Endoscopic Tour of the GI Tract Flashcards
Describe the diff endoscopic and laparoscopic tools available to investigate the GI tract
endoscopy = visualise GI tract
Caliber nasendoscopes = pharynx and larynx
Endoscopic retrograde cholangiography and pancreatography (ERCP) = biliary or pancreatic ductal systems
Capsular endoscopy = small bowel
Colonoscopy = colon
What is barrett’s oesophagus?
Long term gastroesophageal reflux disease (GERD)
Metaplasia = stratified squamous ep to simple columnar ep with goblet cells
What is hiatus hernia?
Weakness in the oesophageal hiatus (opening in the diaphragm, oesophagus and vagus nerve pass through) allows the cardia and the fundus of the stomach to herniate into the thorax
What are oesophageal varicies?
Extremely dilated sub-mucosal veins in the lower third of the oesophagus
Mixed venous drainage into the portal system
Most commonly due to portal hypertension caused by cirrhosis
Outline dysphagia
Difficulty/discomfort swallowing
Achalasia = failure of smooth muscle fibres to relax, sphincter to remain closed
Malignancy
Benign stricture = narrowing of oesophagus
Discuss gastric ulceration
Commonly benign, on lesser curve at the angulus
Malignancy suspected if irregular margins
What is coeliac disease?
SI is hypersensitive to gluten = inflam = diff digesting food
Vili and crypts atrophy
Why would the oesophagus be dilated?
Procedure to correct narrowing, due to scaring from reflux
Anaesthetic throat spray, endoscope, dilation with a balloon or plastic dilators
How does oesophageal perforation occur?
Vomit against a closed epiglottis
Iatrogenic
What is boerhaave syndrome?
Rupture of oesophageal wall due to vomiting = sudden increase in intraesophageal press combined with relatively -ve intrathoracic pressure
What are gallstones and why do they form?
Either in the gallbladder or common bile duct
Made up of mainly cholesterol
Cause = high cholesterol, bilirubin. Incomplete/infrequent emptying of the gallbladder may cause the bile to become over-concentrated and contribute to gall formation
What is a choledocoduodenal fistula?
Fistulous connection between the gallbladder and the duodenum
What is gallstone ileus?
Rare form of small bowel obstruction caused by an impaction of a gallstone within the lumen of the SI
What are duodenal ulcers and the cause?
crater in the lining of the beginning of SI
caused by infection with Helicobacter pylori
Other factors predisposing a person to ulcers include anti-inflam meds and smoking
Describe peritonitis
inflam of the peritoneum, typically caused by bacterial infection either via the blood or after rupture of an abdominal organ.
What is zollinger-ellison syndrome?
gastrin-secreting tumour or hyperplasia of the islet cells in the pancreas causes overproduction of gastric acid, resulting in recurrent peptic ulcers
What is aorta-duodenal fistula and its cause?
Connection between the aorta and duodenum
Usually secondary to abdominal aortic aneurysm
Outline SMA syndrome
Superior mesenteric artery
gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery
What is the cause of obstructive jaundice?
Blockage of the bile ducts or abnormal retention of bile in the liver
Gallstones, tumours
Bile remains in bloodstream
When is the pringle manoeuvre used?
Surgical manoeuvre in some abdo ops
Clamping the petatoduodenal ligament = interrupting blood flow through hepatic artery and portal vein = control bleeding from liver
Obstruction of the caecum can cause what?
May dilate to the point of necrosis or perforation
if the ileocaecal valve is competent it prevents back flow of excess air and colonic contents which may not pass distally
Discuss colonic tumours
20% occur in the caecum and right side of the colon
often present with a mass
change in bowel habit, iron def anaemia, pain
What is an appendicitis?
inflam of appendix
Caused by blockage of the hollow portion
What is diverticulosis?
Condition of having multiple pouches (diverticula) in the colon (not inflamed)
These are out-pockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall
