4: Pathology of the small bowel (new lecture not up yet :(((((((()

Question 1

make use of pictures in these lectures

Question 2

plica folds, red spots are peyer’s patches (4)

Question 3

(5) villi, note presence of lymphocytes

Question 4

(6) superior mesenteric artery supplies small bowel (midgut)

Question 5

(7) strangulation is not the same as occlusion

Question 6

small bowel being strangled by ligament

Question 7

(11) transmural haemorrhagic infarctions - gangrene

Question 8

(12) at apical end, mucosa has sloughed, but beyond muscularis propria the tissue is still viable

Question 9

(14) pain will be experienced on high metabolic demand in the same way as angina, IHD

Question 10

(15) vitello-intestinal duct used to connect us to yolk sac as embryo

Question 11

(17) primary tumours of the small bowel are incredibly rare - secondary tumours (metastases) are a lot more common

Question 12

diffuse thickening of small bowel wall, slight discolouration

mass lesion on right image - diffuse mass of small lymphocytes

Question 13

carcinoid tumours are remarkably monotonous - small, round, look the same

Question 14

if you see adenocarcinoma, think crohn’s or coeliac disease

Question 15

Occlusion of which artery can cause small bowel ischaemia?

Answer 15

Superior mesenteric artery

Question 16

Which process, involving fatty acid build up in the lumen, can cause occlusion of the superior mesenteric artery?

Answer 16

Atherosclerosis

Question 17

Apart from atherosclerosis, what else could block the superior mesenteric artery?

Answer 17

Thromboembolism

Question 18

Bowel ischaemia is usually (acute / chronic).

Answer 18

acute

Question 19

By which non-occlusive means can the SMA be obstructed?

Answer 19

Strangulation

Question 20

What is infarcted in small bowel ischaemia?

Answer 20

Bowel wall

Question 21

The longer acute ischaemia of the bowel goes on, the more likely it is to be ___.

Answer 21

transmural

i.e passing through the whole bowel wall