abdomen 2

KIDNEY

Cyst

Stone

Angiomiolipoma (AML)

Cancer

Hydronephrosis

  • frequency increases with age detected with CT or US exam
  • well-marginated anechoic lesion with thin walls
  • a few thin septa may be present (5% of cysts)
  • a small amount of intracystic hemorrhage/debris may be present, and may require further evaluation (5% of cysts)
  • Most patients tend to present between 30-60 years of age
  • incidence is high, seen in as many as 5% of women and 12% of males
  • The most common stone is calcium oxalate (75%)
  • A type of benign renal neoplasm and are composed of vascular, smooth muscle and fat elements.
  • They can spontaneously haemorrhage, which can be fatal
  • Age of presentation: 43 years
  • A strong female predilection
  • Renal cell carcinomas (RCC)
    Usually occur in 50-70 year-old patients
    Macroscopic haematuria occurs in 60% of the cases
    A moderate male predilection of 2:1
  • Dilatation of the urinary collecting system of the kidney

Gastrointestinal Tract

Colorectal carcinoma

  • The commonest malignant tumor of the gastrointestinal tract and the second commonest malignant tumor in men and women
  • The peak incidence is between 50 and 70 years of age
  • The predominant histological type is adenocarcinoma (70%), followed by mucinous carcinoma (20%) and anaplastic carcinoma
  • Approximately 90% of all colorectal carcinomas arise from polyps

CT

  • show an exophytic, polypous type of growth with frequent central degeneration, and they tend to infiltrate the bowel wall
  • More than 50% of colorectal carcinomas occur the rectum and sigmoid colon
  • Regional lymph node metastases involve the pericolic and perirectal nodes
  • Potential complications of colorectal carcinoma includes: bowel obstruction, perforation, hemorrhage, fistula formation

CT morphology

  • Focal or circular wall thickening
  • or intramural masses that show enhancement with intravenous contrast
  • CT colonography is indicated to detect additional lesions proximal to a stenotic primary that cannot be passed by the endoscope

Bowel perforation

  • CT is more sensitive than plain film radiography for the detection of a small pneumoperitoneum and unsuspected gastroduodenal perforation
  • Perforation can be result of an injury (seat belt, steering wheel or iatrogenic) or an intrinsic lesion (Crohn’s disease, diverticulitis)
  • Perforation of the jejunum, ileum or colon may cause substantial amounts of intra-abdominal free air

Bowel obstruction

  • In mechanical bowel obstruction, dilated bowel loops with gas-fluid levels are seen proximal to the obstruction
  • CT usually provides more detailed information of the cause (e.g. adhesions, tumor) and location of the obstruction

Gastric ulcer

  • The peptic ulcer disease is encountered more frequently in males (M:F 3:1)
  • Usually in the older population
  • Risk factors include: Helicobacter pylori infection, NSAIDs, corticosteroid

Ulcerative Colitis

  • An inflammatory bowel disease which predominantly affects the colon
  • Typically ulcerative colitis manifests in young adults (15-40 years of age) and is more prevalent in males
  • X-Ray: a mural thickening with thumbprinting

Colonic diverticulosis

  • Is very common in westernised countries
  • Typically found in older individuals
  • At 40 years of age, approximately 5% of the population have diverticula
  • At 60 approximately 30%, increasing to 50-80% by the age of 80

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