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ESOPHAGUS 
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cervical 
thoracic Generalized ileus
abdominal 
3 esophageal constrictions 
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 Small bowel obstruction
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Small Intestine 
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 Duodenum-- Mechanical LBO
 Jejunum-- 
 Ileum-- 
LARGE VS SMALL BOWEL 
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 Mechanical LBO
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Abnormal gas patterns 
  Hampton’s line
Hiatal Hernia Ulcer collar
1. Sliding Hiatal Hernia (99%) Ulcer mound-
2. Paraesophageal Hiatal Hernia Ring shadow
Carcinoma of the Esophagus
X-ray signs of malignant ulcers

Carmen meniscus sign-Kirklin meniscus complex

Carcinoma of the Stomach
Histology
Morphology
Esophageal Varices

1. Uphill varices
Causes
Metastases
2. Downhill varices
Causes Malignant ulcer
Ulcerating malignancy
Plain film Linitis plastica (scirrhous carcinoma)signet ring cell
Upper GI Series Duodenal Ulcer Disease
CT scan
Achalasia Pathophysiology
Location
Gastric Ulcers • Bulbar (95%)
Location • Postbulbar (3-5%)
• Almost all lesser curvature gastric ulcers <1cm are benign X-ray
Kissing ulcers
X-Ray Signs of a benign gastric ulcer Giant duodenal ulcer
Ulcer crater-(penetration) Clover-leaf deformity
Complications X-ray
Diffuse Small Bowel Disease Radiation Enteritis
X-ray
Sprue
X-ray Lymphoma
dilatation and dilution Sigmoid Volvulus
Segmentation 8%
Fragmentation elderly
Moulage sign
Scleroderma Abdominal plain films usually diagnostic
X-ray 1. Inverted U-shaped
dilated 2. Loss of haustra
not have increased secretions 3. Coffee-bean sign
Whipple’s Disease Sigmoid volvulus –
X-ray Cecal volvulus –
nodules markedly thickened bowelwall 4. Bird’s-beak or bird-of-prey sign 
Amyloidosis Ascariasis
X-ray
thickening of the valvulae Life cycle
Hypoproteinemia X-ray findings
X-ray 
Folds are quite thick (picket-fence) 
Giardiasis 
X-ray
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Thickening of the folds
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Marked spasm and irritability of the bowel
Ischemic Bowel Disease 
X-ray 
narrowed 
Folds are thickened“thumb-printing” 
Intramural Bleeding 
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 Causes of bull's eye, or target, metastases
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 Causes of calcified metastases
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 Causes of heterogeneously echogenic liver metastases
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Cystic metastases 
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 Mucinous cystic neoplasms
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Intraductal papillary mucinous tumors 
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  Infectious
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  Traumatic
  Vascular
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