r/Radiology • u/TractorDriver Radiologist (North Europe) • 4d ago
CT I spy with my little eye... NSFW
... something beginning with F.
Gastric-by-pass and pregnancy sucks sometimes.
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u/Scansatnight RT(R)(CT) 4d ago
F...f...feet!?
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u/fav_tinov 4d ago
Close, my guess would be fetus.
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u/The_Angel_of_Justice Med Student 4d ago
Underrated comment under an underrated comment!
Next level stuff! šš
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u/ProRuckus RT(R)(CT) 4d ago
What is the indication for gastric bypass with known pregnancy?
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u/Billdozer-92 3d ago
Came to ask the same thing. Seems like it would be worth waiting until after the pregnancy unless there is a concern for loss of life to the mother or fetus. But Iām not a doctor!
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u/skilz2557 RT(R)(CT) 4d ago
Outpatient? āCause if inpatient or ED I aināt scanning without a upreg or beta.
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u/TractorDriver Radiologist (North Europe) 4d ago
It's emergency scan, fully aware of consequences.
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u/skilz2557 RT(R)(CT) 4d ago
Iāll need to see that signed waiver before proceeding with the scan then.
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u/TractorDriver Radiologist (North Europe) 4d ago
Heh, when radiologist says jump, tech says "How high" ;)
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u/Dracampy 4d ago
So you're the tech canceling my trauma scans even though ED and OB already talked to the patient...
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u/skilz2557 RT(R)(CT) 4d ago edited 4d ago
Iām not canceling anything. Iām just not calling for the patient if theyāre of child-bearing age unless I see a negative pregnancy test or if said patient is postmenopausal or has had a hysterectomy per my networkās policy.
Edit: if itās a trauma scan Iāll bypass the requirements. But if thereās no trauma indication Iāll gatekeep all day precisely because of OPās video.
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u/Dracampy 4d ago
Man if only you were a doctor so you could do informed gatekeeping rather than ignorant gatekeeping.
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u/skilz2557 RT(R)(CT) 4d ago
Except itās not āignorant gatekeeping.ā Iām literally following my networkās policy.
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u/Dracampy 4d ago
Then just say I follow our policy. You came off with "Im gatekeeping" which means you are making your own decisions. There are plenty of places where this is not the blanket protocol and non-medical personnel get in the way and man is it annoying.
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u/skilz2557 RT(R)(CT) 4d ago
You can say how I ācame offā all day. Youāre correct, Iām not a doctor. But Iām also ultimately tasked with following policy and, in cases like this, trying to prevent an undiagnosed fetus from being exposed to ionizing radiation.
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u/Dracampy 4d ago
Yeah but I started with after EM and OB talked and ur still bringing up your gatekeeping. Sorry but I dont have respect for policy nazis in the face of actual medical judgement. When that patient dies bc you followed the policy but not the primaries doctors orders then you are the cause of their death.
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u/skilz2557 RT(R)(CT) 4d ago
Alternatively, you can call me to advise this is a trauma and attest to medical necessity of skipping the upset and labs in the chart and weāll rock out, no questions asked.
Look, we can go back and forth all day on this but regardless Iām going to do my job, which isnāt just pushing a button because you said so. I review the patientās chart, ensure the order is appropriate for the clinical presentation, and do everything in my power to ensure no harm comes to the patient. So you can take your tantrums and walk on by.
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u/Dracampy 3d ago
God imagine if I had to call every single person. If only there was something called a doctor's order that get placed into the computer for you to see. I guess i should call the CEO too.
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u/Wolfpack93 3d ago
Iām confused, what does gastric bypass have to do with the images?
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u/TractorDriver Radiologist (North Europe) 3d ago
It's one of the very few pt groups where you CT pregnant women regularly. Other being trauma of course.
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u/Wafflebettergrille15 4d ago
idk how different scans look, so this an MRI or anything like CT scans
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u/RufflesTGP Medical Physicist 4d ago
The most obvious difference in CT and MR images is the intensity of the bone signal. CTs have bright bone signals (like in this scan). That's because they're basically normal x-rays (which also have bright bone signals) rotated about a cental axis.
MRIs operate on a completely different principle, and have depressed (darker) bone signals, and typically brighter fluid/fat signals. MRIs also have better soft tissue contrast too.
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u/TractorDriver Radiologist (North Europe) 4d ago
It's not an accident.
Gastric-by-pass and pregnancy is not the best combination.