Abdomen Ch 5 Pathology Flashcards
The lining of the abdomen
Peritoneum
Lining attached to abdominal organs
visceral peritoneum
Churns gastric content and propels it toward pylorus
Peristalsis
Appears as longitudinal lines within the stomach–Only can see when empty
Rugae
How each section of the small bowel will appear radiographically?
- Duodenum-transverse rigid appearance
- jejunum-appears delicate and feathery
- Ileum-folds look like those of the duodenum but not as large in diameter
What are two things always present on an abdominal image of an un-prepped patient?
- Gas patterns
- Fecal Matter
Presence of air-fluid levels on an erect image of normal patients?
Few if any air fluid levels
Where gas patterns are normally only seen at on an adult patient?
- stomach
- colon
What image is taken to show air-fluid levels when patient cannot stand?
left lateral decubitus
What does endoscopy do?
Allows for the visualization of both ends of the internal surfaces of the GI system
What does endoscopy use?
Lighted instruments with optics to visualize diseases of GI system
When thick barium is used on the esophagus?
When esophagus is single object of study
When is thin barium used on an esophagus?
When esophagus is studied as part of the GI system along with other parts
What is difficult swallowing known as? It is also the most common chief complaint when performing esophagrams?
Dysphagia
What does an UGI procedure evaluate>
Contour, position, rugae, and peristaltic changes
When a stoma is surgically created in the abdominal wall to allow drainage of bowel contents in a pouch located on the outside of the body
Colostomy
What is a common indication for ileostomy?
ulcerative colitis
What 2 conditions CT of the colon is commonly done to evaluate?
- Diverticulitis
- appendicitis
Why endoscopic procedures are used on GI system?
Used to look inside GI tract and other hollow organs and cavities of the body
What’s a contraindication for capsule endoscopy?
Bowel obstruction
What gastric tubes are used for?
- Aspiration of gastric contents
- Decompression and removal of contents
- Nutritional support
- Medication Administration
Congenital absence or closure of a normal body orifice or tubular organ?
Atresia
When the esophagus fails to develop past some point?
Esophageal atresia
Abnormal tube like passage?
Fistula
What’s the radiographic appearance of bowel atresia?
Double bubble sign- gaseous distension of the stomach creates one bubble and gas in proximal duodenum creates a second bubble
What is an imperforate anus?
COngenital disorder in where there is no anal opening to the outside
What’s the common area of fistula in boys and girls?–Imperforate anus
Boys- between bowel and urethra
Girls-between bowel and vagina
What is hypertrophic pyloric stenosis?
Congenital anomaly of stomach where pyloric canal leading out of stomach is greatly narrowed
Is hypertrophic pyloric stenosis the most common indication for surgery in infants?
Yes
Who does hypertrophic pyloric stenosis most commonly effect?
first born males
What are the signs and symptoms of hypertrophic pyloric stenosis?
Projectile vomiting at 2-6 weeks. Infants often becomes dehydrated and fails to gain weight
With hypertrophic pyloric stenosis what does an UGI evaluates?
Demonstrates delayed gastric emptying accompanied by a classic string sign as the barium trickles through the narrowed elongated pyloric canal
The complete reversal of ALL the abdominal organs is called?
Situs Inversus
What is Hirschsprung’s Disease?
Theabsence of neurons in bowel wall, typically sigmoid colon primarily affecting men
Hirschsprung’s Disease also referred to as
Congenital megacolon
What is toxic megacolon?
Develops from bacterial overgrowth leading to fluid and electrolyte imbalances in the infant that could result in death
What is Meckel’s Diverticulum?
Congenital diverticulum of distal ileum
What does Meckel’s diverticulum symptoms mimic?
Appendicitis except for location of pain
What esophageal strictures are commonly secondary to?
Ingestion of caustic material
What is GERD?
Results from an incompetent cardiac sphincter allowing the backwards flow of gastric acid and contents into the esophagus
IS reflux always considered abnormal?
Not necessarily
What are the treatments for GERD?
