Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

937 results found
Article

Colonic anastomotic leak

Colonic anastomotic leaks occur in the early or late postoperative phase, in which the enteric anastomosis fails. This may be a small leak that can be managed conservatively or less commonly complete dehiscence requiring repeat surgery. Epidemiology In one large surgical series, the incidence ...
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Colonic diverticulosis

Colonic diverticulosis refers to the presence of multiple diverticula. It is quite distinct from diverticulitis which describes inflammation and infection of one or multiple diverticula. Epidemiology Diverticulosis is very common in westernised countries and is typically found in older individ...
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Colonic oesophageal interposition

Colonic oesophageal interposition is a now rarely performed upper gastrointestinal tract surgical procedure, in which colon is used to replace the distal oesophagus. This was performed for long oesophageal strictures or in some cases malignancy. The haustra of the colon are illustrated on plai...
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Colonic pseudo-obstruction

Colonic pseudo-obstruction (also known as Ogilvie syndrome) is a potentially fatal condition leading to an acute colonic distention without an underlying mechanical obstruction. It is defined as an acute pseudo-obstruction and dilatation of the colon in the absence of any mechanical obstruction....
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Colonic stricture

Colonic strictures can be long (>10 cm) or short. Short scirrhous colorectal carcinoma (apple core sign) post surgical (anastamotic stricture) Long malignancy scirrhous colorectal carcinoma gastrointestinal lymphoma inflammatory bowel disease (IDB) ulcerative colitis Crohn disease pos...
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Colon polyp

Colon polyps are mucosal outgrowths of the colon wall. They are of interest to physicians and radiologists because of the accepted progression of adenomatous polyps to colon carcinoma. Pathology adenomatous colon polyps tubular polyps tubulovillous polyps villous colon polyps dysplastic co...
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Colorectal cancer (staging)

Colorectal carcinoma staging can be performed using two systems. The traditional Dukes staging system has largely been replaced by the TNM system, but is nonetheless often used clinically. Staging Dukes (Astler-Coller modification) stage A: confined to mucosa stage B: through muscularis prop...
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Colorectal cancer (summary)

Colorectal cancer, also called colorectal carcinoma (CRC), is the most common cancer of the gastrointestinal tract and the second most frequently diagnosed malignancy in adults. CT and MRI are the modalities most frequently used for staging. Surgical resection may be curative although five-year ...
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Colorectal carcinoma

Colorectal carcinoma (CRC) is the most common cancer of the gastrointestinal tract and the second most frequently diagnosed malignancy in adults. CT and MRI are the modalities most frequently used for staging. Surgical resection may be curative although five-year survival rate is 40-50%. Epidem...
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Colovaginal fistula

Colovaginal fistula is one form of genitourinary fistula. It is also sometimes classed under a type of gastro-intestinal fistula. Pathology It refers to a communication between the colon (practically the rectum or sigmoid colon) with the vagina. At times, specific terms are used dependent on ...
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Colovesical fistula

Colovesical fistulas are communications between the lumen of the colon and that of the bladder, either directly or via an intervening abscess cavity (foyer intermediaire). When the communication is between the rectum and urinary bladder, the term rectovesical fistula is used. Epidemiology The ...
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Comb sign (mesentery)

The comb sign refers to the hypervascular appearance of the mesentery in active Crohn disease.  Fibrofatty proliferation and perivascular inflammatory infiltration outline the distended intestinal arcades. This forms linear densities on the mesenteric side of the affected segments of small bowel...
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Common bile duct

The common bile duct (CBD), which is sometimes simply known as the bile duct, is formed by the union of the cystic duct and common hepatic duct.  Gross anatomy The CBD is approximately 8 cm long and usually <6 mm wide in diameter but this can be dependent on a number of factors including age a...
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Common hepatic artery

The common hepatic artery (CHA) is a terminal branch of the coeliac artery. Gross anatomy Origin and course The CHA is a terminal branch of the coeliac artery, it passes to the right in the lesser sac, and enters the lesser omentum to pass slightly upwards towards the porta hepatis. It gives ...
Article

Common hepatic duct

The common hepatic duct is formed by the junction of the right and left hepatic ducts. It joins the cystic duct to form the common bile duct.  It is approximately 4 cm long and 4 mm in diameter.  Together with the cystic duct  (laterally) and cystic artery (superiorly), they form Calot's triang...
Article

Complications following gastric banding

There are many complications that can occur following gastric banding. It is helpful to divide these into early and late post-surgical complications. Clinical presentation Although the exact mode of presentation can vary depending on the underlying complication common modes of presentation tha...
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Complications post optical colonoscopy

