Acute appendicitis

Advantages &
Disadvantages
Diagnosti
c Imaging

Advantages

Ultrasound

Abdominal ultrasound
examination is more
useful in children and
thin adults, particularly if
gynaecological pathology
is suspected, with a
diagnostic accuracy in
excess of 90%

CT scan

Contrast-enhanced CT
scan is most useful in
patients in whom there is
diagnostic uncertainty.
May be cost-effective by
reducing both the
negative
appendicectomy rate and
the length of hospital
stay.

Disadvantages

Retrocecal appendix can

escape detection with
ultrasound.

Diverticular disease

Advantages &
Disadvantages
Diagnostic
Imaging

Advantages

CT Scan

Scan of choice to detect pericholic inflammatory change

Complications of diverticulitis including perforation,
abscess formation, fistulation and strictures can be
detected.
Used to guide percutaneous abscess draninage.

Acute Cholecystitis

Advantages &
Disadvantages
Diagnostic
Advantages

Disadvantages

Imaging
Abdominal XRay

Check out for stones and

look for any other
pathologies

Pickup rate for

gallstone less than
10%

Ultrasound

**Investigation choice for

gallstone
More sensitive than CT
scan

ERCP

Therapeutic
potential(stone removal,
sphincterotomy,
stenting)

High level of
complications(Panc
reatitis,
Cholangitis,
Haemorrhage,
Perforation into bile
duct,duodenum)

CT scan

Done in symptomatic
patient when uncertain
the causal of symptoms

Not done to
diagnose stones.
Might miss small

Intestinal Obstruction

Advantages &
Disadvantages
Diagnostic
Imaging

Advantages

X- Ray

Screening tool for

bowel obstruction, but
do not exclude this if
they are normal.
The main findings
include dilated bowel
loops with or without
the presence of fluid
levels.
Erect chest
radiographs can also
be used to screen for
complicating
perforation.

CT scan

Disadvantages

Urolithiasis

Advantages &
Disadvantages
Diagnostic
Imaging

Advantages

KUB X- Ray

May be able to see radioopaque stones (90% of

renal stones are radioopaque)
Look at the kidney size

Ultrasound

Can look at features of

stones (echogenic rim,
posterior acoustic
shadowing)

CT scan

mainstay of investigation
for acute ureteric colic.

Disadvantages

Opacities on a plain abdominal

radiograph that may be confused
with renal calculus

Abdominal Aortic
Aneurysm

Advantages &
Disadvantages
Diagnost Advantages
ic
Imaging
X- Ray

Disadvantages

In the
A tortuous, calcified aorta
anteroposterior or
may mimic an AAA
lateral projection,
unless both walls can be
calcification of
seen clearly.
both opposing
The lack of overlying
abdominal aortic
bony structures in the
walls must be
lateral projection may
present to outline
allow clearer definition of
AAAs.
the aneurysm.
However, this finding is
present in less than 50%
of cases.
Ultrasoun The screening
May not adequately
d
examination of
depict the entire
choice to evaluate
abdominal aorta if a large

Advantages &
Diagnosti Advantages
Disadvantages

Disadvantages

c Imaging
CT scan

An excellent
screening
examination for
AAA.
CT depicts the
absolute size of
the aneurysm.

Angiograph Safe procedure

y
In planning
surgical or
endovascular
repair

The extent of mural

thrombus and the presence
of dissection cannot be
evaluated without the
administration of contrast
material.
Contraindications to CTA,
include anaphylactic
reaction to contrast
material, renal failure and
pregnancy.
Invasive procedure
The true size of the
aneurysm may not be
discernible because of a
mural thrombus; therefore,
underestimation of the true