Thread by @DrVikasShah

THREAD: I enjoyed giving a talk on abdominal cases from the archives at #BIRAC19 earlier today - as promised, here are some of the cases I showed (all on @Radiopaedia)

#IDOR2019 #FOAMrad #FOAMed #WRD2019

1/11

This one had me running to the ward to try and fish a gallstone out of a stoma bag! radiopaedia.org/cases/recent-g…

#IDOR2019 #BIRAC19 #FOAMrad #FOAMed #WRD2019

2/11

This is the stone in the gall bladder on an earlier CT...

#BIRAC19 #IDOR2019 #FOAMrad #FOAMed #WRD2019

3/11

And this is it in the stoma bag with mildly dilated small bowel loops - so a self-resolved gallstone ileus...

#BIRAC19 #IDOR2019 #FOAMrad #FOAMed #WRD2019

4/11

Another case was this CT with a prior abnormal CXR...

radiopaedia.org/cases/hepatic-…

#BIRAC19 #IDOR2019 #FOAMrad #FOAMed #WRD2019

5/11

Avid enhancement in liver is pseudolesion caused by perfusion by superior vein of Sappey, one of the paraumbilical veins that communicates w/ internal thoracic and superior epigastric veins; an attempt to bypass obstructed SVC.

#BIRAC19 #IDOR2019 #FOAMrad #FOAMed #WRD2019

6/11

Named after Marie Philibert Constant Sappey 👉🏼 en.m.wikipedia.org/wiki/Marie_Phi…

#BIRAC19 #IDOR2019 #FOAMrad #FOAMed #WRD2019

7/11

This venous route also plays a role in portal hypertension and the caput medusae sign - hepatofugal flow in paraumbilical vein to shunt towards systemic circulation (portosystemic shunt).

#BIRAC19 #IDOR2019 #FOAMRad #FOAMed #WRD2019

8/11

Finally, when the ureter decides to go it’s own way. This one is trapped in the greater sciatic notch.

radiopaedia.org/cases/herniati…

#BIRAC19 #IDOR2019 #FOAMRad #FOAMed #WRD2019

9/11

Known on IVU studies (and I guess now on CT IVU studies like this one) as the curlicue ureter sign.

#BIRAC19 #IDOR2019 #FOAMRad #FOAMed #WRD2019

10/11

And that’s it! Happy #IDOR2019.

#BIRAC19 #FOAMrad #FOAMed #WRD2019

11/11