Complications post optical colonoscopy are most commonly assessed by CT if patients present with abdominal symptoms post colonoscopy. Complications include: bowel perforation (most common) pneumoperitoneum pneumoretroperitoneum pneumomediastinum pneumothorax lower gastrointestinal haemorrh...
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Computed tomographic (CT) colonography

Computed tomographic (CT) colonography, also called CTC, virtual colonoscopy (VC) or CT pneumocolon, is a powerful minimally invasive technique for colorectal cancer screening. Indications screening test for colorectal carcinoma colon evaluation after incomplete or unsuccessful conventional c...
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Computed tomographic (CT) gastrography

Computed tomographic (CT) gastrography, also called virtual gastroscopy (VG), is a noninvasive procedure for the detection of gastric abnormalities. Advantages rapid and noninvasive exam offers information about local tumor invasion, lymph node and distant metastasis in cases of gastric cance...
Article

Cone-shaped caecum (differential)

A cone-shaped caecum refers to a loss of the normal rounded appearance of the caecum, which instead becomes narrow and cone-shaped with the apex pointing towards the base of the appendix. It is encountered in a number of conditions including: inflammatory infective blastomycosis amoebiasis ...
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Congenital extrahepatic portosystemic shunt classification

This congenital extrahepatic portosystemic shunt classification was proposed by Morgan and Superina in 1994 1: type 1: complete diversion of portal blood into the Inferior vena cava with congenital absence of the portal vein 1a: superior mesenteric vein and splenic vein do not join to form a c...
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Congenital intrahepatic portosystemic shunt classification

This congenital intrahepatic portosystemic shunt classification was proposed by Park et al in 1990 1: type 1: single large vessel of constant diameter connecting the right portal vein to the Inferior vena cava type 2: localised, peripheral shunt with one or more communications in a single hepa...
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Congenital portosystemic shunt

​Congenital portosystemic shunts are rare anatomical abnormalities linked to abnormal embryological venous development. They can be extrahepatic or intrahepatic. In either case, the underlying abnormality is shunting of blood from the portal venous system to the systemic venous system thus avoid...
Article

Congenital tracheo-oesophageal fistula

Congenital tracheo-oesophageal fistula is a congenital pathological communication between the trachea and oesophagus.   Epidemiology Tracheo-oesophageal fistula and oesophageal atresia have a combined incidence of approximately 1 in 3500 live births 1-3,5. There is only a minimal hereditary/ge...
Article

Conjoint tendon

The conjoint tendon forms when the medial fibres of the internal oblique aponeurosis unite with the deeper fibres of the transversus abdominis aponeurosis. The conjoint tendon then turns inferiorly and attaches onto the pubic crest and pecten pubis 1. It forms part of the posterior wall of the i...
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Corkscrew sign

The corkscrew sign describes the spiral appearance of the distal duodenum and proximal jejunum seen in midgut volvulus. It has been identified as a diagnostic indicator of midgut volvulus 1. In patients with malrotation and volvulus, the distal duodenum and proximal jejunum do not cross the mid...
Article

Cornual ectopic pregnancy

Cornual ectopic pregnancies are rare and represent a gestational sac within the cornua of a bicornuate or septate uterus.  Terminology Although sometimes interchangeably used with interstitial pregnancy, cornual pregnancy specifically refers to the presence of a gestational sac within a rudime...
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Corrosive oesophagitis

Corrosive oesophagitis usually occurs from accidental or suicidal ingestion of caustic substances (e.g. lye, household cleaners, bleaches, washing soda), and is harmful to the oesophagus due to their alkali medium. The stomach is not affected as the gastric acid can neutralize these substances, ...
Article

Cowden syndrome

Cowden syndrome, also known as multiple hamartoma syndrome, is characterised by multiple hamartomas throughout the body and increased risk of several cancers. Terminology Type 2 segmental Cowden syndrome is the association of Cowden syndrome with a Cowden naevus, when it is considered a type o...
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Crescent in a doughnut sign

The crescent in a doughnut sign refers to the transverse ultrasound appearance of intestinal intussusception, and is a variation of the target sign (which is also known as the doughnut sign) The doughnut is formed by concentric alternating echogenic and hypoechogenic bands. The echogenic bands ...
Article

