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Emergency Radiology (Cambridge, 2010)
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Contents List of contributors xi Foreword Philip Gishen xii Preface xiii Section 1 CT emergencies 1. Head 1 Mayil S. Krishnam 1.1 General principles 1 1.2 Acute subarachnoid hemorrhage 3 1.3 Acute subdural hematoma 5 1.4 Extradural hematoma 7 1.5 Traumatic parenchymal brain injury 7 1.6 Intracerebral/cerebellar hemorrhage 9 1.7 Cerebral venous sinus thrombosis 11 1.8 Ischemic brain injury 13 1.9 Bacterial meningitis 16 1.10 Encephalitis 17 1.11 Cerebral abscess 18 1.12 Hydrocephalus 19 1.13 Intracranial aneurysm 20 1.14 Hypoxic–anoxic brain injury 22 1.15 Carotid/vertebral artery dissection 22 1.16 Miscellaneous 24 2. Cardiovascular and chest 25 Mayil S. Krishnam 2.1 General principles 25 2.2 Chest trauma 27 2.3 Acute aortic dissection/ intramural hematoma 28 2.4 Traumatic aortic injury 32 2.5 Traumatic peripheral vascular injury 34 2.6 Endovascular aortic stent graft 36 2.7 Acute pulmonary embolism 38 2.8 Aortic aneurysm/rupture 40 2.9 Coronary artery imaging 42 2.10 Pleural empyema 44 2.11 Acute mediastinitis 45 2.12 Esophageal perforation/ dissection 46 2.13 Superior vena cava syndrome 48 2.14 Mesenteric vascular ischemia/ occlusion 49 2.15 Spontaneous subcutaneous emphysema 50 2.16 Miscellaneous: Stridor 51 3. Abdomen and pelvis 52 Mayil S. Krishnam 3.1 General principles 52 3.2 Abdominal trauma – general principles 53 3.3 Spleen trauma 55 3.4 Liver trauma 56 3.5 Renal trauma 58 3.6 Pancreatic trauma 60 3.7 Bladder trauma 61 vii 3.8 Bowel trauma 62 3.9 Intra-abdominal hemorrhage 64 3.10 Intra-abdominal collection 65 3.11 Acute appendicitis 67 3.12 Acute pancreatitis 69 3.13 Acute renal/ureteric colic 70 3.14 Bowel perforation 71 3.15 Acute inflammatory bowel disease 73 3.16 Bowel ischemia 75 3.17 Small bowel obstruction 78 3.18 Diverticulitis and diverticular abscess 81 Section 2 Other emergencies 4. Ultrasound 83 Jolanta Webb and Swati P. Deshmane 4.1 General principles 83 4.2 Abdominal trauma 84 4.3 Pleural empyema 86 4.4 Acute cholecystitis 87 4.5 Gallbladder empyema 88 4.6 Liver abscess 89 4.7 Obstructive jaundice 90 4.8 Biliary stent 91 4.9 Transjugular intrahepatic portosystemic shunt (TIPSS) 92 4.10 Hydro/pyonephrosis 93 4.11 Acute renal failure (ARF) 94 4.12 Renal vein thrombosis 95 4.13 Intra-abdominal collection 96 4.14 Acute deep vein thrombosis (DVT) 98 4.15 Femoral artery pseudoaneurysm 100 4.16 Abdominal aortic aneurysm 101 4.17 Carotid artery dissection 102 4.18 Normal pregnancy 103 4.19 Emergencies in pregnancy 104 4.20 Follicular cyst 108 4.21 Ovarian torsion 109 4.22 Liver transplant 110 4.23 Kidney transplant 111 4.24 Pancreatic transplant 113 4.25 Pericardial effusion 115 4.26 Bacterial endocarditis 116 4.27 Appendicitis 117 4.28 Pancreatitis 118 4.29 Testicular torsion and acute epididymo-orchitis 119 4.30 Psoas abscess and hematoma 121 5. Fluoroscopy 123 John Curtis and Mayil S. Krishnam 5.1 General principles 123 5.2 Spontaneous esophageal perforation 124 5.3 Esophageal anastomotic leak 125 5.4 Esophageal dissection 127 5.5 Gastric volvulus 128 5.6 Small bowel obstruction 130 5.7 Large bowel emergencies 132 5.8 Diverticulitis 137 5.9 Bowel perforation 138 5.10 Nephrostogram 140 5.11 Ascending urethrogram 141 5.12 Cystogram 143 5.13 Intravenous urography 144 5.14 Pegogram 145 6. Magnetic resonance imaging 147 Sacha Niven and Mayil S. Krishnam 6.1 General principles 147 6.2 Spinal cord compression 148 viii Contents 6.3 Acute ischemic stroke 150 6.4 Intracranial hemorrhage 152 6.5 Epidural abscess and discitis 153 6.6 Cerebral vein or sinus thrombosis 155 6.7 Encephalitis 156 6.8 Cauda equina syndrome 157 6.9 Vessel dissection 158 6.10 Central pontine myelinolysis 159 6.11 Pituitary apoplexy 160 6.12 Spinal trauma 161 6.13 Aortic dissection 163 6.14 Acute pulmonary embolism 166 6.15 Myocardial viability 168 6.16 Acute deep vein thrombosis 170 6.17 Critical limb ischemia 172 7. Interventional procedures – basics 175 Michael Murphy 7.1 General principles 175 7.2 Pigtail drainage of abscess 178 7.3 Nephrostomy 180 7.4 Angiography 182 7.5 Embolization 184 7.6 Catheter-directed thrombolyis/ thrombectomy 186 7.7 Transjugular intrahepatic portosystemic shunt (TIPSS) 189 7.8 Inferior vena-caval filters 191 7.9 Emergency aortic stentgrafting 193 7.10 Lumbar puncture 195 8. Pediatrics 197 Shivarama Avula and Nick Barnes 8.1 General principles 197 8.2 Bowel atresia 199 8.3 Small bowel malrotation and volvulus 201 8.4 Meconium ileus 203 8.5 Meconium plug syndrome 204 8.6 Necrotizing enterocolitis 205 8.7 Hirschprung’s disease 207 8.8 Obstructed hernia 208 8.9 Pyloric stenosis 209 8.10 Intussusception 211 8.11 Acute appendicitis 213 8.12 Complicated ovarian cyst 214 8.13 Testicular torsion 215 8.14 The painful hip 217 8.15 Miscellaneous 219 9. Skeletal trauma 223 John Curtis and Mayil S. Krishnam 9.1 General principles 223 9.2 Cervical spine injury 226 9.3 The cranio-cervical junction 227 9.4 Fractures of C1 (atlas) 228 9.5 Fractures of C2 (axis) 228 9.6 Lower cervical spinal injuries 231 9.7 Thoracic/lumbar spine trauma 236 9.8 Pelvic trauma 238 9.9 Facial trauma – general principles 240 9.10 Le Fort fractures 241 9.11 Orbital fractures 243 9.12 Miscellaneous: Orbital cellulitis 244 ix Contents 10. Miscellaneous 246 Swati P. Deshmane and Mayil S. Krishnam 10.1 Ventilation perfusion scan 246 10.2 Contrast media reaction 248 10.3 Nephrogenic systemic fibrosis (NSF) 251 10.4 Glasgow Coma Scale (GCS) 252 10.5 Cardiac arrest 253 10.6 Medications 254 Index 257 x Contents |
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