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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Introduction
Introduction
1 topic, 1 min. of video
Right Upper Quadrant Pain
Right Upper Quadrant Pain
20 topics, 55 min. of video
Normal Anatomy and Basic Ultrasounds: Abdomen and Pelvis
8 m.Cholelithiasis
2 m.Case: Acute Cholecystitis on Ultrasound
2 m.Acute Cholecystitis on Ultrasound
3 m.Case: Acute Cholecystitis on CT
2 m.Acute Cholecystitis on CT
1 m.Case: Cholecystitis With Calcified Stones
3 m.Gallstones on CT
2 m.Case: Tensile Gallbladder Fundus Sign
2 m.Tensile Gallbladder Fundus Sign
2 m.Case: Gangrenous Cholecystitis
2 m.Gangrenous Cholecystitis
2 m.Case: Emphysematous Cholecystitis With Portal Venous Gas Air
2 m.Emphysematous Cholecystitis With Portal Venous Gas Air
4 m.Case: Emphysematous Cholecystitis With Perforation
5 m.Emphysematous Cholecystitis Summary
3 m.Case: Mirizzi Syndrome With Dilated Intrahepatic Bile Ducts
4 m.Mirizzi Syndrome
6 m.Case: Choledocholithiasis
5 m.Choledocholithiasis
4 m.Midline Pain
Midline Pain
10 topics, 24 min. of video
Case: Acute Gallstone Pancreatitis
2 m.Causes of Pancreatitis
4 m.Cases: Pancreatitis Without/With Necrosis
3 m.Revised Atlanta Classification
6 m.Case: Pancreatitis With SMV and Splenic Vein Thrombosis
3 m.Pancreatitis Complication: SMV and Splenic Vein Thrombosis
3 m.Case: Pancreatitis With Pseudoaneurysm of Splenic Artery
2 m.Pancreatitis Complication: Splenic Artery Pseudoaneurysm
2 m.Case: Duodenal Ulcer With Perforation
2 m.Types of Perforated Ulcers
2 m.Lower Quadrant Pain
Lower Quadrant Pain
4 topics, 11 min. of video
Left Lower Quadrant Pain
Left Lower Quadrant Pain
11 topics, 16 min. of video
Case: Classic Diverticulitis
2 m.Diverticulitis
2 m.Case: Diverticulitis With Free Air
2 m.Case: Diverticulitis, Perforated with Abscess
2 m.Diverticulitis: Perforated With Abscess Post Drainage
2 m.Case: Diverticulitis With Colovesical Fistula
2 m.Diverticulitis With Colovesical Fistula
1 m.Case: Diverticulitis With IMV Thrombosis
2 m.Diverticulitis With IMV Thrombosis
2 m.Case: Epiploic Appendagitis
2 m.Epiploic Appendagitis and Omental Infarction
3 m.Bowel Obstruction
Bowel Obstruction
26 topics, 1 hr. of video
Case: Umbilical Hernia
3 m.Obstructing Umbilical Hernias
3 m.Groin Hernias: Introduction
3 m.Case: Indirect Inguinal Hernia
2 m.Inguinal Hernias
2 m.Case: Femoral Hernia
2 m.Case: Obturator Hernia
2 m.Groin Hernias: Summary
3 m.Case: Simple Bowel Obstruction
2 m.Case: High Grade Bowel Obstruction
2 m.Case: Gallstone Ileus
3 m.Gallstone Ileus and Cholecytocolic Fistula
3 m.Case: Closed Loop Small Bowel Obstruction
3 m.Closed Loop Small Bowel Obstruction
5 m.Case: Large Bowel Colonic Obstruction
2 m.Large Bowel Colonic Obstruction
2 m.Case: Perforated Colon From Colon Cancer
3 m.Perforated Colon
4 m.Case: SMA Embolism With Bowel Ischemia
3 m.SMA Embolism
4 m.Case: Mesenteric Vein Thrombosis
3 m.Mesenteric Vein Thrombosis
2 m.Case: Cecal Volvulus
2 m.Cecal Volvulus
4 m.Case: Sigmoid Volvulus
3 m.Sigmoid Volvulus
3 m.Retroperitoneum
Retroperitoneum
15 topics, 46 min. of video
Retroperitoneum
3 m.Case: Ruptured Abdominal Aortic Aneurysm
2 m.Abdominal Aortic Aneurysm Rupture
4 m.Case: Bleeding Angiomyolipoma
3 m.Angiomyolipoma
2 m.Case: Psoas Hematoma
3 m.Retroperitoneal Bleeding
2 m.Case: Renal Stones
3 m.Enhancement Patterns of Kidneys
7 m.Case: Forniceal Rupture
4 m.Forniceal Rupture
2 m.Case: Pyelonephritis
3 m.Pyelonephritis
3 m.Case: Renal Infarcts
3 m.Renal Infarcts
9 m.0:01
Okay. Here we have another abdominal
0:02
CT scan with IV contrast.