Cricopharyngeal bar

Cricopharyngeal bar refers to the radiographic appearance of a prominent cricopharyngeus muscle contour on barium swallow. Terminology The terms cricopharnygeal bar and cricopharyngeal muscle spasm/achalasia are often used synonymously but this is incorrect because studies have demonstrated th...
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Cricopharyngeal muscle spasm

Cricopharyngeal muscle spasm is also known as cricopharyngeal achalasia, although some authors distinguish between these entities, and may present as a cause of dysphagia. Terminology There is confusing use of the terms cricopharyngeal muscle spasm, cricopharyngeal achalasia and cricopharyngea...
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Crohn disease

Crohn disease is an idiopathic inflammatory bowel disease (IBD) characterised by widespread gastrointestinal tract involvement typically with skip lesions. It is also known as regional enteritis, and frequently there is systemic involvement. Epidemiology The diagnosis is typically made between...
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Crohn disease vs ulcerative colitis

Due to the overlap in clinical presentation of Crohn disease (CD) and ulcerative colitis (UC), imaging often has a role to play in distinguishing the two. Distinguishing features include: bowel involved CD: small bowel 70-80%, only 15-20% have only colonic involvement UC: rectal involvement 9...
Article

Cronkhite–Canada syndrome

Cronkhite–Canada syndrome is a type of non-hereditary hamartomatous polyposis syndrome characterised by rash, alopecia, and watery diarrhea. Epidemiology There is a recognised male predilection. Patients typically are middle age, in their 60th 1. Clinical presentation Patients typically pres...
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CT abdomen (summary)

CT abdomen is an increasingly common investigation that is used to help make diagnoses of a broad range of pathologies. A CT abdomen in its simplest form is a CT from diaphragm to symphysis performed 60 seconds after pump-injection of iodinated contrast intro a peripheral vein. However, dependin...
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CT angiography of the splanchnic vessels

Multi-slice CT angiography of the splanchnic vessels is a powerful minimally invasive technique for evaluation of the splanchnic vascular system. Technique   The actual procedure will vary depending on institutional protocol/guidelines but below is a typical description 2, 4: patient receives...
Article

CT colonography reporting and data system

CT colonography reporting and data system is a method devised to standardise CT colonography reporting. Classification It primarily classifies abnormalities into colonic (C) and extra-colonic (E). Colonic classification C0: inadequate study C1: normal colon/benign lesion: routine screening ...
Article

CT enteroclysis

Computed tomographic (CT) enteroclysis refers to a hybrid technique that combines the methods of fluoroscopic intubation-infusion small bowel examinations with that of abdominal CT 1. Indications CT enteroclysis is complementary to capsule endoscopy in the elective investigation of small-bowel...
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CT enterography

Computed tomographic (CT) enterography is a non-invasive technique for diagnosis of small bowel disorders. Advantages  evaluates the entire thickness of the bowel wall offers information about the surrounding mesentery, the mesenteric vasculature and the perienteric fat useful in the assessm...
Article

CT hypotension complex

CT hypotension complex refers to the predominantly abdominal imaging features that occur in the context of profound hypotension. Multiple abdominal organs can display atypical appearances not related to the initial trauma but reflect alterations in perfusion secondary to hypovolemia which affect...
Article

CT peritoneography

CT peritoneography is an examination used to assess difficulties with peritoneal dialysis.  Indications Recurrent peritonitis with difficulty with fluid exchange abdominal wall or genital soft-tissue oedema, localized bulging of the abdomen, and poor ultrafiltration. Technique Before perform...
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CT polytrauma (technique)

CT polytrauma/multitrauma (also called trauma CT) is an increasingly used test in the patient with multiple injuries sustained after significant trauma. There is some evidence that trauma patients who undergo whole body CT (WBCT) / panscan have better survival than patients who undergo selectiv...
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CT severity index in acute pancreatitis

The CT severity index (CTSI) is based on findings from a CT scan with intravenous contrast to assess the severity of acute pancreatitis. The severity of computed tomography findings have been found to correlate well with clinical indices of severity.  The CTSI sums two scores: Balthazar score:...
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Cupola sign (pneumoperitoneum)

The cupola sign is seen on a supine chest/abdominal radiograph in the presence of pneumoperitoneum.  It refers to non-dependent gas that rises within the abdominal cavity of the supine patient to accumulate underneath the central tendon of the diaphragm in the midline. It is seen as lucency ove...
Article

Cystic duct

The cystic duct connects the neck of the gallbladder to the common hepatic duct (CHD), draining bile to and from the biliary tree. Gross anatomy The confluence of the cystic duct and the common hepatic duct forms the common bile duct. The cystic duct is approximately 2-3 cm long and 2-3 mm in ...
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Cystic fibrosis (abdominal manifestations)

