Drain size and method
    • Abscess access with ultrasound guidance
    • Perirenal collection drainage in a renal transplant
    • Special routes for deep pelvic collections
    • Transgluteal drainage of a deep pelvic abscess
    • Transrectal drainage of a deep pelvic abscess in pregnancy
    • Subphrenic collections
    • Complications and follow-up

    13 slides

  5. 05

    Enteric Access

    Gastrostomy and gastrojejunostomy tube placement

    • Indications for gastrostomy tube placement
    • Contraindications to percutaneous gastrostomy tube placement
    • Preparation for gastrostomy
    • Push versus pull gastrostomy
    • Push method steps
    • Gastrostomy placement with T-fasteners
    • Pull method steps
    • Gastrostomy tube placement by pull method
    • Gastrostomy complications
    • Gastrojejunostomy tube placement
    • Conversion of gastrostomy to gastrojejunostomy
    • Conversion of gastrostomy to gastrojejunostomy
    • Key takeaways
    • References
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • Brant and Helms' Fundamentals of Diagnostic Radiology

    21 slides