0:04
You can see in the very first image that
0:05
we have a little bit of ascites here.
0:07
As we come down, you'll notice that there are very
0:10
dilated loops of small bowel throughout the abdomen.
0:14
And I told you, what do I look for,
0:16
I'm always going to look for a hernia.
0:18
We even have some ascites between these loops of small
0:20
bowel, but they're still enhancing, so that's good.
0:22
They're not ischemic necessarily.
0:24
And as we come down into this groin
0:26
location, we're going to see the hernia sac
0:30
here on the right.
0:31
Again, we'll draw that horizontal line from
0:34
the pubic tubercle laterally and determine
0:36
that this is indeed anterior to that line,
0:40
consistent with a typical inguinal hernia.
0:42
Now, you can stop there if you want to, but for
0:44
the heroes amongst us, we always want to diagnose
0:46
if it's an indirect or a direct inguinal hernia.
0:49
So when you do that, you want to use your
0:50
epigastric vasculature as your landmark.
0:53
You can see the epigastric vessels right here.
0:55
They're very small going upwards, and you
0:57
can see that this hernia sac comes out
0:59
lateral to your epigastric vasculature.
1:01
Notice that there is some edema
1:04
and fluid within the sac as well.
1:05
Also notice that this indirect inguinal hernia,
1:08
because it comes out lateral to the epigastric
1:10
vasculature, goes in an oblique fashion down
1:13
the inguinal ligament, and that is a typical
1:16
trajectory of the indirect
1:18
inguinal hernia down that process
1:20
vaginales of the inguinal ligament. So this is an indirect
1:25
inguinal hernia causing small bowel obstruction.
1:28
Hopefully they can just pop that back in, and this
1:30
patient can then go on to feeling much better.
Case: Indirect Inguinal Hernia
HIDEInteractive Transcript
0:01
Okay. Here we have another abdominal
0:02
CT scan with IV contrast.
0:04
You can see in the very first image that
0:05
we have a little bit of ascites here.
0:07
As we come down, you'll notice that there are very
0:10
dilated loops of small bowel throughout the abdomen.
0:14
And I told you, what do I look for,
0:16
I'm always going to look for a hernia.
0:18
We even have some ascites between these loops of small
0:20
bowel, but they're still enhancing, so that's good.
0:22
They're not ischemic necessarily.
0:24
And as we come down into this groin
0:26
location, we're going to see the hernia sac
0:30
here on the right.
0:31
Again, we'll draw that horizontal line from
0:34
the pubic tubercle laterally and determine
0:36
that this is indeed anterior to that line,
0:40
consistent with a typical inguinal hernia.
0:42
Now, you can stop there if you want to, but for
0:44
the heroes amongst us, we always want to diagnose
0:46
if it's an indirect or a direct inguinal hernia.
0:49
So when you do that, you want to use your
0:50
epigastric vasculature as your landmark.
0:53
You can see the epigastric vessels right here.
0:55
They're very small going upwards, and you
0:57
can see that this hernia sac comes out
0:59
lateral to your epigastric vasculature.
1:01
Notice that there is some edema
1:04
and fluid within the sac as well.
1:05
Also notice that this indirect inguinal hernia,
1:08
because it comes out lateral to the epigastric
1:10
vasculature, goes in an oblique fashion down
1:13
the inguinal ligament, and that is a typical
1:16
trajectory of the indirect
1:18
inguinal hernia down that process
1:20
vaginales of the inguinal ligament. So this is an indirect
1:25
inguinal hernia causing small bowel obstruction.
1:28
Hopefully they can just pop that back in, and this
1:30
patient can then go on to feeling much better.
Report
Faculty
Laura L Avery, MD
Assistant Professor of Emergency Radiology Harvard Medical School
Massachusetts General Hosptial
Tags
Small Bowel
Gastrointestinal (GI)
Emergency
CT
Body
Acquired/Developmental
Abdominal Wall
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