Abdominal manifestations in cystic fibrosis are common, varied and nearly all organ systems can be affected. Only 39% of patients with cystic fibrosis (CF) have pulmonary symptoms as their sole complaint 1. 7% of CF patients do not present until adulthood. For a general discussion of cystic fib...
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Cystic lesions of the pancreas (differential)

The differential for cystic lesions of the pancreas includes: unilocular pancreatic pseudocyst intraductal papillary mucinous neoplasms (IPMN) serous cystadenoma uncommonly uni/macrolocular pancreatic cysts occur in association with  von Hippel Lindau syndrome autosomal dominant polycysti...
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Cystic lesions of the spleen (mnemonic)

A mnemonic for causes of cystic lesions in the spleen is: TEAM Mnemonic T: trauma E: echinococcal A: abscess M: metastasis
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Cystic (necrotic) lymph nodes

Cystic or necrotic appearing lymph nodes can be caused by a number of infectious, inflammatory or malignant conditions: Systemic squamous cell carcinoma metastases treated lymphoma leukemia plasmacytoid T-cell leukemia acute myeloid leukemia viral lymphadenitis herpes simplex lymphadenit...
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Cystic retroperitoneal lesions

A cystic retroperitoneal lesion can carry a relatively broad differenital which includes: retroperitoneal cystic lymphangioma retroperitoneal mucinous cystadenoma retroperitoneal cystic teratoma retroperitoenal cystic mesothelioma pseudomyxoma retroperitonei with cystic change perianal muc...
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De Garengeot hernia

De Garengeot hernia is defined as a femoral hernia containing the appendix. It is a rare phenomenon, with only 1% of all femoral hernias containing the appendix (and usually found incidentally at surgery), and only 0.08-0.13% containing an incarcerated acute appendicitis (sometimes detected on p...
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Degloving bowel injury

Degloving bowel injuries are a rare type of bowel and mesenteric injury only being described a handful of times in the literature 1-5. In these injuries the bowel is stripped of its mesentery and muscle, leaving a "mucosal tube" 2,3. Perforation may or may not be present.  See also degloving i...
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Degloving injury

Degloving injuries can refer to a number of conditions: degloving soft tissue injury Morel-Lavallee lesion (closed degloving soft tissue injury) intramuscular degloving injury degloving bowel injury
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Dehiscence

Dehiscence is a general term referring to 'splitting open' and is used in a variety of contexts in medicine generally and radiology more specifically.  The two most common usages are: splitting open of a wound (e.g. sternal dehiscence) loss of bone separating one structure from another (e.g. ...
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Dependent viscera sign

The dependent viscera sign is one of the signs of diaphragmatic rupture on axial CT or MR images, where herniated viscera lie against the posterior thoracic wall in a dependent position, as they are no longer supported by the diaphragm. See also  collar sign (or hourglass sign)
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Descending colon

The descending colon is the continuation of the transverse colon after the left colic flexure, where the colon loses its mesentery.  Gross anatomy The descending colon measures up to 25 cm length and is secondarily retroperitoneal. It descends down and is attached to the left posterior abdomin...
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Desmoplastic small round cell tumour

Desmoplastic small round cell tumour (DSRCT) is a rare and highly aggressive primary peritoneal malignancy. It is seen usually in young adoloscent and has male predominance with a mean survival of 2-3 years. Clinical presentation It usually presents with a palpable abdominal mass and abdominal...
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Diaphragm

The diaphragm is the dome-shaped muscle that separates the thoracic cavity from the abdominal cavity, enclosing the inferior thoracic aperture. Gross anatomy The muscular fibres of the diaphragm originate around the circumference of the inferior thorax and converge to a common insertion point ...
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Diffuse colonic nodularity (differential)

Diffuse colonic nodularity on barium enema or CT colonography has a range of possible etiologies: lymphoid hyperplasia (tend to be small and discrete) lymphoma (tend to be larger nodules and confluent) urticaria (closely spaced polygonal lesions, history is often helpful) pseudomembranous co...
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Diffuse oesophageal spasm

Diffuse/distal oesophageal spasm (DOS) is a motility disorder of the oesophagus. On barium swallow, DOS may appear as a corkscrew or rosary bead oesophagus, but this is uncommon. Manometry is the gold-standard diagnostic test.  Diffuse oesophageal spasm differs from hypercontracting oesophagus ...
Article

