Congential Anomalies and Esophagus Path Flashcards
What organs should be evaluated promptly if a GI congenital anomaly is noticed? (5)
Liver Gall Bladder Pancreas Lungs Spleen
Two most common types of GI atresia
Esophageal atresia (Tracheoesophageal fistula)
Imperforate anus (intestinal atresia)
GI Tract Ectopia
Definition and Examples (3)
Nodules of tissue from one organ misplaced on another organ (developmental rests)
Inlet Patch: upper third of esophagus
Ectopic Pancreatic Tissue
Gastric Heterotopia
Omphalocele vs Gastroschisis
Omphalocele is herniation of viscera into ventral membranous sac from failure of abdominal musculature to close
Gastroschisis is when the viscera is herniated all the way through from the peritoneum to exposed skin
Meckel Diverticulum
Pathogenesis (2), Clinical Features (4)
Failed involution of the Vitelline duct forming true diverticulum
2 feet from ileocecal valve
2 inches long
2x as common in males
Symptomatic by age 2 (but mostly asymptomatic)
Pyloric Stenosis
Correlations (3), Presentation (4)
Most common in males
Turner Syndrome
Trisomy 18
Presents in babies (3-6 weeks)
Regurgitation and projectile vomiting
Frequent feeding demands
Firm ovoid abdominal mass
Hirschsprung Disease
Pathogenesis, Morphology, Association, and Clinical Features (6)
*means life threatening
Failure of neural crest cells to migrate from cecum to rectum
Ganglion cell absence
Megacolon
Trisomy 21 (Downs Syndrome)
Constipation Abdominal distension Bilous vomit Enterocolitis* Perforation* Peritonitis*
Esophageal Obstruction Causes
Functional (3) and Mechanical (3)
Functional: peristalsis abnormality
Nutcracker Esophagus
Diffuse Esophageal Spasm
Systemic Sclerosis
Mechanical: physical blockage
Stricture
Stenosis
Mass
Achalasia
Characteristics (4), Primary and Secondary (2) Descriptions
Incomplete Lower esophageal sphincter relaxation
Increased LES tone
Aperistalsis of esophagus
Bird beak sign on Barium swallow CXR
Primary
Degeneration of ganglion cells in distal esophagus
Secondary
Chagas infection that destroys distal myenteric plexus
Causes dilation of esophagus
Infectious Esophagitis Causes
Healthy (1) and Immunocompromised (5)
Herpes Simplex Virus (in healthy people)
Immunocompromised People: Cytomegalovirus Herpes Simplex Virus Candida albicans Mucor Aspergillus
Chemical Esophagitis
Presentation (4) and Causes (4)
Odynophagia
Stricture
Hematemesis
Perforation
Pill Induced
Graft vs Host Disease
Chemotherapy
Radiation therapy
Reflux Esophagitis
Prevalence, Cause and Underlying Etiologies (4)
Most common esophagitis
GERD
Increased abdominal pressure
Obesity
Sliding hiatal hernia
Gastroparesis
Eosinophilic Esophagitis
Symptoms (3), Associations (2) and Diagnosis
Food impaction
Dysphagia
Feeding intolerance (infants)
Atopic dermatitis
Seasonal/Food allergies
EGD showing corrugated ring esophagus
Esophageal Varices
Relevant Anatomy, Pathogenesis (4) and Clinical Features (2)
Portal vein has collateral circulation with caval system that connects it to Esophageal Veins
Liver cirrhosis causes Portal HTN which backs up blood into Esophageal veins forming submucosal/subepithelial varices
Variceal hemorrhage is leading COD in cirrhosis
High rate of hemorrhage recurrence
Barrett Esophagus
Etiology, Pathogenesis (2), and Clinical Features (3)
Columnar metaplasia caused by chronic GERD
Refluxed acid causes squamous to columnar metaplasia
As GERD continues, dysplasia may occur leading to adenocarcinoma
Diagnosed by endoscopy with biopsy
Progression to adenocarcinoma is greatest concern
Seen most in white males
