GI Imaging - Upper GI Disorders & Pneumoperitoneum MCQs

Air under Right hemidiaphragm is feature of Pneumoperitoneum or hollow viscus perforation and is better seen on CXR Erect.

The position of a normal GS is in the mid to upper uterus.As the sac implants into the decidua,it should be adjacent to the linear central cavity echo complex(intradecidual sign). As the sac enlarges, it gradually deforms the central cavity echo complex giving rise to sonographic appearance of double decidual sac sign, which consists of two echogenic concentric lines surrounding a portion of gestational sac,formed by decidua capsularis & decidua parietalis. Reference: Ultrasound in obstetrics and gynecology by Dr. P. K. shah, Dr. Mandakini megh, Dr. Nandita palshetkar page number 45

The abdominal radiograph most useful to identify free intraperitoneal gas (pneumoperitoneum) is lateral decubitus view especially the left Lateral Decubitus view. Best Xray view is CXR erect and demonstrates Air under Right Hemidiaphragm IOC-CT scan Reference : Morgan, M., Murphy, A. Abdomen (lateral decubitus view). Reference article, Radiopaedia.org. (accessed on 20 Feb 2022) https://doi.org/10.53347/rID-38092

MRCP is non invasive, should be performed before ERCP for proper management . The patient is showing signs of hepatitis with dilatation of the common bile duct and the next step would be ERCP/MRCP to look for an gall stone obstructing the bile duct and causing such symptoms and lab findings. Reference: MRI made easy, second edition, page no 183.