Abdominal Radiology

Clerkship Director: Ashish P. Wasnik, MD (ashishw@med.umich.edu, pager # 16441)

Assistant Clerkship Director: Kim Shampain, MD (kshampai@med.umich.edu, pager # 19121)

Administrative Contact: Kim Desbrough (desbroug@med.umich.edu) Ph: (734) 615-9016

WELCOME to Abdominal Radiology clerkship! Details of your elective are listed below. Please contact Dr. Wasnik or the elective coordinator, Kim Desbrough at 615-9016, or desbroug@med.umich.edu if you have any questions.

Introduction

This elective is designed to introduce students to Abdominal Imaging in the Radiology Department. You will have the opportunity to see many different techniques for imaging the abdomen and are expected to learn the clinical indications for using different imaging modalities; for example, when is ultrasound (US) a better test than CT and vice versa, as you will require knowledge of optimal utility of imaging modalities in the right clinical context to practice your future specialty. As you probably already know, imaging technology is an important and integrative tool for diagnosis and clinical decision making. Improving your understanding of imaging modalities and basic imaging interpretation should lead to improved patient care.

You will have the opportunity to independently review cases (during the 3rd-4th week) and go over the imaging based approach and diagnosis with a fellow or faculty.

Schedule

The first day of your rotation Kim Desbrough will meet you in Radiology library and give you orientation of the rotation. Dr. Wasnik/ Dr. Shampain will meet you and briefly go over the specifics of the ultrasound rotation.

You are expected to be in the reading room from 8:30 am – 12:00 noon (optional till 5:00 pm). The reading rooms can be busy places. Please wear white coat and your id badge at all times. Please introduce yourself to the physicians, fellows, residents, ultrasound practitioners, nurses, technologists and reading room coordinators who may be present. All have something to offer and would like to be engaged.

Please send electronic evaluation forms/link to the faculties/fellows that you may have worked for daily assessment.

General Review of Course

You can tailor this rotation to your interests as long as you get a fair variety of experience. You must be somewhat flexible, as the department must accommodate all students on this rotation. The main areas, which constitute the core of this clerkship, are fluoroscopic GI/ GU, CT, and US. Limited exposure to Body Interventional may be available if interested. This will be arranged Dr. Wasnik depending on availability in the other sections.

Each area involves performance of the examination and interpretation of the finished studies. Get involved in both! Document your work by filling out the provided case list (name, hospital ID number, brief radiologic diagnosis). Of course, save the data safely (with HIPAA compliance).

Clinical Areas/Studies:

Gastrointestinal/Genitourinary Fluoroscopy

  • Abdomen plain radiographs
  • Esophagram, Upper GI study
  • Barium enema
  • Small bowel follow-through
  • Drain injection
  • Videofluoroscopy Swallow Studies
  • Defecography
  • Hysterosalpingogram
  • VCUG
  • Retrograde urethrogram

CT

  • CT Abdomen & Pelvis
  • CT Enterography
  • CT Urography
  • CT Angiography
  • Other Specialized protocols

Cross Sectional Interventional (optional)

  • Abscess Drainage
  • US guided thoracentesis/paracentesis
  • Image guided biopsy

Ultrasound

  • Ultrasound including Doppler evaluation of the abdomen (including liver, renal, pancreas transplant evaluation)
  • Pelvic ultrasound (including obstetric and gynecologic cases)

MRI (optional)

  • Basic introduction to abdomen and pelvis MRI

Available Teaching Conferences

Remember, all of the abdominal imaging conferences are optional, but you are encouraged to attend.

Resident Teaching Conference 
Everyday 12 – 1:30 pm, UH 2C 108 (presented by faculties)

Body CT Conference
Every Friday, 7:30 - 8:30 am, UH 2C 108 (presented by residents and fellows)

Body US Conference
Every other Tuesday, 12 – 1:30 pm, UH 2C 108 (presented by fellows)

Body MRI Conference
Every other Thursday, 7:30 – 8:30 am, UH B1 C111(presented by fellows)

End of Rotation Presentation

  • You are required to present 3 cases as oral PowerPoint presentation in 9 minutes (on the provided template) to Dr. Wasnik/Dr. Shampain and the other student(s) in the last week of the rotation. You will be informed about the date and location for your presentation in the third week. (Kim Desbrough will schedule this).
  • Choose 3 cases you have seen during your rotation. These are short succinct presentations with emphasis on imaging aspects and should NOT exceed 9 minutes for 3 cases (you may lose points for longer presentations).
  • Preparing the conference entails using webpacs to import selected images. Alternatively, images can be imported from clinical workstations (PACS) using departmental RadPix software into PowerPoint.
  • You will need help from radiology residents, fellows, or attending radiologists to get started. Review studies during the workday with any radiologist beforehand to select appropriate images. Do not use patient name. MRN for cases can be added ONLY on the first slide. Please e-mail your presentation to Kim Desbrough one day before the schedule presentation.
  • Please use original images for your presentation, although occasionally you may use web images or illustrations to augment your presentation.
  • Kim Desbrough can assist you with using the departmental resources that are needed.
  • Each teaching file case must be fully worked up, including: history, imaging findings, diagnosis, brief differential diagnosis, and discussion of disease with focus on relevance to the imaging features. Try to include ACR appropriateness criteria pertinent to the case. Information from textbooks and pertinent publications as references is expected.

Evaluation and Grading

Daily attendance and compiling the four (4) teaching file cases are required to achieve pass. A grade of honors can be achieved by completing additional work under the supervision of one of the radiology faculty/fellow and or strong recommendations from faculties you may have worked during the rotation. This may include additional teaching file cases, preparation of a case report, participation in or contribution to a research project, etc. The quality and intensity of the additional work completed will be evaluated in determining your grade. Bear in mind that extra work of poor quality may not merit a grade of high pass or honors. Similarly, a grade of high pass or honors may be also achieved on the basis of an outstanding performance during the required daily clinical activities (as recommended by faculties), attendance and the required teaching files.

Recommended Reading Material

  • Diagnostic Imaging: Abdomen and Pelvis by Federle et al
  • Diagnostic Ultrasound: Abdomen and Pelvis by Kamaya et al
  • Expert DDx: Abdomen and pelvis: Federle et al

Downloads

Abdomen Case Form