Ischemic Bowel Disease; CT or Angio! - USMLE Forums
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Old 08-14-2011
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GIT Ischemic Bowel Disease; CT or Angio!

CT abdomen or angiography ?
In MTB-CK page 385 in the question it is angiography and on the next page it is CT abdomen!!!
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Old 08-14-2011
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http://www.usmle-forums.com/usmle-st...-ischemia.html
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Quote:
Originally Posted by miss patho View Post
u gave me the same question but with no answer lool
anyway thank you
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Quote:
Originally Posted by youssef2310 View Post
u gave me the same question but with no answer lool
anyway thank you
the answer i think if he ask u the next step in acute new mesentric ischemia will be ct
but if chronic for months had symptoms of mesentric ischemia just do the most accurate test angio not ct
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Old 08-14-2011
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Ok this is my interpretation of it...

The question on pg. 385 asks "most appropriate next step"
the patient is in "Severe Abdominal pain (The box says: 10 out of 10)

So in this scenario the patient is in acute distress and we suspect Acute Mesenteric Ischemia.

In a less acute presentation one may assume we have time do a
CT Scan of the abdomen but that's only the "Best Initial test"

Since we assume this acute presentation is a vessel pathology
"Most Accurate" test would be Angiography

So I was thinking more in a circumstantial manner...based on the acute presentation of the patient...I would rather skip the formality of the initial test and go straight to the most accurate test.

In my opinion this is the most "appropriate" next step...

I may be wrong
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Old 08-14-2011
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Quote:
Originally Posted by Kartopia View Post
Ok this is my interpretation of it...

The question on pg. 385 asks "most appropriate next step"
the patient is in "Severe Abdominal pain (The box says: 10 out of 10)

So in this scenario the patient is in acute distress and we suspect Acute Mesenteric Ischemia.

In a less acute presentation one may assume we have time do a
CT Scan of the abdomen but that's only the "Best Initial test"

Since we assume this acute presentation is a vessel pathology
"Most Accurate" test would be Angiography

So I was thinking more in a circumstantial manner...based on the acute presentation of the patient...I would rather skip the formality of the initial test and go straight to the most accurate test.

In my opinion this is the most "appropriate" next step...

I may be wrong
im much more convenced wz ur opinion cause it is how i got it too
but i wanna get sure
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Old 08-14-2011
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Quote:
Originally Posted by miss patho View Post
the answer i think if he ask u the next step in acute new mesentric ischemia will be ct
but if chronic for months had symptoms of mesentric ischemia just do the most accurate test angio not ct

but for acute mesenteric ischemia we must do angio before surgery
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Quote:
Originally Posted by i_m_possible View Post
but for acute mesenteric ischemia we must do angio before surgery
iam talking about next step u do
for sure after ct we do angio
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Old 08-14-2011
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According to CMDT
in patients with acute or chronic mesenteric ischemia, a CTA or MRA can demonstrate narrowing of proximal vessels.
In acute mesenteric ischemia from a nonocclusive low flow state, angiography is needed to display the typical "pruned tree" appearence of distal vascular bed.
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Quote:
Originally Posted by youssef2310 View Post
u gave me the same question but with no answer lool
anyway thank you
First. TAC... Then angio. Anglo is never first step in nothing.
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