explorarea radiologica a tubului digestiv 2
DESCRIPTION
tb digTRANSCRIPT
![Page 1: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/1.jpg)
Sindromul piloric
- Secundar unui ulcer piloric recidivant, trenanatRx.: stomac “in chiuveta”- alungit, dilatat, cu fundul sub creasta iliaca- Aton, achinetic- Pliuri sterse- Lichid de staza, mucus, resturi alimentare- Umplere de jos in sus, imagini de “fulgi de zapada”- Absenta evacuarii in cursul examinarii- Bariu in stomac >3 ore de la ingestie si la 24 de ore
Stenoza antro-pilorica maligna
- Secundar unui proces proliferativ vegetant sau ulcerant antro-piloric– aspect aparent alungit al pilorului– ingustare a regiunii antrale prepilorice –
stenoza axiala sau excentrica– contur neregulat, imagini de semiton,
pinteni maligni – in t. vegetante– pereti rigizi, regulati – in t. infiltrative– tranzitul prezent transpiloric, redus
cantitativ– dilatare a stomacului suprajacent
(niciodata pana la dimensiunile din stenoza benigna)
Stenoza pilorica ulceroasa
![Page 2: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/2.jpg)
Stenoza pilorica benigna
![Page 3: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/3.jpg)
Stenoza maligna antro-pilorica
![Page 4: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/4.jpg)
Stomacul operatFara rezectie gastrica- Vagotomie cu piloroplastie- Sutura ulcerului- Gastroentero-anastomozeCu rezectie gastrica- Anastomoza gastroduodenala T-T tip Pean-Billroth I- Anastomoza gastro-jejunala T-L tip Reichel-Polya- Anastomoza gastro-jejunala T-L tip Hoffmeister-FinstererManifestari patologice postoperatoriiLa nivelul bontului:- Gastrita- Ulcerul peptic- Invaginatia- Cancerul La nivelul anastomozei- StomitaLa nivelul anselor anastomotice- Ulcerul peptic- Sindr. de ansa aferenta- “dumping” sindrom – secundar unei evacuari rapide a bontului
![Page 5: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/5.jpg)
Stomacul operat
A G-D
A R-P
A H-F
![Page 6: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/6.jpg)
Stomac operat – coturul
neregulat, cu pinteni maligni
Stomac operat – coturul
neregulat, cu pinteni maligni
![Page 7: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/7.jpg)
DUODENUL
Aspectul radiologic normalBulbulNormoton: forma triughiulara - lungime
3-6 cm.Hipoton: alungitHiperton: rotund2 curburi (mica si mare); 2 fete (ant. si post.)Relieful mucos: pliuri subtiri,
longitudinale la nivelul bulbuluiCadrul duodenalRelief mucos cu pliuri transversale,
perpendiculare pe contur -aspect dintat
Tranzit in 60-90 sec
![Page 8: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/8.jpg)
![Page 9: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/9.jpg)
AFECTIUNILE DUODENULUI
Diverticulii duodenali
- plusuri de umplere legate prin pedicul
- unici sau multiplii,
- obisnuit pe DII sau DIII
- forma rotund-ovalara, contur net.
Duodenitele
Sunt inflamatii ale mucoasei duodenale, obisnuit secundare ulcerului gastro-duodenal, afectiunilor hepato-biliare, pancreatita, apendicita.
Radiologic:
Semne functionale: hipertonie si hiperkinezie; in formele vechi – hipotonie
Semne organice: mucoasa ingrosata polipoida, contur neregulat, calibru ingustat neuniform.
