Problem Oriented Imaging of Gastrointestinal Tract (GIT); "News and Views"

The anatomic and functional abnormalities of GI-tract can be divided into congenital disorders to be observed in early life and acquired diseases which manifest themselves later on. The clinical symptoms in both groups are generally; vomiting or gastric retention, abdominal distention, pain, failure to pass meconium or abnormal defecation and others depending on severity and location of such disorders. An imaging approach has to be related to the clinical finding and it should be problem orientated. The available modalities for evaluation of different GIT abnormalities include abdominal plain film, ultrasound, CT, MRI, endoscopy and nuclear scanning. Abdominal plain film and ultrasound can be considered as the first step in most of the emergency cases. The use of GI series with contrast media is a golden standard in a large number of upper and lower GI abnormalities. The technique and the manner of examination are reported differently in literature and textbooks. The diagnostic approach in GI-series needs an appropriate technique depending on the age and condition of the patient to avoid the risk of aspiration and other complications. Endoscopy and MR enteroclysis are the first choice in evaluation of colitis and Crohn' s disease. Only in exceptional cases are GI-series with contrast agent indicated. Because of the high radiation dose of the CT, it is to be reserved for complicated cases of intestinal disorders, such as complex intestinal infection with abscesses and detection of sonographic unrecognizable appendicitis, tumors and others. Nuclear scanning is frequently needed for detection and localization in occult gastro-intestinal bleedings especially when there is clinical suspicion of Meckel's diverticula and intestinal duplication; ectopic gastric tissue shows intense uptake of radio nuclide if gastric tissue exists. The aim of this workshop is to show my own experiences and practical new techniques in evaluation of GI abnormalities. Special attention should be paid to diversities of sonographic finding in appendicitis and appropriate techniques in hydrostatic reduction of intussusceptions. Additionally, special methods in the diagnosis of Hirschsprungs disease and anorectal malformation with contrast media will be shown.