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Medical Science Optional daily answer writing practice for CSE 2023 – Dec 1

Topic: Bleeding peptic ulcer, tuberculosis of bowel, ulcerative colitis

Question: Enumerate the causes of radio-opacities on a plain abdominal radiograph.

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Causes of radio-opacities seen on plain abdominal radiographs without mentioning bone fragments:

  1. Surgical clips/metallic implants – Patients with previous abdominal or pelvic surgeries may have retained metallic surgical clips or prosthetic implants like mesh which appear radio-opaque on radiographs.
  2. Phleboliths – These are calcifications that occur within dilated or thrombosed pelvic veins, usually seen in ovaries or within hemorrhoidal veins.
  3. Urinary calculi – Radiopaque renal or ureteric calculi can be identified on plain films depending on their composition (eg. calcium oxalate, calcium phosphate, struvite, cystine).
  4. Gallbladder calculi – Radio-opaque gallstones are usually composed of calcium bilirubinate and calcium carbonate.
  5. Densities within bowel loops – This could be due to ingested foreign bodies like dentures, coins etc. ingested radiopaque contrast may also be identified.
  6. Pneumoperitoneum – Presence of air in the peritoneal cavity appears as linear or localized densities.
  7. Metastatic calcifications – Widespread metastatic calcifications can occur in advanced renal disease producing a sandstorm appearance.
  8. Phlebolithomatosis – In neutrophilic disorders like Sweet’s syndrome, there may be widespread phlebolith-like calcifications.
  9. Post-operative changes – Sutures, drains etc. used during previous abdominal surgeries can sometimes be radiopaque.

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