DOC. ANDAL - GIT part1 Flashcards
common birth defect
near tracheal bifurcation
ATRESIA
COMPLETE ABSENCE -
INCOMPLETE -
COMPLETE ABSENCE - AGENESIS
INCOMPLETE - ATRESIA
MOST COMMON FORM OF CONGENITAL ATRESIA
FAILURE OF CLOACAL DIAPHRAGM TO INVOLUTE
IMPERFORATE ANUS
INCOMPLETE FORM OF ATRESIA
LUMEN REDUCED IN CALIBER
BX FIBROUS THICKENING OF THE WALL
STENOSIS
INCOMPLETE ‘FORMATION OF THE DIAPHRAGM
ABDOMINAL VISCERA TO HERNIATEINTO THORACIC CAVITY
DIAPHRAGMATIC HERNIA
MOST COMMON LOCATION OF
DIAPHRAGMATIC HERNIA
LEFT - MOSTLY
SPACE FILING EFFECT
CAN CAUSE PULMONARY HYPOPLASIA (INCOMPATIBLE WITHLIFE)
DIAPHRAGMATIC HERNIA
INCOMPLETE CLOSURE OF ABDOMINAL MUSCULATURE
WITH SAC ( AMNION)
AMNION WITH PERITONEUM INSIDE SUPPORTED BY WHARTON GEL
OMPHALOCELE
OR
EXOMPHALMOS
ALL LAYERS OF THE ABDOMINAL WALL
WITHOUT SAC
LIMITED TO INTESTINES
GASTROSCHISIS
COMMON SITE
UPPER 1/3 ESOPHAGUS
CAN RESULT IN : [D-E-B-A]
- DYSPHAGIA
- ESOPHAGITIS
- BARRETS ESOPHAGUS
- ADENOCARCINOMA
ECTOPIA
ECTOPIC GASTRIC MUSCOSA
LED FREQUENT
FOUND IN ESOPHAGUS/ STOMACH
ASYMPTOMATIC
ECTOPIC PANCREATIC TISSUE
FAILED INVOLUTION OF VITTELINE DUCT
TRUE DIVERTICULUM
BLIND OUTPOUCHING (ALL LAYERS)
MECKEL DIVERTICULUM
RULE OF 2s IN MECKEL DIVERTICULUM
= 2% OF POPULATION
2 FEET (60CM) OF THE ILEOCECAL VALVE)
=2INCHES (5CM) LONG
2X MORE IN MALES
2 Y/O SYMPTOMATIC
3RD TO 6TH WEEK OF LIFE
MOST COMMON CONGENITAL
CONGENITAL HYPERTROPIC PYLORIC STENOSIS
BIRD BEAK SIGN IN BARIUM SWALLOW
CONGENITAL HYPERTROPIC PYLORIC STENOSIS
PYLORIC STENOSIS
INCREASED RISK FOR:
MONOZYGOTIC TWINS
TURNER SYNDROME
TRISOMY 18
ERYTHROMYCIN OR AZITHROMYCIN EXPOSURE
OLIVE SHAPED
FIRM (1-2CM ABDOMINAL MASS)
ABNORMAL LEFT TO RIGHT HYPERPERISTALSIS PRIOR TO VOMITING
PYLORIC STENOSIS
MICROSCOPIC FINDINGS
1. HYPERPLASIA OF PMP (PYLORIC MUSCULARIS PROPRIA)
2. EDEMA - MUCOSA AND SUBMUCOSA
PYLORIC STENOSIS
10% CHILDREN - DOWN SYNDROME
5% - SERIOUS NEUROLOGICAL ABNORMALITIES
HIRSCHSPRUNG DISEASE
CONGENITAL AGANGLIONIC MEGACOLON
FAILURE OF GANGLION CELLS TO MIGRATE TO WALL OF COLON
HIRSCHSPRUNG DISEASE
CONGENITAL AGANGLIONIC MEGACOLON
GANGLION CELLS - IHC
WHAT IS ABSENT IN THE INVOLVED SEGMENT
ACETYLCHOLINESTERASE
HIRSCHSPRUNG DISEASE
CONGENITAL AGANGLIONIC MEGACOLON
ALWAYS AFFECTED -
MOST AFFECTED -
SEVERE CASES -
ALWAYS AFFECTED - RECTUM
MOST AFFECTED - SIGMOID & RECTUM
SEVERE CASES - ENTIRE COLON
LOSS OF FUNCTION MUTATIONS
IN RECEPTOR TYROSINE KINASE RET
HIRSCHSPRUNG DISEASE
FAILURE TO PASS MECONIUM
HIRSCHSPRUNG DISEASE
SEVERE CASES OF HIRSCHSPRUNG DISEASE
[P-E-P-E]
PERFORATION
ENTEROCOLITIS
