Gastrointestinal System Pathologies Flashcards
Achalasia
Functional obstruction of the distal section of the esophagus with proximal dilation.
Imaging appearance: Dilated esophagus (CXR) or narrowing of distal esophageal segment (GI)
Treatment: Medication to relax sphincter, balloon dilation, surgical myotomy.
Esophageal varices
Dilated veins in the wall of the esophagus.
Imaging appearance:
Treatment:
Foreign body
*It is essential that any suspected foreign body be evaluated on two projections to be certain that the object projected over the esophagus truly lies within
Imaging appearance:
Treatment:
Tracheoesophageal fistula
Failure of a satisfactory esophageal lumen to develop completely seperate from the trachea.
Imaging appearance:
Treatment:
Esophageal carcinoma
Cancer of the esophagus.
Imaging appearance: Flat plaque like lesion, irregular wall, mass
Treatment: Surgical resection, palliative therapy (chemo/radiation therapy)
Cholelithiasis
Gallstones. Gallstones can develop whenever bile contains insufficient bile salts and lecithin (fat) in proportion to cholesterol to maintain the cholesterol in solution.
Imaging appearance: Cholelithiasis evident if calcified
Treatment: Lithotripsy, chemical dissolution, ERCP for stone retrieval, laparoscopic cholecystectomy.
Cirrhosis
Chronic destruction of liver cells and structure, it is an end stage liver disease.
Imaging appearance: Haziness in ascites
Treatment: Dietary modifications, cessation of alcohol consumption. *curable only by liver transplant.
Hiatal hernia
The most common diaphragmatic hernia is a hiatal hernia; the stomach slips through the esophageal hiatus and in to the chest. An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal.
Imaging appearance: Numerous thicker folds of the stomach above the diaphragm
Treatment: no treatment in most cases, surgical intervention includes tightening the hiatus.
Crohn’s disease
Chronic inflammatory disorder if unknown cause.
Imaging appearance: Irregular thickened mucosal folds, cobblestone appearance, string sign and skip lesions.
Treatment: Medication, surgery if complications occur.
Peptic/Duodenal ulcers
Peptic ulcer disease is a group of inflammatory processes involving the stomach and duodenum. It is caused by the action of acid and the enzyme peptic secreted by the stomach. Duodenal ulcer is the most common, it occurs in the first portion of the duodenum (the duodenal bulb)
Imaging appearance: Small shallow erosions to perforations, rounded or linear collection of contrast.
Treatment: Avoid acidic foods. antibiotics for infection, histamine antagonist to reduce acidic secretions, proton pump inhibitors.
Diverticulitis
Perforation of a diverticulum (abnormal sac/pouch) leads to the development of a peridiverticular abscess.
Imaging appearance: Diverticular perforation with possible abscess.
Treatment: Surgery for the perforated diverticula or antibiotics
Intussusception
The telescoping of one part of the intestinal tract onto another because of peristalsis.
Imaging appearance: Coiled spring appearance on contrast enema
Treatment: Reduction of telescoping bowel (rectal insufflation)
Ulcerative colitis
Inflammatory bowel disease that causes long-lasting inflammation and ulcers in the digestive track.
Imaging appearance: Deep ulcers with intraluminal gas or polypoid changes, loss of haustral markings.
Treatment: Nutritional supplements, dietary modifications, anti-inflammatory drugs, surgical resection.
Volvolus
Twisting of the bowel on itself.
Imaging appearance: Distended cecum, displaced upward and to the left. Distended rectum, sausage or balloon shape.
Treatment: Surgical detorsion, water soluble enema may be therapeutic.
Hepatitis
Inflammatory disease of the liver.
Imaging appearance: Macronodules, enlargement of the portal venous system.
Treatment: Prevention is most effective. Vaccines for hep A and B; immune globulin for short term immunization.
Pneumoperitoneum
Free air in the peritoneal cavity.
Imaging appearance: Free intraperitoneal gas under the diaphragm (upright) or air collection between lateral margin of the liver and outer abdominal wall (left lat decubitus)
Treatment: Immediate surgery for visceral perforation, IV antibiotics.
Anemia
A decrease in the amount of oxygen-carrying hemoglobin in the peripheral blood.
Imaging appearance: Other complication in the bones, cardiomegaly, renal papillary necrosis.
Treatment: Splenectomy, blood transfusion, bone marrow transplant.
Ascites
Accumulation of fluid in the peritoneal cavity.
Imaging appearance: Increased density of the abdomen, poor definition of the soft tissue shadows, displacement of bowel, etc.
Treatment: modified diet, medications (diuretics), ascitic taps
Bowel obstruction
Blockage in the small or large intestine.
Imaging appearance: Dilated bowel loops
Treatment: Surgical intervention
Carcinoma of stomach
Malignant cancer cells form in the lining of the stomach.
Imaging appearance: mass, wall thickening, ulceration
Treatment: surgical intervention.
Cholecystitis
Inflammation of the gallbladder.
Imaging appearance: Gas in gallbladder lumen, calcification in the muscular layers.
Treatment: Lithotripsy, chemical dissolution, ERCP for stone retrieval; laparoscopic cholecystectomy.
Colorectal cancer
Cancer of the gastrointestinal tract.
Imaging appearance: Mass, bowel thickening, ulceration, complications (obstruction, fistula, etc)
Treatment: Surgery, chemotherapy, chemoradiation, radiationtherapy.
Diabetes mellitus
Common endocrine disorder in which either beta cells inside the islets of Langerhans of the pancreas fail to secrete insulin or target cells throughout the body fail to respond to this hormone.
Imaging appearance: Peripheral vessel calcification, osteomyelitis, gas gangrene, emphysematous cholecystitis.
Treatment: Oral medication, insulin, proper diet, islet cell transplantation, insulin gene insertion.
Dysphagia
Difficulty swallowing.
Treatment varies depending on what is causing the difficulty swallowing.
