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Surgery - Abdominal Investigations
Fecal occult blood testing may be chemical or immunological/quantitative—specifically, the quantitative fecal immunochemical test (qFIT). The primary application is as the initial community test for colorectal carcinoma, as outlined in the National Bowel Cancer Screening Programme.
Flexible sigmoidoscopy
• Minimal risk (perforation <1 in 10,000), typically conducted without sedation. • should visualize up to the descending colon. facilitates small therapeutic interventions (polypectomy, biopsy, injection). commonly employed for: diagnosis and evaluation of colitis colonic neoplasia, investigation anorectal hemorrhage.< />pan>
Colonoscopy: Low risk (perforation 1 in 1000); conducted with or without intravenous sedation or Entonox®; necessitates bowel preparation.
• The entire colon should be visualized in over 95% of cases. Permits minimal therapeutic interventions—polypectomy, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), injection, tattoo marking, and biopsy. Applicable when comprehensive colonic evaluation is warranted or when colonic and/or terminal ileal pathology is suspected.
Transabdominal ultrasonography
Simple, secure, non-invasive, and eliminates radiation exposure. Common applications encompass: • 1° examination of the biliary tree for gallstones, bile duct dimensions, and liver parenchymal characteristics. • Detection of ovarian pathology, for instance, in cases of suspected appendicitis. Evaluation of the hepatic and splenic parenchyma. Detection of free fluid in abdominal trauma.
Computed Tomography scanning
• Simple and non-invasive; necessitates considerable radiation exposure and intravenous/oral contrast.
• Common applications encompass:
• Initial evaluation of all intra-abdominal masses.
• Staging of intra-abdominal and pelvic neoplasms.
• Examination of acute stomach pain (gaining prevalence).
• Examination of potential intestinal blockage.
• Assessment of probable postoperative sequelae.
MRI scanning
• Eliminates radiation exposure.
• Can be conducted using specific contrast agents.
• Commonly employed for: • Examination of suspected bile duct pathology—magnetic resonance cholangiopancreatography (MRCP).
Evaluation of hepatic pathology and potential metastases. Evaluation of the pancreatic.
Evaluation of pelvic and retroperitoneal soft tissue pathology, such as pelvic malignancies and intricate perianal sepsis.
• Evaluation of the small intestine where radiation exposure should be minimized (magnetic resonance enterography)
Standard abdominal radiograph
• may detect intestinal blockage, urinary tract calculi, free intra-abdominal air, and intra-abdominal fluid.
The Barium/Gastrografin® enema can be performed as either a single contrast, where contrast material fills the colon to detect strictures and blockages, or a double contrast, which involves a dilute contrast and air to cover the mucosal surface of the colon, however the latter is currently hardly utilized.
Computed Tomography Colonography • Necessitates comprehensive bowel preparation and rectal catheter placement; entails considerable radiation exposure with intravenous or oral contrast.
• Generally employed as an alternative to colonoscopy when it is contraindicated or unfeasible, such as in cases of advanced age, frailty, known strictures, or unsuccessful colonoscopy attempts. Studies on intestinal transit
• Serial abdominal X-rays (AXR) are utilized to monitor the progression of ingested radio-opaque markers.
• They are employed to evaluate intestinal motility and transit duration. PET scanning involves the injection of a radioactive metabolic substrate to identify metabolically active tissues, such as malignancies or areas of inflammation/infection. It is combined with high-resolution CT scanning to accurately locate 'hot spots.' Commonly employed to detect unrecognized metastatic tumor deposits or to distinguish fibrosis from remaining tumor following surgery.
Physiological assessment
• Manometric evaluation of the esophagus, encompassing the lower esophageal sphincter and the anal canal. Pressure sensitivities of the esophagus and anal canal. pH assessment of the esophageal contents (either isolated or continuously over 24 hours).
