Chapter 17-Small Intestine And Colon Flashcards
What is the most common cause of intestinal obstruction worldwide
Hernias
What are the common causes in the formation of adhesions
Surgical
Infection
Peritoneal inflammation
Endometriosis
What is the most common cause of herniations in the US
Adhesions
What is the most common cause of obstruction in patients under the age of 2
Intussusception
What are the two steps in the intestinal response to ischemic injury
1) Hypoxic injury due to vascular compromise
2) Reperfusion injury during restoration of blood
What are the watershed areas of the colon that are susceptible to ischemia
1) Splenic flexure (SMA and IMA)
2) Sigmoid Colon and rectum (IMA, pudundal, and iliac)
Which portion of the colon is prone to ischemic event, and which is more resistant
Surface epithelium is prone, while the crypts are more resistant
Transmural infarction is due to what
Acute arterial obstruction
What type of necrosis is seen in the ischemic events of the colon
Coagulative necrosis
When does ischemic disease of the colon commonly happen
After 70 years of age and in women
How does acute colonic ischemia typically present
Sudden onset of cramping, lower left abdominal pain, desire to dedicate and passage of blood or bloody diarrhea
Which portion of the colon is more severe with regards to an ischemic event
Right sided (mortality is doubled)
Which prognostic indicators prove to have a worse result with acute ischemia of the colon
-COPD and symptoms lasting 2 weeks
Why is the right side of the colon correlated with a worse prognosis
SMA supplies it, so its the first presentation of severe disease, such as the occlusion of the SMA
During radiation enterocolitis, what are the common clinical findings
- Radiation fibroblasts in the stroma
- anorexia
- Abdominal cramps
- Malabsorption diarrhea
What is the most common acquired GI emergency of neonates and what is the cause/presentation
Necrotizing enterocolitis aka transmural necrosis
- During low birth weight or prematurity
- Presents when oral feeding is initiated
When does Angio dysplasia present
After 60 years old
What is the cause of the angiodysplasia and where does it commonly occur
-Malformed submucosal blood vessels, and occurs in the right colon or cecum
What is a very important cause of malabsorption and diarrhea
Intestinal graft versus host disease after allogenic hematopoietic stem cell transplantation
What is the process of intraluminal digestion
Proteins, carbs, and fats are broken down into absorbable forms
What is the process of terminal digestion
Hydrolysis of carbs and peptides by disaccharidases and peptidases in the brush border
What is the process of transepithelial transport
Nutrients, fluid, and electrolytes are transported across and processed in the small intestine epithelium
What are the qualifications for secretory diarrhea
isotonic stool persisting during fasting
What are the qualifications for osmotic diarrhea
Excessive osmotic forces exerted by nonabsorpable luminal solutes