PERITONITIS
ELECTROLYTE DISTURBANCES
25 CM
FROM FOREGUT
3RD WEEK AOG
ESOPHAGUS
PROTECT AIRWAY
UPPER ESOPHAGEAL JXN
PROTECT ESOPHAGUS
LOWER ESOPHAGEAL JXN
MUSCLES IN ESOPHAGUS ARE UNCOORDINATED
INTENSE HIGH AMPLITUDE CONTRACTIONS
DISTAL ESOPHAGUS
NUTCRACKER ESOPHAGUS
DIAGNOSIS IN NUTCRACKER ESOPHAGUS
MANOMETRY
CORKSCREW ESOPHAGUS
DIFFUSE ESOPHAGEAL SPASM
REPETITIVE SIMULTANEOUS CONTRACTIONS
DISTAL ESOPHAGEAL SMOOTH MUSCLE
DIFFUSE ESOPHAGEAL SPASM
LEADS TO DEVELOPMENT OF SMALL DIVERTICULA
EPIPHRENIC DIVERTICULUM
HYPERTENSIVE LE SPHINCTER
FALSE DIVERTICULUM
UNCOMMON
HALITOSIS
REGURGITATION
ZENKER DIVERTICULUM
OR
PHARYNGOESOPHAGEAL DIVERTICULUM
NAROWING OF THE LUMEN
SUBMUCOSA FIBROUS THICKENING
MUSCULARIS PROPIA ATROPHY
SECONDARY EPITEHIAL DAMAGE ( DUE TO RADIATION OR CHRONIC REFLUX)
ESOPHAGEAL STENOSIS
LEDGE LIKE PROTRUSIONS
ASSOCIATED WITH GERD
ESOPHAGEAL MUCOSAL WEB
AKA SCHATZKI RINGS
SIMILAR TO WEBS BUT CIRCUMFERENTIAL AND THICKER
INCLUDES MUCOSA AND SUBMUCOSA + MUSCULARIS PROPRIA
ESOPHAGEAL RINGS
IN SCHATZKI RING
DISTAL ESOPHAGUS ( SQUAMOUS MUCOSA)
A RING
IN SCHATZKI RING
SCJ OF LOWER ESOPHAGUS
B RING
TIGHT LES (LOWER ESOPHAGEAL SPHINCTER)
ACHALASIA
TRIAD OF ACHALASIA
- INCOMPLETE LES RELAXATION
- INCREASED LES TONE
- APERISTALSIS OF ESOPHAGUS
DYSPHAGIA OF SOLIDS AND LIQUIDS
DIFFICULTY OF BELCHING
CHEST PAIN
ACHALASIA
DISTAL ESOPHAGEAL INHIBITORY NEURONAL DEGENERATION
CAUSE UNKNOWN - RARE
PRIMARY ACHALASIA
CHAGAS DISEASE
TRYPANOSOMA CRUZI (T. CRUZI) INFECTION
DESTRUXCTION OF MYENTERIC PLEXUS
FAILURE PERISTALSIS
ESOPHAGEAL DILATION
SECONDARY ACHALASIA
TREATMENT OF ACHALASIA
MYOTOMY
PNEUMONIC BALLOON DILATION
BOTOX (BOTULINUM TOXIN)
TRIPLE A SYNDROME
ALLGROVE SYNDROME
1. ACHALASIA
2. ALACRIMA
3.ACH RESISTANT
SEVERE RETCHING/ VOMITING
SECONDARY TO ALCOHOL INTOXICATION
MALLORY-WEISS TEAR
LONGITUDINAL MUCOSAL TEARS
NEAR GASTROESOPHAGEAL JUNCTION
INVOLVES MUCOSA AND SUBMUCOSA
MALLORY-WEISS TEAR
INTENTIONALLY EAT MANY THEN VOMIT
REFLUX ESOPHAGITIS
SUPERFICIAL LACERATIONS
HEMATEMESIS
MELENA (UPPER GI BLEED)
TRANSMURAL TEARING RUPTURE OF DISTAL ESOPHAGUS
BOERHAAVE SYNDROME
BOERHAAVE’S SYNDROME
WHAT IS THE SIGN?
HAMMAN SIGN
PUNCH PUT ULCERS
HSV
VIRAL ESOPHAGITIS
SHALLOWER ULCERS
CMV
VIRAL ESPHAGITIS
MOST COMON CAUSE OF GERD
IS TRANSIENT LES RELAXATION
REFLUX ESOPHAGITIS
HIGH CHANCE OF BARRET ESOPHAGUS
INCREASE CHANCE OF CARCINOMA
R/O MI
REFLUX ESOPHAGITIS
BASAL ZONE HYPERPLASIA
ELONGATION LAMINA PROPRIA
EOSIONOPHILS RECRUITED
REFLUX ESOPHAGITIS
FELINE ESOPHAGUS
STACKED CIRCULAR RINGS
EOSIONOPHILIC ESOPHAGITIS