• used to evaluate anorectal function, esophageal motility and function, and gastroesophageal reflux
Fecal occult blood testing may be chemical or immunological/quantitative—specifically, the quantitative fecal immunochemical test (qFIT). The primary application is as the initial community test for colorectal carcinoma, as outlined in the National Bowel Cancer Screening Programme.
Flexible sigmoidoscopy
• Minimal risk (perforation <1 in 10,000), typically conducted without sedation. • should visualize up to the descending colon. facilitates small therapeutic interventions (polypectomy, biopsy, injection). commonly employed for: diagnosis and evaluation of colitis colonic neoplasia, investigation anorectal hemorrhage.< />pan>
Colonoscopy: Low risk (perforation 1 in 1000); conducted with or without intravenous sedation or Entonox®; necessitates bowel preparation.
• The entire colon should be visualized in over 95% of cases. Permits minimal therapeutic interventions—polypectomy, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), injection, tattoo marking, and biopsy. Applicable when comprehensive colonic evaluation is warranted or when colonic and/or terminal ileal pathology is suspected.
Transabdominal ultrasonography
Simple, secure, non-invasive, and eliminates radiation exposure. Common applications encompass: • 1° examination of the biliary tree for gallstones, bile duct dimensions, and liver parenchymal characteristics. • Detection of ovarian pathology, for instance, in cases of suspected appendicitis. Evaluation of the hepatic and splenic parenchyma. Detection of free fluid in abdominal trauma.
Computed Tomography scanning
• Simple and non-invasive; necessitates considerable radiation exposure and intravenous/oral contrast.
• Common applications encompass:
• Initial evaluation of all intra-abdominal masses.
• Staging of intra-abdominal and pelvic neoplasms.
• Examination of acute stomach pain (gaining prevalence).
• Examination of potential intestinal blockage.
• Assessment of probable postoperative sequelae.
MRI scanning
• Eliminates radiation exposure.
• Can be conducted using specific contrast agents.
• Commonly employed for: • Examination of suspected bile duct pathology—magnetic resonance cholangiopancreatography (MRCP).
Evaluation of hepatic pathology and potential metastases. Evaluation of the pancreatic.
Evaluation of pelvic and retroperitoneal soft tissue pathology, such as pelvic malignancies and intricate perianal sepsis.
• Evaluation of the small intestine where radiation exposure should be minimized (magnetic resonance enterography)
Standard abdominal radiograph
• may detect intestinal blockage, urinary tract calculi, free intra-abdominal air, and intra-abdominal fluid.
The Barium/Gastrografin® enema can be performed as either a single contrast, where contrast material fills the colon to detect strictures and blockages, or a double contrast, which involves a dilute contrast and air to cover the mucosal surface of the colon, however the latter is currently hardly utilized.
Computed Tomography Colonography • Necessitates comprehensive bowel preparation and rectal catheter placement; entails considerable radiation exposure with intravenous or oral contrast.
• Generally employed as an alternative to colonoscopy when it is contraindicated or unfeasible, such as in cases of advanced age, frailty, known strictures, or unsuccessful colonoscopy attempts. Studies on intestinal transit
• Serial abdominal X-rays (AXR) are utilized to monitor the progression of ingested radio-opaque markers.
• They are employed to evaluate intestinal motility and transit duration. PET scanning involves the injection of a radioactive metabolic substrate to identify metabolically active tissues, such as malignancies or areas of inflammation/infection. It is combined with high-resolution CT scanning to accurately locate 'hot spots.' Commonly employed to detect unrecognized metastatic tumor deposits or to distinguish fibrosis from remaining tumor following surgery.
Physiological assessment
• Manometric evaluation of the esophagus, encompassing the lower esophageal sphincter and the anal canal. Pressure sensitivities of the esophagus and anal canal. pH assessment of the esophageal contents (either isolated or continuously over 24 hours).
• used to evaluate anorectal function, esophageal motility and function, and gastroesophageal reflux
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