Diffuse peritoneal leiomyomatosis

Diffuse/disseminated peritoneal leiomyomatosis (DPL), also known as leiomyomatosis peritonealis disseminata, is an exceedingly rare benign disorder characterised by multiple vascular leiomyomas growing along the submesothelial tissues of the abdominopelvic peritoneum. Epidemiology DPL is usual...
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Diffuse small bowel disease

Diffuse small bowel disease may be caused by a number of conditions may be generalised multisystem disorders or conditions that effect the bowel in a global fashion: sprue scleroderma Whipple's disease amyloidosis hypoproteinaemia giardiasis intramural haemorrhage radiation enteritis sm...
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Discrete colonic ulceration

Discrete colonic ulcerations are nonspecific findings, and can be due to: Crohn disease infective colitis Yersinia entercolitis shigellosis tuberculosis cytomegalovirus (CMV) amoebic colitis vasculitic colitis Behcet disease
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Distal intestinal obstruction syndrome

Distal intestinal obstruction syndrome (DIOS) is one the of many abdominal manifestations of cystic fibrosis. In older children or young adults with cystic fibrosis, the distal small bowel may become obstructed with a mucofaeculent material in the distal ileum and right colon.    Epidemiology ...
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Diverticular disease

Diverticular disease covers a range of pathologies and may account for a wide variety of presentations. Pathology Outpouchings of bowel result in blind-ended diverticula in communication with the lumen of the bowel. They most commonly occur within the sigmoid colon, although they may be presen...
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Diverticulitis

Diverticulitis is one of the presentations of diverticular disease and is most often a complication of colonic diverticulosis. Differentiating one from the other is critical since uncomplicated diverticulosis is mostly asymptomatic and acute diverticulitis is a potentially life-threatening illne...
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Diverticulitis (summary)

Diverticulitis is one of the presentations of diverticular disease and is most often a complication of colonic diverticulosis. Differentiating one from the other is critical since uncomplicated diverticulosis is mostly asymptomatic and acute diverticulitis is a potentially life-threatening illne...
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Diverticulum

Diverticula are out-pouchings of a hollow viscus and can be either true or false. True diverticula contains all layers of the wall of the parent organ (typically mucosa, muscular layer and serosa) uncommon e.g. Meckel diverticulum False diverticula does not contain all layers (typically mu...
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Doge cap sign

The doge cap sign is a radiographic sign of pneumoperitoneum. It presents as a triangular-shaped gas lucency in the right upper quadrant on abdominal radiographs due to air in the Morison pouch, which resembles the medieval caps worn by Italian doges.
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Dorsal pancreatic agenesis

Agenesis of the dorsal pancreas is an extremely rare congenital pancreatic anomaly.  While complete agenesis of the dorsal pancreas is extremely rare, partial agenesis of the dorsal pancreas is thought to be most common than ventral pancreatic agenesis 4. Clinical presentation While many pati...
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Double barrel sign (disambiguation)

Double barrel sign is an imaging appearance of two lumens adjacent to each other. It can be seen in: dilated bile duct adjacent to portal vein double barrel aorta: aortic dissection double barrel oesophagus: oesophageal dissection
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Double bubble sign (duodenum)

The double bubble sign is seen in infants and represents dilatation of the proximal duodenum and stomach. It is seen in both radiographs and ultrasound, and can be identified antenatally 2. Pathology Causes include 1,2: congenital obstruction duodenal web duodenal atresia duodenal stenosis...
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Double contrast barium enema

The double contrast barium enema is rapidly being replaced by CT colonography, but remains in some centres for: the detection of polyps and colorectal cancer follow up screening for postoperative colorectal cancer evaluation of diverticular disease failed colonoscopy investigation of non-sp...
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Double duct sign

The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualise the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP).  The...
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Double track sign (pyloric stenosis)

The double track sign is a radiological sign described in pyloric stenosis on various imaging modalities.  Barium study Double streaks of barium passing through the narrow pylorus 1. Ultrasound On fluid aided real-time examination, the pyloric fluid is compressed into smaller tracks as it is...
Article

Double wall sign

The double wall sign is another name for the Rigler sign. It is a sign of pneumoperitoneum with gas outlining both sides of the bowel wall. It is seen when large amounts of free gas, >1000 mL, are present. It should be distinguished from the false double wall sign which refers to two dilated lo...
Article

