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Gastrointenstinal > Gastrointestinal Emergencies > Flashcards

Gastrointestinal Emergencies Flashcards

1
Q

What is the peritoneal cavity?

A

The space between the visceral and parietal layers of the peritoneum

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2
Q

What is found in the peritoneal cavity?

A

A small amount of fluid

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3
Q

What is primary peritonitis?

A

An infection of ascitic fluid

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4
Q

How would primary peritonitis be diagnosed?

A

Aspiration of ascitic fluid with high neutrophil count

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5
Q

What is secondary peritonitis?

A

Inflammation in the peritoneal cavity secondary to infection, inflammation or perforation of abdominal structure

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6
Q

What are some causes of secondary peritonitis from ruptured viscera?

A

Appendicitis (perforated), peptic ulcer disease (perforation), diverticulitis (perforation)

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7
Q

What are some none bacterial causes of secondary peritonitis?

A

Ectopic pregnancy rupture, ovarian cyst rupture

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8
Q

What is the clinical presentation of secondary peritonitis?

A

Severe abdominal pain with gradual or acute onset, patient may stay very still to avoid pain

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9
Q

What are two common causes of bowel obstruction in children?

A

Intussusception, intestinal atresia

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10
Q

What are two common causes of small bowel obstruction in adults?

A

Adhesions, incarcerated hernias

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11
Q

What is intussusception?

A

When one part of the gut tube telescopes into an adjacent section

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12
Q

What treatment is used for intussusception?

A

Air enema, sometimes surgery

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13
Q

What are the most common symptoms of small bowel obstruction?

A

Nausea, vomiting and abdominal distension

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14
Q

What are inta-abdominal adhesions?

A

Abnormal fibrous bands between organs/tissue in abdomen which are usually separated

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15
Q

What is the biggest cause of intra-abdominal adhesions?

A

Abdominal surgeries

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16
Q

What are some common causes of large bowel obstruction?

A

Colon cancer, diverticula disease, volvulus

17
Q

How will onset of symptoms differ between large bowel obstruction caused by colon cancer compared to a volvulus?

A

Symptoms with cancer often appear gradually and volvulus more abrupt

18
Q

What are some symptoms of large bowel obstruction?

A

Abdominal distension, cramps abdominal pain, change in bowel habit (cancer). Later on there may be nausea/vomiting

19
Q

What is a volvulus?

A

Where a part of the colon twists on its mesentery

20
Q

Which two places are volvulus most common?

A

Sigmoid colon and caecum

21
Q

What sign shows on abdominal X-ray with sigmoid colon volvulus?

A

Coffee bean sign

22
Q

What are some key differences in presentation between small and large bowel obstruction?

A

Small: colicky every few minutes, vomiting first
Large: colicky every 10-15 minutes, constipation first

23
Q

What is acute mesenteric ischaemia?

A

A symptomatic reduction in blood supply to the GI tract

24
Q

What are some risk factors of acute mesenteric ischaemia?

A

Elderly, peripheral vascular disease, CVD risk factors, more common in females

25
Q

Why is pain often left died in acute mesenteric ischaemia?

A

Splenic flexure is area most likely affected as blood supply most fragile

26
Q

How is acute mesenteric ischaemia treatment?

A

Surgical resection of ischaemic bowel

27
Q

Which part of the duodenum is most susceptible to peptic ulcers?

A

The first part of the duodenum

28
Q

Which artery lies behind the first part of the duodenum?

A

Gastro-duodenal artery

29
Q

Where in the stomach are peptic ulcers most likely to form in the stomach?

A

Lesser curve and antrum

30
Q

If a peptic ulcer forms in the body of the stomach, which artery could it possibly erode into?

A

Splenic artery

31
Q

What is the first line treatment of a bleeding oesophageal varice?

A

Endoscopic band ligation

32
Q

What is a transjugular intrahepatic portosystemic shunt (TIPS), how does this help oesophageal varices?

A

Expandable stent placed in liver helps blood flow from portal vein to hepatic veins and so reduces portal vein and varicella pressure

33
Q

What is an abdominal aortic aneurysm?

A

A permanent pathological dilation of the aorta

34
Q

What are some risk factors of an AAA?

A

Male, smoking, increasing age, family history

35
Q

In relation to the renal arteries, where do most aortic aneurysms occur?

A

Below the renal arteries (infrarenal)

36
Q

What are symptoms of an unruptured AAA?

A

Usually asymptomatic, can have pulsating mass or effects from compression of nearby organs (nausea, frequency, back pain)

37
Q

What is the usual presentation of AAA rupture?

A

Persistent abdominal and back pain, syncope, sudden cardiovascular collapse

Gastrointenstinal (9 decks)

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