Transcript PALET Slides

PALET: A tool for making an
engaging teaching event
Kadom and Fasih
Disclosures
None
“PALET” tool
Preparation
Attention
Link
Engagement
Transfer
Professor E.D. Ott
Case presentation
Abdominal Imaging fellows
45 y.o. F, family history colon cancer
Acute abdominal pain during annual colonoscopy
Plain film signs free air:
1. Air under diaphragm
2. Falciform ligament sign
3. Air both sides of bowel (Rigler sign)
Pearls:
• Best erect or l lat decub
• CT more sensitive
• Most common cause perforated ulcer
• 1 in 400-500 colonoscopies, rectosigmoid site most
common
Mag view
Washington DC
Abdominal Imaging CEDP
course
Quiz case
April 13th, 2013
History withheld
What is going on?
Supine
Mag view
Quiz 1-Use I respond
software
Q. Which segment of the bowel is most
likely to have perforated and why?
A. Rectosigmoid
Quiz 2
Q. What are the two most common causes
of pneumo-retroperitoneum?
A. Perforated diverticulitis
b. Perforated duodenal ulcer
Quiz 3
What is the rate of perforation in:
A: Optical Colonoscopy?
1 in 400-500
B: CT Colonography?
1 in 3000
Axial
Coronal
Coronal
Supine
Pearls
• CT is the most sensitive modality to detect
complications of endoscopy.
• Rectosigmoid junction is the most frequent
site of perforation.
• Most cases are managed conservatively.
Methods of Engagement
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Multiple choice Q and A, touch pads, show of hands
Quiz, games, case
Questions, answers, discussion – dialogue!
Visuals (slides, videos, white board drawing)
Handouts (tables, articles, resources etc)
Demonstration, simulation, role play
Thank you
Audience #2
High school students
Scenario
• 45 year old woman visits the family doctor
for annual health exam.
• Anxiety regarding personal health. Parents
had cancer of the large intestine.
• Family doctor refers for a camera test of
the large intestine called
Colonoscopy(Colon=large bowel,
Scope=direct visualization)
Course of events
• Patient develops severe belly pain
during the camera examination.
• An x –ray of the belly is requested
and performed in the Radiology
department.
Normal structures ( Anatomy)
A
Normal X-RAY
B
Patient’s X-RAY
X ray of the Belly
Patient lying
down
Patient lying down: enlarged
view
Specialist doctor performing the
camera test (Gastroenterologist)
requests a CAT scan.
CAT scanner
(Computerized
Axial Tomography)
Image from a CAT scan
optimized to show free air
X ray of the Belly
Take home points
• Camera examination of the bowel is
used to detect cancers in the large
intestine.
• Rarely, this may produce a hole in the
intestinal wall resulting in air and
other contents to leak out into the
belly.
• This is an emergency…
Questions?