The Imaging Department in The Gastroenterology & Hepatology Teaching Hospital
The imaging department in out hospital has , the radiological and the ultra sonic divisions, The radiological division has two subdivisions, the conventional and the In the past , only plain radiological examination are done, now contrast studies are done every day. ( Ba swallow, Ba meal , Ba follow through and Ba enema , plus gastrographin studies for the post operative patients , all these are done under fluoroscopic vision.
The interventional procedures are done using our C arm. Digital fluoroscopic machine ; oesophageal stenting , oesophageal dilatation, duodenal stenting, ERCP and it's affiliated procedures , stone crushing and extraction, pancreatic stenting and bile duct stenting by both plastic and expandable wall stents.
Now with the availability of percutaneous stenting apparatus , this procedure has been added to our repertoire , for the palliative management of Klatskin tumours at the hepatic hilum for the relief of jaundice , an expandable stent is inserted through the skin , the area of narrowing is crossed after a PTC examination and the stent is left for the remainder of the patient's life.
Another interventional procedure is the celiac axis block for the relief of intractable abdominal pain caused by pancreatic tumours. Chronic pancreatitis.
The ultrasonic division has two machines though we are awaiting our first 4 D ultra sound machine which will enable us to do 3 D examinations real time.and an operative ultra sounds machine for both laparotomy and laproscopic procedures to provide further information to the surgeons.
When the hospital was first established all radiological examinations were done in the radiology department of the Specialized Surgical Hospital with the generous help of our colleagues there , now all our interventional radiology work is done in our hospital , routine and Colour Doppler studies still form a great part of our work but the emphasis is on interventional procedures, so percutaneous needle biopsy both fine and large bore needles, from the liver, pancreas abdominal masses & lymph nodes , post operative collection , liver abscess and pseudo cyst of the pancreas drainage are done frequently by needling or insertion of a draining tube under direct ultra sonic guidance.
At first PTCD was done under ultra sound guide with limited success due to technical difficulties , but now only under fluoroscopic control.
Another service provided by our hospital is the endoscopic US examination to provide information about mucosal lesions in the oesophagus , stomach, pancreatic pathology, better visualization of the gall bladder, bile duct stones and ampulla of Vater pathology and now transrecral ultra sound examination is done as well.
In the future we hope to have an integrated fully equipped imaging department using a cath lab .with vascular procedures , to the celiac axis SMA& IMA , where bleeding is controlled, embolization of the hepatic artery in cases of liver tumours are carried out, and as a preliminary examination for the liver trasplant project.
A Ct and an MRI machine are also necessary for full investigation of the GIT with utilization of their full capabilities like virtual reality colonoscopy and perfusion studies if the liver.
Having open hearts and minds and keeping the interests of our patients foremost in our thoughts , great leaps in knowledge and experience are possible and together with out colleagues working as a team we can a lot to alleviate the suffering of our brethren.