Tentiran coss

Gas in
stomach
Gas in a few
loops of
large bowel
Gas in
rectum or
sigmoid
Normal Gas Pattern
Erect Abdomen
Always
air/fluid level
in stomach
A few
air/fluid
levels in
small bowel
Sentinel Loops
Supine Prone
Pancreatitis
Ulcer
Diverticulitis
Cholecystitis
Appendicitis
Ulcer
Ureteral calculus
Sentinel Loops

Normal plain abdominal film of a newborn
ILEUS PARALITIK
SBO
LARGE BOWEL OBSTRUCTION
Pneumoperitoneum
Free Intraperitoneal Air
Air on both sides of
bowel wall Riglers
Sign
Free Intraperitoneal Air
Falciform
Ligament
Sign
Football sign
Pneumoperitoneum. Note falciform ligament
(arrow) and air in the left scrotal sac(S).

Crescent
sign
Free Intraperitoneal Air
Hepatomegali

Duodenal Atresia
Plain film double
bubble sign, no sign
of bowel gas at distal
region.
US stomach and
duodenum distention,
full fluid filled
No other radiologic
examination is need
Duodenal Stenosis
Radiologic findings
depend on severity and
stenotic location
double bubble sign, still
shown gas at distal
region.
Sometimes no double
bubble sign
Could be caused by
pancreas annulare or
duodenal web.
Atresia ileum
Atresia duodenum
INTUSSUSCEPTION
a cup-shaped filling defect at the site of obstruction & coiled
spring appearance
Hirschsprung disease
1. dilatasi tanpa udara & feses
2.zona transisi
Rasio rectosigmoid < 1
Esophageal
atresia
Esophageal Atresia
Diaphragm Congenital Hernia
APP
vesikolithiasis
URETEROLITHIASIS
Plain film : knee-chest
position horizonral ray
pubocoxygeal line
MR ; important in pre
or post operation (T1),
size of levator sling,
external sphingter
muscle and
surrounding
abnormalities
Wrong mesenteric fat
location
incontinentia

Esophageal Disease
Motility Disorders
Esophageal
Diverticula
frequently occur in
the middle and lower
third
Traction typemid-
esophagus
Pulsion typedistal
esophagus
Esophageal Disease
Neoplasms
Benign
Leiomyomas
duplication cysts
and lipomas
epithelial polyps are
rare
1.
The Stomach and Duodenum-
Benign Neoplasms
Adenomatous and
Inflammatory Polyps and
Villous Adenomas
Intramural Tumors
(Lipomas, neurofibromas,
and leiomyomas)
Polyposis syndromes
(familial colonic
polyposis, Gardners
syndrome, Peutz-Jeghers
syndrome, Cronkhite-
Canada syndrome)

PEMERIKSAAN RADIOLOGIS
Foto Polos: KOLITIS ULSERATIF, stadium akut. Tampak
dilatasi usus (5,5 cm) dengan bukti peninggalan ulserasi yang
lanjut merupakan sisa-sisa mukosa yang edema, mucosa
islands (panah-panah putih).
Diambil dari: Grainger GR, A David. Grainger & Allisons Diagnostic Radiologi :
A textbook of medical imaging. 3th ed, USA : Churchill Livingstone. 1997
BEKG: Tampak hilangnya lipatan
haustra pada kolon descending
dan tampak kesan ulserasi kecil-
kecil multipel, kecil dengan
gambaran lead-pipe
Gambar dari :
http://www.learningradiology.com/caseofweek/caseoftheweekpix2
BEKG: Tampak lesi granuler difuse
dan hilangnya struktur haustra
pada pleksura lienalis
Grainger GR, A David. Grainger & Allisons
Diagnostic Radiologi : A textbook
of medical imaging. 3th ed, USA :
Churchill Livingstone. 1997
Grafik: tampak
"collarbutton" ulcers dan
hilangnya seluruh haustra pada kolon
descendens dan sigmoid
collar stud ulcers (panah)
Memberi kesan keluar melewati
garis mukosa (kepala panah)
Federle MP, Jeffrey RB, Desser TS,
Anne VS, Eraso A et al.
Diagnostic Imaging Abdomen.
1th ed. Amirsys. 2004
Grainger GR, A David. Grainger & Allisons
Diagnostic Radiologi : A textbook of medical
imaging. 3th ed, USA :
Churchill Livingstone. 1997
Kolitis ulceratif

LANJUT:SEMUA MUKOSA KOLON
AWAL:HANYA MUKOSA REKTUM
Julh JH, Krummy AB, Kuhlman JE.
Paul & Juhls Essentials of Radiologic Imaging,
7th ed, Philadelphia : Lippincott, Williams and Wilkins.1998
Crohns disease
Pseudodivertikel
aphthoid ulcers multipel

Sutton D.
Textbook of Radiology and Imaging.
7th ed, London :
Churchill Livingstone. 2003
Gambar. Crohn disease
multipel ulkus yang bergabung
membentuk gambaran cobble stone
Gambar. String sign
penyempitan dan rigiditas dari loop
jejunum
ISCHAEMIC COLITIS
Gambaran klasik
'thumb-printing' di
splenic fleksura
splenikum

Julh JH, Krummy AB, Kuhlman JE.
Paul & Juhls Essentials of
Radiologic Imaging, 7th ed, Philadelphia :
Lippincott, Williams and Wilkins.1998

TOXIC MEGACOLON


Tak tampak gambaran haustra kolon pada kolitis ulseratif
kronis
Kolon tranversum tampak dilatasi dan gambaran "shaggy"
yang disebabkan oleh mucosa yang erosi & pseudopolyps

Federle MP, Jeffrey RB, Desser TS, Anne VS, Eraso A et al.
Diagnostic Imaging Abdomen. 1th ed. Amirsys. 2004
Adenocarcinoma
colon
BESK kolon tidak tampak haustra pada kolitis ulseratif
kronis uc. Striktur Apple core pada kolon transverse (panah)
karena adenocarcinoma

Federle MP, Jeffrey RB, Desser TS, Anne VS, Eraso A et al.
Diagnostic Imaging Abdomen. 1th ed. Amirsys. 2004
ACHALASIA
Kegagalan relaksasi spingter esophagus distal
>> anak-anak
Px kontras meal :
dilatasi esophagus disertai gambaran rats tail pada GEJ
HYPERTROPHIC PYLORIC STENOSIS

Penyebab belum
diketahui
Hipertropi otot sirkuler
massa canalis pylorus
Onset : 4-6 minggu
Laki-laki >>

Gejala :
muntah proyektil, BB
turun, dehidrasi
Px kontras meal :
Tampak gambaran tit sign dan double track sign pada regio pylorus
Ulkus duodeni
- Etiologi faktor stres, hiperasiditas, infeksi
Helikobakter, terapi steroid
- Dx : tanda 2
nd
spasme bulbus duodenum dan
antrum, deformitas pascabulbar
Karsinoma Kolon
Federle MP, Jeffrey RB, Desser TS, Anne VS, Eraso A et al.
Diagnostic Imaging Abdomen. 1th ed. Amirsys. 2004
Grafik: tumor dengan gambaran "apple core,
menyempitkan kolon sigmoid dengan
penyempitan lumen dan sebuah nodul pada
permukaan lumen tersebut
BEKS: gambaran klasik lesi "apple core"
di kolon, segmen pendek irreguler,
penyempitan lumen dan mukosa yang
rusak serta nodul "shoulders".