![Page 10: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/10.jpg)
Diverticuli duodenali
![Page 11: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/11.jpg)
Diverticul duodenal pe conturul intern D III
![Page 12: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/12.jpg)
Diverticul pe D II
![Page 13: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/13.jpg)
Diverticul dd (neomogen) cu resturi alimentare
![Page 14: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/14.jpg)
Diverticuli duodenali – vezi pedicul
![Page 15: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/15.jpg)
Ulcerul duodenal– in 90% cazuri – ulcer bulbar
Radiologic: • semnul direct – imaginea de nisa - situata pe una dintre fete, foarte rar pe curburi• semne indirecte functionale: - hipertonie, hiperkinezie, hipersecretie la nivelul stomacului- aspect de bulb iritabil, intolerant, care se evacueaza rapid, spasme localizate.• semne indirecte morfologice:- alterarea reliefului gastric cu aspect de gastrita,- pilor descentrat, - bulb cu modificari de forma si dimensiuni.
Tumorile duodenului
Benigne: polipi – imagini lacunare, omogene, net conturate
Maligne – extrem de rare.
Modificarile duodenului in patologie de vecinatate
Patologia pancreatica: pancreatite acute, cronice, t. pancreatice
-Largirea cadrului dd.
-Stergerea pliurilor pe conturul intern
-Contur intern neregulat, dintat, rabotat
Bulb acut ulceros: nedeformat, imagine de nisa inconjurata de edem
Bulb cronic ulceros: deformat, neomogen, pliuri neregulate, eventual stenozant
![Page 16: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/16.jpg)
Ulcere bulbare in oglinda
![Page 17: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/17.jpg)
Imagine de nisa: plus de umplere
![Page 18: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/18.jpg)
Bul dd normal/ deformat “trifoi”
![Page 19: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/19.jpg)
Deformare bulb duodenal
![Page 20: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/20.jpg)
Ulcer duodenal
![Page 21: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/21.jpg)
Ulcer duodenal/ staza in genunchiul inferior
![Page 22: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/22.jpg)
Ulcer duodenal/ compresie
![Page 23: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/23.jpg)
Polip bulbar
![Page 24: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/24.jpg)
Polip bulbar
![Page 25: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/25.jpg)
Afectiunile intestinului subtireAspect radiologic normal
Topografie-Jejun – hemiabdomen stg. sup. si periombilical
-Ileon – hemiabdomen dr. inf. si pelvis
Calibru – 3 cm-2-2,5 cm
Relieful mucos – autoplastica vie
Contururi – dintaturi fine , regulate, simetrice-jejun
Tonus si cinetica
Tranzitul – in 3-4 ore la valva ileocecala
Anomalii congenitale
Mezenterul comun
- rotatia incompleta sau inversa a intestinului primar
- mezenterul primitiv nu se mai segmenteaza in mezouri, ramane comun intestinului subtire si colonului
- intestin subtire pe dr. si colon pe stg. abdomenului
Diverticulii
Diverticulul Meckel
- persistenta partiala a canalului omfalo-vitelin
- situat la 20-50 cm de valva ileocecala
![Page 26: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/26.jpg)
Intestinul gros
Aspect radiologic normal
![Page 27: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/27.jpg)
Timp I
Reflux in ultima ansa ileala
![Page 28: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/28.jpg)
Timp II – evacuarea continutului
![Page 29: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/29.jpg)
Opacifiere neomogena a rectului si sigmoidului-materii fecale
![Page 30: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/30.jpg)
Timp III/ Proba Fischer
![Page 31: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/31.jpg)
Apendice vermiform
![Page 32: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/32.jpg)
Opacifiere neomogena a rectului si sigmoidului-materii fecale
![Page 33: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/33.jpg)
Imagin lacunare – de fapt prezenta bulelor de aer introduse cu clisma baritata
![Page 34: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/34.jpg)
Apendicita cronica
