SKILL LAB

RADIOLOGI
GASTROINTESTINAL
Univesitas Muhammadiyah
Yogyakarta
dr. Khoirul Anwar

FOTO POLOS ABDOMEN

A Normal plain film of the abdomen. The lower margins of the

posterior portion of the liver, the hepatic angle (H), and the lower
part of the spleen (S) are delineated by a fat shadow. Both kidneys
(K) and the psoas muscle shadows (arrowheads) are outlined by a
fat shadow. The properitoneal fat stripe is also shown bilaterally
(arrows). B Diagram of normal abdominal plain film.

FOTO POLOS ABDOMEN

Normal Gas
Pattern

Gas in
stomach
ALWAYS

Gas in a
few loops
of small
bowel
D = 2.5 CM
Gas in
rectum or
sigmoid
ALMOST
ALWAYS

FOTO POLOS ABDOMEN

Always
air/fluid
level in
stomach

A few
air/fluid
levels in
small
bowel

Erect Abdomen

FOTO POLOS ABDOMEN

Large Bowel

Di tepi
Dinding dipisahkan oleh
Haustra

Small Bowel

Sentral
Valvulae extend across
lumen
Maximum diameter 2"

HYPERTROPY PYLORIC
STENOSIS

Penyempitan
kongenital
Hipertrophi pilorus
Single buble
String sign (pita)
Pada dewasa
kemungkinan karena
proses neoplasma

DUODENUM OBSTRUCTION
atropia duodeni

Kelainan kongenital
Bagian-bagian duodenum tak
tersambung
double buble

Abnormal Gas Patterns

Ileus Fungsional

Lokal (Sentinel Loops)

Generalized adynamic ileus

Mechanical Obstruction

Usus halus (SBO)

Usus besar (LBO)

ILEUS TERLOKALISIR
Key Features

One or two persistently dilated

loops of large or small bowel
Gas in rectum or sigmoid

May resemble early

mechanical SBO

Supine

Sentinel Loops

Prone

Sentinel
Loops
Cholecystitis

Appendicitis

Pancreatitis
Ulcer

Diverticulitis
Ulcer
Ureteral
calculus

Generalized Ileus
ILEUS PARALITICUS

Gas in dilated small bowel and

large bowel to rectum

Long air-fluid levels

HAUSTRA INCISURA

COIL SPRING

Supine

Erect

Gas in dilated small bowel and

large bowel to rectum
COIL SPRING

HAUSTRA INCISURA

Ileus Paralitikus
a diffuse abnormal gas pattern
with distention of the small
bowel, colon, and rectum
suggests functional ileus. Two
days later the patient underwent
laparotomy, and small bowel
ischemia was found

Mechanical SBO

small intestine distention due to mechanic

obstruction

Dilated small
bowel

Cause

Hernia*

Air fluid level

adhesions

Little gas in
colon,
especially
rectum

Volvulus

Hearing bone

Key:

Gallstone
ileus*
Intussuscept
ion

Dilated small bowel

Hearing bone

Mechanical LBO
Key Features

Dilated colon to
point of
obstruction
Haustra
incisura
Little or no air
in
rectum/sigmoid
Little or no gas
in small bowel,

Cause

Tumor

Volvulus

Hernia

Diverticulitis

Intussusception

Haustra incisura
Dilated colon

PNEUMOPERITONIUM
Perihepatic sign (tampak luscen di
aspek anterior hepar) lihat di buku
Semilunair shadow picture (cresent
sign)
Triangular sign lihat di buku
Football sign
Rigler sign

Crescent
sign /
semilunair
sign

Free Intraperitoneal Air

Air on both sides

of bowel wall
Riglers Sign

Free Intraperitoneal Air

Air on both sides of the

bowel wall (Riglers sign).
Normally (see below) you
do not see the bowel wall
as a discrete line.

Normal

Football
sign

Free Intraperitoneal Air

VOLVULUS
MEGACOLON
HERNIA DIAPHRAGMA
APPENDISITIS
ASITES
COLITIS
BACA DI BUKU BLOCK GUIDE ALIMENTARY SYSTEM (SUDAH
LENGKAP)