Mayo Clinic Gastrointestinal Imaging Review.

916 Pages·2014·36.158 MB·English

by  C Daniel Johnson

MAYO CLINIC
Gastrointestinal
Imaging Review
Second Edition
Mayo Clinic Scientifi c Press

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MAYO CLINIC
Gastrointestinal
Imaging Review
Second Edition
C. Daniel Johnson , MD
Chair, Department of Radiology
Mayo Clinic, Scottsdale, Arizona
Professor of Radiology
College of Medicine, Mayo Clinic
MAYO CLINIC SCIENTIFIC PRESS OXFORD UNIVERSITY PRESS
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Catalog record is available from the Library of Congress
ISBN: 978–0–19–986215–3
Mayo Foundation does not endorse any particular products or services, and the reference to any products or services
in this book is for informational purposes only and should not be taken as an endorsement by the authors or Mayo
Foundation. Care has been taken to confi rm the accuracy of the information presented and to describe generally accepted
practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences
from application of the information in this book and make no warranty, express or implied, with respect to the contents of
the publication. Th is book should not be relied on apart from the advice of a qualifi ed health care provider.
Th e authors, editors, and publisher have exerted eff orts to ensure that drug selection and dosage set forth in this
text are in accordance with current recommendations and practice at the time of publication. However, in view of
ongoing research, changes in government regulations, and the constant fl ow of information relating to drug therapy
and drug reactions, readers are urged to check the package insert for each drug for any change in indications and
dosage and for added wordings and precautions. Th is is particularly important when the recommended agent is a
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Some drugs and medical devices presented in this publication have US Food and Drug Administration (FDA)
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9 8 7 6 5 4 3 2 1
Printed in China on acid-free paper
To Th erese, my wife, the love of my life
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ABOUT THE COVER
Th e cover for the book was adapted from the cover of the fi rst edition. For the fi rst
edition, a magnifi cent Kandinsky painting was the inspiration and foundation for
an illustration depicting each portion of the gastrointestinal tract. Th e paintings of
Kandinsky were seen as analogous to radiographic images—abstract to many view-
ers and understood only with knowledge of anatomy, radiography, and pathology.
To demonstrate that this edition is an updated and more modern version of the fi rst,
I selected a next-generation artistic style, that of Pablo Picasso, as the underlying
structure. Th e beauty of the interrelated gastrointestinal organs has been preserved,
but with an increasingly modern fl air.
Jim Rownd, the artist for the cover of the fi rst edition, again designed and created
this second edition cover. Th e individual gastrointestinal components are placed on
the title pages of their respective chapters. I am most grateful to Jim for his artistic
guidance and talents. Th e freedom given to me to create the book of my choice is also
greatly appreciated. I hope you enjoy it.
C. Daniel Johnson, MD
vii
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PREFACE
Th e purpose of this second edition is to update and supplement the fi rst edition of
Mayo Clinic Gastrointestinal Imaging Review . Th e goal of the book is to provide a
radiologic atlas of common abnormalities that aff ect the gastrointestinal tract that
can be detected with imaging examinations. Emphasis is placed on images that are
large enough to study the fi ndings with a minimal amount of text. Th e book is not
intended to be an inclusive source of gastrointestinal diseases and their many mani-
festations. Rather, the most important disease processes aff ecting the gastrointestinal
tract and their commonest presentations are included. Only a few selected pediatric
cases are included to provide a comparison with adult disease processes. Readers are
directed to pediatric textbooks for a more comprehensive review of these disorders.
Th e content of this book is directed primarily to radiology residents learning the
fundamentals of gastrointestinal imaging and for board preparation. In addition,
radiologists preparing for recertifi cation examinations may fi nd the book helpful as
an effi cient review.
Many of the cases in this second edition were in the fi rst edition, although out-
dated images have been replaced when possible and new disease entities and imag-
ing approaches have been added. For example, many magnetic resonance images
have been added. Th e format for cases remains standardized to a description of
the radiologic fi ndings, pertinent diff erential diagnoses, the actual diagnosis, and a
brief discussion. Students are urged to review the case fi rst without reading the text
(answers). Numerous summary tables and illustrations synthesize information and
provide key points and case references for review. New features of the book are the
questions at the end of each chapter and a fi nal chapter of examination-type ques-
tions. Th ese have been added to help students prepare for written examinations and
to assess their learning as they progress through the book. Selected readings and
references are not included—an acknowledgment that readers of this book are likely
looking for an effi cient single-source review and that references are easily acces-
sible online. Th ere are multiple other textbooks on gastrointestinal imaging with
comprehensive references that the reader should access for supplementation of their
knowledge in this fi eld.
C. Daniel Johnson, MD
ix