![Page 35: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/35.jpg)
Ptoza de colon transvers
![Page 36: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/36.jpg)
Fecaloame aderente la perete (examen cu dublu contrast)
![Page 37: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/37.jpg)
TUBERCOLOZA ILEOCECALA
=Inflamatia specifica a foliculilor limfatici si placilor Payer
Debut : ultima ansa dilatata prin atonie inflamatorie + edem +aspect “batut in cuie” (hipertrofia formatiunilor limfoide)
Nodulul de alarma = pierdere de substanta pe marginea libera a ileonului, la ~ cm de cec prin Htrofia unei placi Payer sau compresia unui ggl. Htrofiat
Cec cu contur neregulat, fund retractat
Ulceratiile = semn al cazeificarii foliculilor limfatici = dintaturi pe contur sau opacitati persistente de fata
Tranzit accelerat la nivelul ansei bolnave
Semnul lui Stierlin = segment ileocecal interesat intolerant pentru bariu
Stadiu avansat = ileon terminal rigid, fixat, ingustat prin scleroza
ILEITA TERMINALA (BOALA CROHN)
= inflamatie nespecifica, ileon terminal
Debut : dilatatie hipotona, cu staza + edem + aspect “batut in cuie”, pseudipolipoid
Hipertonie localizata, cu lumen ingust, iritabil si spasm al sfincterului ileocecal
Ulceratii = dintaturi marginale sau opacitati persistente
Semnul lui Bodart = asimetria ansei terminale prin scurtarea marginii mezenterice pe care se gaseste ulceratia
Semnul Stierlin
Cec spasmodic
Stadiu avansat = semnul corzii (al lui Kantor) = ileon terminal ingust, rigid, fixat, scurtat
Anse din amonte dilatate, cu staza si nivele hidroaerice
Fistule – caracteristice -abcese in fosa iliaca dr., fistule la piele, vezica, vagin
Enteritele nespecifice
- Modificari functionale hipertonia si hipotonia, tranzit accelerat sau intarziat, continut gazos si nivele hidroaerice
Modificari morfologice
- pliuri ingrosate, rigide, neregulate,
- autoplastica diminuata
Enteritele
![Page 38: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/38.jpg)
Boala Crohn
![Page 39: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/39.jpg)
Tuberculoza ileo-cecala
![Page 40: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/40.jpg)
Boala inflamatorie cronica
![Page 41: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/41.jpg)
Diverticulii colonului-La adulti, frecvent multipli, de la ~mm la ~cm
-Plusuri de umplere legate prin pediculi
Diverticuloza
Diverticulita
Fistule colice
Colitele
Modificari functionale-De tranzit – accelerat sau intarziat
-De tonus - hipertonie/hipotonie
-De secretie – hipersecretie
Modificari morfologice
De relief mucos – pliuri ingrosate, neregulate, imprecis delimitate, cu retinere de bariu intre pliuri, aderent la depozitele de mucus sau patrunderea lui in ulceratii
De contur
– haustrele isi pierd simetria si dispozitia regulata, apoi dispar
- dintaturi ce traduc ulceratii
De calibru
- Initial larg prin hipotonie, apoi stenozat prin procese cicatriceale retractile
![Page 42: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/42.jpg)
Diverticuli – plus de umplere
![Page 43: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/43.jpg)
Diverticuli – plus de umplere
![Page 44: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/44.jpg)
Rest de Ba in diverticuli – la 24/ 48 de ore
![Page 45: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/45.jpg)
Plus de umplere (diverticuli) neomogeni prin prezenta continutului colic- diverticulita
![Page 46: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/46.jpg)
Ocluzia intestinala
= sindrom morfo-functional caracterizat prin oprirea tranzitului intestinal
Cauze mecanice – tumori intrinseci, compresii /invazii extrinseci, torsiuni, aderente
Cauze dinamice (functionale) – pareze intestinale – reflexe sau inflamatorii
Rx. = imagini hidroaerice
- La nivelul colonului : dispuse pe flancuri, numar mic, diametru mare dispus vertical
- La nivelul ileonului : dispuse abdominal central, diametrul mare orizontal
- La nivel jejunal : dispuse in hemiabdomenul stg. Superior, cu aceleasi caractere de la ileon
- In ocluziile cu localizare joasa : imagini intricate
![Page 47: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/47.jpg)
![Page 48: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/48.jpg)
![Page 49: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/49.jpg)
