Gen Surg: Radiology lessons

So check it out- radiology at my school was somewhat... subpar. So I have been saving certain characteristic or obvious CTs and xrays to help me learn. And trust me, when you're scrolling through half a dozen CTs, MRIs, and xrays full of shades of grey every couple hours these aren't so easy to pick out. So here are a few of the images and there answers (i've kindly added the 'arrow sign') below (don't cheat!) So here is a radiology lesson of the past monthish of patients, see if you can find the defect.

Here is a general xrays of a patient who had a collapsed lung (pneumothorax). You might be familiar with this condition because TV shows glamorize this condition (when the doc stabs someone in the chest with a needle and suddenly they can breath again). For the most part, the TV treatment is true but generally something has to HAPPEN to your lung for it to collapse (aka car accident, lung CA or disease, emphysema, etc), it doesn't just happen in the middle of a restaurant...usually. And unlike they show on TV if its less than 10% of the lung (as both of these are) and if the patient is not symptomatic, we don't  stab anyone with anything. You body will reabsorb it on its own without any problems. (i know.... so much less fantastic than TV).

Crash Course for beginners: a CT scan (also known as a CAT scan) is probably one of the most useful scans done in the hospital. It is a 2d picture of your insides, showing your docs what's going on inside. Typically, they are loaded on a computer for doctors to scroll through some 200 images are taken every millimeter of your body. It starts at your feet and works it way up to your head. They are done at different angles depending on what the doctor wants, but ususally they are done with the patient laying down.

This patient is a person who was in a MVC (motor vehicle collision) we also call it car vs. pole.  He had some abdominal pain and a quickly dropping H&H (hemoglobin and hematocrit). We got the CT and immediately called the trauma team. You can see how the blood is pooling by the liver (the liver bleeds fast!)

This is an elderly (88yo) woman who was incontinent and who often had UTIs. Everyone just assumed she was old. Then due to an incidental finding by an ER doc and a bunch of workups later we found this. A hole between two different organs is called a fistula Poor Poor woman.  She has a hole between her anus and vagina and then vagina and bladder.  So if you can imagine... she has poo coming out not only her vagina but also poo in her bladder.

Here is an easy picture that hopefully anybody can see. Blood in the lungs, we call it hemothorax.

It is very important to look at the CT a couple of times because oftentimes you find other things you wouldn't have normally seen. Below are some images of the above patients who had some very cool incidental findings. The first one is calcifications of the aorta.

Well hopefully that was enlightening :) Fun pictures definitely. Interesting if nothing else. Til next time.