Kissing artifact
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CLASSICS IN ABDOMINAL RADIOLOGY
Kissing artifact Naiim Ali1 · Robert D’Agostino1 Received: 28 May 2020 / Revised: 1 July 2020 / Accepted: 9 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Kissing artifact refers to the adherence of two sides of bowel wall which may mimic the appearance of a mucosa-based abnormality. This artifact can occur during double contrast fluoroscopy when there is incomplete luminal distension due to insufficient gas. When imaged en face, the adherent anterior and posterior walls of the imaged bowel results in a peculiar appearance, with the apposition of the bowel walls akin to touching of lips with a kiss (Fig. 1). Although the imaging appearance of this artifact was first described by Laufer in 1975 [1], it was not until 1978 that Gohel, Kressel and Laufer used the phrase the “kissing” artifact [2]. If not recognized, this artifact may be mistaken for
an ulcerated or polypoid lesion. In double contrast evaluation of the upper gastrointestinal tract, this artifact can commonly be seen along the greater curvature of the stomach, or as the stomach passes over the abdominal aorta when evaluating an under-distended stomach (Fig. 2a). This artifact can be easily differentiated from true pathology by introducing more air and/or changing patient positioning to facilitate air movement (Fig. 2b). Although originally described in the stomach, this artifact has also been reported in the distal small bowel [3].
* Naiim Ali [email protected] Robert D’Agostino [email protected] 1
University of Vermont Medical Center, Burlington, USA
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Abdominal Radiology Funding No funding was received for this study.
Compliance with ethical standards Conflict of interest The authors declare that they have no conflict of interest. Ethical approval The article does not contain any studies with human participants or animals performed by any of the authors. Informed consent Statement of informed consent was not applicable since the manuscript does not contain any patient data.
Fig. 1 Greater flamingos photographed kissing near Chennai, India. (https://commons.wikimedia.org/wiki/File:Greater_flamingos_kissi ng.jpg). Accessed May 26, 2020
Fig. 2 Fluoroscopic double contrast upper gastrointestinal study performed with barium and effervescent crystals. Initial upright spot radiograph (a) shows apposition of the anterior and posterior walls of the lower gastric body along the greater curvature (arrows) as well as
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peculiar appearance of the gastric antrum (arrowheads) as it passes over the abdominal aorta. After turning the patient into a left posterior oblique position (b) causing movement of intraluminal air, these artifacts disappear
Abdominal Radiology
References 1. Laufer I (1975) A simple method for routine double-contrast study of the upper gastrointestinal tract. Radiology, 117(3): 513-518 2. Gohel VK, Kressel HY, Laufer I (1978) Double-contrast artifacts. Gastrointestinal radiology, 3(1): 139-146
3. Antes G, E
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