Surgical and Procedural Care: Abdominal CT

SPC Week 5 Radiology Session Student Guide.pdf


The following material is part of 1 hour course for medical students at the University of Wisconsin-Madison during the Surgical and Procedural Care rotation, adapted for virtual learning due to COVID-19. Students/faculty from any instutition are welcome to adapt the material to suit your educational goals.

The major goals of this course are to learn the basics of abdominal CT anatomy and the key features of the following diagnoses:

  • acute appendicitis
  • perforated appendicitis
  • perforated diverticulitis
  • perforated ulcer
  • small bowel obstruction
  • closed-loop obstruction

This course uses a web-based DICOM/PACS viewer to look at real radiology studies, which will help you to learn the essentials of imaging viewing as you make connections between gross/radiologic anatomy and start to familiarize yourself with imaging of surgical diagnoses. The ability to pull up a radiology study, scroll through the images, and find the relevant anatomy are key but often overlooked skills, so take time to build a strong foundation. Please refer to the PDF student guide which will help to guide you through the material.

Part 1: How to use a basic PACS viewer

Pull up a CT and review it like a pro!

This quick video that reviews how to properly manipulate radiology images that every student and trainee should be familiar with. This includes changing window/level settings, basic annotation, measuring ROI, and changing the layout to triangulate a finding in two planes.

Part 2: Interactive review of key normal anatomy

For CASE 1, complete the anatomic checklist of solid organs, lower GI, and upper GI listed on the PDF above.

I recommend referencing my search pattern videos where I review the anatomy in greater detail in both axial and coronal planes. Generally, the coronal plane is more intuitive for non-radiologists beceause it reflects the way you learn anatomy in the cadaver lab and through illustrations, and is also the way you view the patient during physical examination.

For CASE 2, apply your knowledge by finding the normal appendix.

Tech tips:

  • Use Chrome or Safari, NOT Internet Explorer
  • Tips for smooth scrolling with a laptop:
    • Consider using an external mouse with middle scroll wheel
    • If using a trackpad select the "Stack Scroll" button (it is defaulted when you open the case), click with one finger (index) and scroll with a second (middle) for a smoother, slower scroll than with two fingers alone

Click the blue paper icon

Opens study notes to guide you through the case

Part 3: Cases

Review the following cases applying the knowledge of normal anatomy from Part 2. Each case contains notes and selected annotations that can be accessed by clicking on the blue paper icon in the upper corner. These notes will review the key imaging findings and the linked text will take you to specific annotated images.