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Colon > Bowel inflammation other than IBD > Flashcards

Bowel inflammation other than IBD Flashcards

1
Q

DDx for bowel inflammation

A
  1. infection
  2. IBD
  3. HUS
  4. HSP
  5. Bechet disease
  6. PLE
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2
Q

Infections associated with HSP?

A

viral
Staphylococcus

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3
Q

GI manifestations of HSP

A
  1. abdominal pain (worse post meal)
  2. GIB (occult>overt bleed+melena>hematochezia)
  3. pancreatitis
  4. cholecystitis
  5. ileoileal intussusception
  6. perforation
  7. mesenteric vasculitis –> massive GIB
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4
Q

Histology of HSP

A

leukocytic vasculitis
IgA and C3 deposits

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5
Q

Investigations in HSP

A

UA-hematuria and proteinuria
High LFTs
High IgA
Imaging (US): bowel wall thickening, hepatomegaly, GB wall thickening, intussusception

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6
Q

Rx for HSP

A

Symptomatic treatment
Steroids ? effective in GIB (controversial)
Surgery

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7
Q
  1. HUS triad
  2. Investigations
  3. Rx
A
  1. Hemolytic anemia, thrombocytopenia, acute renal failure +/- diarrhea (non-bloody>bloody)
  2. Labs, stool cx (E.Coli O157:H7) + other organ investigatios
  3. Rx underlying infection + supportive
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8
Q

Bechet’s etiology/Sx

A

Chronic multi-systemic vasculitis
Painful oral & genital ulcers
uveititis
aseptic meningitis
arthritis
EN, pustules
GI: abdo pain, GIB, PA, ischemia, infarct, weight loss, diarrhea

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9
Q

Hirschsprung’s disease etiology

A

Migratory arrest of neural crest cells

Absence of submucosal (Auerbach) and myenteric (Messiner) plexuses –> spastic contraction of colon involved–>stool retntion–> dilation of bowel proximal to affected segment

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10
Q

Syndromes associated with HD

A
  1. T21
  2. Waardenburge-Shah
  3. Ondine curse
  4. MEN2
  5. Neurofibromatosis
  6. Neuroblastoma
  7. Smith-Lemli Optiz

Associated gene: RET proto-oncogene

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11
Q

HD presentations

A
  1. Failure to pass meconium
  2. Chronic constipation
  3. Abdominal distension
  4. Feeding intolerance and bilious vomiting
  5. HAEC
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12
Q

Risk factors for HAEC

A
  1. Genetic syndrome (T21, Cartilage-hair hypoplasia)
  2. Delayed dx > 1 wk
  3. other major congenital anomylies (Cardiac, GI, GU, CNS)
  4. Long segment disease
  5. Post-op complications (obstruction)
  6. FHx of HD
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13
Q

Radiological findings in HD

A
  1. Cut-off sign in recto-sigmoid colon
  2. dilated bowel loops
  3. air fluid levels
  4. penumatosis intestinalis
  5. sawtooth appearance of inetsinal lining
  6. free air with perforation
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14
Q

Diagnosis of HD

A

Gold STD: Full thickness or suction biopsy
Finding: aganglinosis, hypertrophic nerve fibers using ACh stains, calretinin to improve histo accuracy

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15
Q

Rx of HD

A

Surgery: resection of aganglionic segment and transition zone

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16
Q

HD complications post surgery

A

Only 50% will have optimal bowel function
1. Abnormal bowel function
2. poor sphincter performance
3. fecal incontinence
4. constipation
5. sexual dysfunction
6. urinary dysfunction
7. enterocolitis

Colon (9 decks)

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