Imaging techniques in gastroenterology

1. Big picture

Imaging in gastroenterology is not about “choosing the most modern test.” It is about choosing the right test for the clinical question:

Acute abdomen? → CT
Gallstones/biliary pain? → ultrasound first
Bile duct obstruction? → MRCP for diagnosis, ERCP for therapy
GI bleeding? → endoscopy or CT angiography depending on stability
Liver lesion? → contrast-enhanced US/CT/MRI
Pancreas? → CT/MRI/EUS depending on acute vs chronic vs tumor
IBD/small bowel? → MR/CT enterography, colonoscopy, capsule in selected cases

The examiner wants to hear that imaging is selected according to:

1. Urgency: stable vs unstable patient
2. Organ system: esophagus, stomach, bowel, liver, biliary tree, pancreas, peritoneum
3. Diagnostic vs therapeutic purpose
4. Risks: radiation, contrast nephrotoxicity, perforation, pancreatitis after ERCP, pregnancy

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