Elevate the head o the bed, avoid drinks such as coffee and alcohol that stimulate acid secretions, avoid foods such as cholate that decrease sphincter competence, avoid smoking, anatacids was to gastric acids out of the esophagus for pain relief and medical therapy, surgery is used as a last result
What is a peptic ulcer?
an erosion of the mucous membrane of the lower end of the esophagus, stomach, or duodenum
Where are peptic ulcer is most commonly located?
The duodenal bulb and lesser curvature of stomach
What is the radiographic appearance of a peptic ulcer?
Radiating spike like wheels of mucosal folds that run to the edge of the crater
What is gastroenteritis?
Inflammation of the mucosal lining of the stomach and small bowel… General grouping of a number of inflammatory disorders
What is gastroenteritis radiographic appearance?
Slit like collection of barium surrounded by radiolucent holds of swollen elevated mucosa
What is Chron’s Disease or Regional Enteritis?
Chronic inflammatory disease with unknown etiology
What is the Radiographic appearance Crohn’s disease/regional enteritis?
Cobblestone appearance when there’s ulcers. String sign seen when ileum is so diseased and stenotic that barium just trickles through opening
What is the most common abdominal surgery performed in the US?
Appendicitis- appendectomy
Inflammatory lesions of colon, mucosa, unknown etiology(thought to be autoimmune) 4xs more likely to occur in white Jewish people, typically affecting 15-25 year olds–develop excessive diarrhea with blood, pus, and mucous
Ulcerative Colitis
What are esophageal varices?
Abnormally dilated lengthened superficial veins of the esophagus
What is the radiographic appearance of esophageal varices?
Worm-like defects within the thin barium suspensory
When Esophageal varices are to be viewed is thick or thin barium used?
Thin because thick can cover the appearance of the varices
A protrusion of a loop of bowel thru a small opening usually the abdominal wall– occurs because of the anatomic weakness
hernia
Common in men–occurs when a bowel loop protrudes through a weakness in the inguinal ring and may descend downward into the scrotum
Inguinal Hernia
When a herniated loop of bowel can be pushed back into the abdominal cavity
Reducible hernia
When the herniated loop becomes stuck and cannot be reduced
Strangulated hernia
What is a hiatal hernia?
It occurs in about 1/2 the population of people over the age of 50- happens when there’s a weakness of esophageal hiatus that permits some portions of stomach to herniate into the thoracic cavity
When can hiatal hernias be reduced?
in early stages
What is the most common appearance of a mechanical bowel obstruction?
Gas confined to the small bowel with multiple air fluid levels visible on an upright abdomen indicates a mechanical bowel obstruction
In a mechanical bowel obstruction what does emesis containing bile indicate?
A mechanical obstruction
When a gallstone erodes from the gall bladder and creates a fistula to small bowel
gallstone ileus
Twisting of bowel loop about its mesenteric base (or on itself)
volvulus
When does intussusception occur?
When a segment of bowel, constricted by peristalsis telescopes into a distal segment and is driven further into the distal bowel by peristalsis
What is the radiographic appearance of intussusception?
Coiled spring–this is common in infants and children
Failure of normal peristalsis. Gas distributed throughout both the large and small bowel is indicative of a _____
paralytic ileus
When does a paralytic ileus occur?
After surgeries that require bowel manipulation
A pouch or sac of variable size that occurs normally or is created but herniation of a mucous membrane through a defect in its muscular coat
diverticula
A pulsion type found at pharyngoesophageal junction at the upper end of the esophagus
Zenker’s Diverticulum
When is a colonic diverticulae seen in which portion of the colon?
sigmoid colon 95%
Colonic diverticulae is sometimes referred as?
left sided appendicitis
Where do esophageal tumors occur?
lower 1/3 of esophagus, but can occur anywhere
What is a leiomyoma?
benign smooth muscle tumors
What is the only successful treatment for stomach tumors?
surgical removal
What are colon polyps?
Small masses of tissue arising from bowel wall that project inward into the lumen
What two ways do colon polyps attach to the colon?
- sessile-attached directly to bowel wall with wide base
- pedunculated-attached by narrow stalk
What is the radiographic appearance if colon polyps?
Rounded filing defect or contour defect in the barium shadow
Predisposing factors of colon cancer
family history and ulcerative colitis
Radiographic appearance of colon cancer?
“apple core” commonly called apple core lesion
