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Common GI PathologiesKhalid Alkhamis
Content
Common GI Pathologies 2016 1
Stomach & duodenum
Small intestine
Large intestine
Esophagus
Common GI Pathologies 2016 2
Esophageal abnormalities
Strictures of Esophagus
Dilatation of Esophagus
• Esophageal cancer• Peptic strictures• Achalasia• Corrosive strictures
• Benign tumours (leiomyomas)• Other mediastinal masses• Anomalous right subclavian artery
• Obstructive• with a visible stricture e.g. achalasia or carcinoma
• Non-obstructive• E.g. scleroderma or disease involves the esophageal muscle
Other abnormalities• E.g. Zenker’s diverticulum or esophageal web
Zenker's Diverticulum
LocationOutpouching of pharyngeal mucosa above the cricopharyngeus (upper esophageal sphincter)
ImagingDiagnosis can be made by barium esophagogram or endoscopy. Barium esophagogram reveals a barium filled outpouching in the region of the esophageal inlet.
Common GI Pathologies 2016 3
Esophageal abnormalities
Common GI Pathologies 2016 4
Achalasia
Location & CauseNeuronal degeneration within the Auerbach'splexus in the esophagus.
ImagingBarium swallow reveals dilated esophagus with distal tapering and narrowing.
dilated esophagus with a sharply tapered “bird beak" narrowing
Esophageal abnormalities
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Esophageal abnormalities
Esophageal Carcinoma Peptic stricture
Common GI Pathologies 2016 6
Stomach & Duodenum
Peptic Ulcer
The ulcer (arrow) projects from the lesser curve of
the stomach
En face the ulcer (arrow) is seen as a rounded collection of barium.
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Stomach & Duodenum
Hiatus hernia
Sliding Rolling
gastro-esophageal junction (arrow)
Imaging Signs
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Small Intestine
Dilatation
Mucosal abnormality
Narrowing
UlcerationNormal barium follow-through
Common GI Pathologies 2016 9
Small Intestine
Dilatation Mucosal abnormality
Common GI Pathologies 2016 10
Small Intestine
Narrowing Ulceration
Small bowel loops are centrally located as compared to the large bowel
Extrinsic: Hernias, adhesions, masses, volvulusIntrinsic: Gallstones, foreign bodies
Common GI Pathologies 2016 11
Causes
Location
Small intestine Obstruction
Common GI Pathologies 2016 12
Small Intestine Obstruction
multiple distended centrally located small bowel loops with air-fluid levels
Imaging Signs
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Large Intestine
Narrowing or dilatation of the lumen
Filling defects
Diverticula and muscle hypertrophy
UlcerationNormal double-contrast
barium enema
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Large Intestine
Narrowing of the lumen Filling defects
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Large Intestine
muscle hypertrophy Ulceration
Common GI Pathologies 2016 16
AXR shows a grossly distended coffee bean shaped loop of bowel in the right upper
quadrant
Sigmoid Volvulus
A smooth narrowing is seen in the sigmoid colon where the colon has
twisted (arrow)
Common GI Pathologies 2016 17
References