![Page 50: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/50.jpg)
Tumorile colonului Tumori benigne- Polipul – frecvent rectosigmoidia- Polipoza rectocolonicaTumori maligne- Adenocarcinoame – vegetante sau infiltrante, asociind leziuni ulcerativeForma vegetanta = lacuna + relief malign + semiton + pinteni maligni (“pantalon
de golf”, explozie de grenada”, “cotor de mar”)Forma infiltranta = rigiditate parietala, contur dintatIn stadii tardive, in ambele forme - stenoze axiale sau excentrice- ulceratii cu aspect de nisa maligna
![Page 51: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/51.jpg)
Minusuri de umplere/ imagini lacunare (polipi)
![Page 52: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/52.jpg)
Polipi colonici
![Page 53: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/53.jpg)
Polipoza familiala – status precanceros
![Page 54: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/54.jpg)
Cancer vegetant cecal - imagine lacunara ce intereseaza regiunea cecala, cu pinten malign si imagine de semiton
![Page 55: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/55.jpg)
Cancer vegetant ceco-ascendent
![Page 56: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/56.jpg)
Cancer predominant infiltrant - stenoza axiala cu pasajul substantei baritate, pinteni maligni si imagini de semiton – realizeaza imaginea de “cotor de mar”
![Page 57: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/57.jpg)
Cancer vegetant-infiltrant
![Page 58: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/58.jpg)
Cancer vegetant – flexura hepatica/colon transvers
![Page 59: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/59.jpg)
Stop complet al substantei de contrat la nivelul flexurii hepatice – proces expansiv vegetant
![Page 60: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/60.jpg)
Stenoza axiala sigmoidiana: proces infiltrativ +/- vegetant
![Page 61: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/61.jpg)
Imagine tintita stenoza sigmoidiana
![Page 62: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/62.jpg)
Stenoza sigmoidiana maligna
![Page 63: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/63.jpg)
Imagine lacunara la nivelul peretelui posterior al ampulei rectale, ce prezinta contur neregulat
![Page 64: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/64.jpg)
Cancer vegetant rectal
![Page 65: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/65.jpg)
Rectocolita ulcero-hemoragica= proces inflamator cu sindr. dizenteric si singe in scaune, cu evolutie in pusee
-Debut recto-sigmoidian
-Scaune numeroase, cu mucus si singe
-Stadiul initial apartine colonoscopiei
Rx. : iritabilitate, cu pasaj rapid, contur fin dintat
- dupa insuflatie : discontinuitatea liniei de siguranta
pete opace datorita bariului lipit de grunji de mucus sau de puroi
-Ulterior : se accentueaza dintaturile sub forma de ghimpe sau spiculi prin ulceratii ale mucoasei, evoluind spre imagini de “buton de guler de camasa” sau chiar diverticulare mici = depasirea mucoasei
-In relief se constata imagini pseudolacunare , initial date de grunjii de mucus si puroi, edemul de mucoasa dintre ulceratii, apoi de mugurii de granulatie si focarele de hiperplazie mucoasa in faza de regenerare
-Ultimul stadiu :hiperplazie, scleroza si retractia peretelui cu atrofia mucoasei
Rx. : segmente tubulare, inguste, dehaustrate, rigide, scurtate
unghiuri colonice desfacute
Complicatii : perforatii in peritoneu sau organe vecine
cancerul la virsta tinara (de obicei dupa 10 ani de evolutie)
megacolon toxic – in forme cu evolutie fulminanta – de obicei colon transvers
![Page 66: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/66.jpg)
dintaturile sub forma de ghimpe sau spiculi prin ulceratii ale mucoasei
![Page 67: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/67.jpg)
retractia peretelui cu atrofia mucoasei
Imagini pseudolacunare , initial date de grunjii de mucus si puroi, edemul de mucoasa dintre ulceratii, apoi de mugurii de granulatie si focarele de hiperplazie mucoasa in faza de regenerare
![Page 68: Explorarea Radiologica a Tubului Digestiv 2](https://reader030.vdocuments.mx/reader030/viewer/2022033008/55cf8f51550346703b9b2335/html5/thumbnails/68.jpg)