Down syndrome

Down syndrome (or trisomy 21) is the most common trisomy and also the commonest chromosomal disorder. It is a major cause of intellectual disability, and also has numerous multi-system manifestations. Epidemiology According to the world health organisation (WHO), the approximate worldwide inci...
Article

Duct penetrating sign

The duct penetrating sign is a radiographic sign which can be useful in differentiating between focal pancreatitis (inflammatory pancreatic mass) from pancreatic carcinoma. A positive sign is when a mass is penetrated by an unobstructed pancreatic duct; this makes focal pancreatitis the most li...
Article

Dukes staging system for colorectal cancer

The Dukes staging system is a classification system for colorectal cancer. This system is now mainly of historical interest as it has largely been replaced by the TNM staging system. It is not recommended for clinical practice. Dukes A: invasion into but not through the bowel wall (90% 5 year s...
Article

Duodenal atresia

Duodenal atresia results from a congenital malformation of the duodenum and requires prompt correction in the neonatal period. It is considered to be one of the commonest causes of a fetal bowel obstruction. Epidemiology The prevalence of duodenal atresia is ~1 in 5,000-10,000 newborns, and th...
Article

Duodenal diverticula

Duodenal diverticula are outpouchings from the duodenal wall (intraluminal diverticulum discussed separately). They may result from mucosal prolapse or the prolapse of the entire duodenal wall and can be found at any point in the duodenum although are by far most commonly located along the media...
Article

Duodenal diverticulitis

Duodenal diverticulitis is a rare, inflammatory complication of duodenal diverticula.  Clinical presentation While the vast majority of patients are asymptomatic, patients with diverticulitis usually present with epigastric pain, nausea and vomiting.  Radiographic features CT duodenal diver...
Article

Duodenal filling defects

Duodenal filling defects may be caused by a wide variety of duodenal pathology which may be divided by their location and pathological process. Extrinsic gallbladder impression common bile duct impression gas-filled diverticulum Intrinsic Note: please refer to duodenal mucosal nodular fill...
Article

Duodenal haematoma

Duodenal haematoma results in haematoma formation in the duodenal wall. It may occur as a result of blunt abdominal trauma, non-accidental injury to children and spontaneously in anti-coagulated patients. Distinction must be made from duodenal perforation since the latter will require immediate...
Article

Duodenal varices

Duodenal varices is the dilatation of the posterior superior pancreaticoduodenal vein secondary to portal hypertension. They are much less common than oesophageal, rectal or fundal varices, but may be associated with them. Radiographic features Fluoroscopy Lobulated filling defects are best d...
Article

Duodenal web

A duodenal web, diaphragm or intraluminal diverticulum refers to a complete or incomplete obstruction at the duodenum due to a membranous web or intraluminal diverticulum. There is usually a small aperture at the centre differentiating this from a duodenal atresia.  Although they are frequently...
Article

Duodenitis

Duodenitis is a term given to inflammation of the duodenum. Pathology Aetiology A duodenitis can result from both intrinsic processes within the duodenum as well as from processes occuring outside the duodendum. It can occur from infective as well as non-infective inflammatory processes. Non...
Article

Duodenojejunal flexure

The duodenojejunal (DJ) flexure or junction is the anatomical border between the duodenum and the jejunum. Gross anatomy The DJ flexure is located anterolateral to the aorta at the level of the upper border of the second lumbar vertebra. It makes a sharp turn anteroinferiorly to become the jej...
Article

Duodenum

The duodenum is the first part of the small intestine and is the continuation of the stomach. Gross anatomy The duodenum is a 20-30 cm C-shaped hollow viscus predominantly on the right hand side of the vertebral column. It lies at the level of L1-3 and the convexity of the duodenum usually enc...
Article

Duplex appendix

Duplex appendix is a rare anomaly of the appendix and is usually discovered incidentally during surgery for appendicitis. Epidemiology Duplication of the vermiform appendix is extremely rare. It is found in only 1 in 25,000 patients (incidence ~0.004%) operated on for acute appendicitis. Altho...
Article

Dysphagia

Dysphagia refers to subjective awareness of difficulty or obstruction during swallowing. It is a relatively common and increasingly prevalent clinical problem.  Fluoroscopy is the mainstay of imaging assessment but manometry can help evaluate the esophageal motor pattern and lower esophageal sp...
Article

Dysphagia megalatriensis

Dysphagia megalatriensis, also known as cardiovascular dysphagia or cardiac dysphagia, is an impairment of swallowing due to oesophageal compression from a dilated left atrium.  Clinical presentation Presentation is generally with mild dysphagia, although a minority of patients will have dysph...

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