GI 3 Flashcards
Erythema nodosum and pyoderma gangrenosum is often found in what GI condition?
IBD
More so Crohns.
Painless rectal bleeding in a child.
Meckels diverticulum
Vomiting + abdominal pain + passage of blood per rectum.
Mass in right upper quadrant, possibe emptiness in right lower quadrant (Dance’s sign)
Intussusception
Best initial test for intussusception vs what test is diagnostic and therapeutic?
US initial.
Air or contrast enema is therapeutic.
This is congenital megacolon due to an absence of ganglion cells, leading to a functional obstruction.
Common to distal colon and rectum.
Presents as failure of meconium passage in a full term infant. Bilious vomiting, abdominal distention.
Hirschprung disease
How to dx hirschsprung disease?
contrast enema
Rectal biopsy is definitive.
Patients with a malabsorption presentation such as iron deficiency anemia, steatorrhea, osteomalacia, or osteoporosis.
Also GI complaints of diarrhea, abdominal pain/distension, bloating.
Celiac disease
Hirschsprung’s is strongly associated with
Down syndrome
Which esophageal cancer classically develops in the upper 2/3rds of the esophagus?
Squamous cell carcinoma
Seen in those that smoke and or drink.
Asymptomatic sliding hiatal hernia management
Reassurance and observation
If symptomatic, wt. loss, PPI.
Management for a patient with a full thickness esophgeal rupture caused by forceful retching or vomiting.
Clinically retrosternal chest pain worse with deep breathing and swallowing.
Crepitus on chest auscultation and mediastinal crackling with every heart beat.
Boerhaave syndrome
Stable: IV fluids, NPO, antibiotics,
Large or severe: Emergent surgical repair
Dx study for Mallory-weiss tear vs Boerhaave syndrome?
Mallory weiss = Upper endoscopy
Boerhaave = Esophagram or CT with gastrografin.
Management for an elderly patient with obstructed tympanitic abdomen.
Crampy abdominal pain, distention, NV, constipation.
Imaging shows U shaped appearance of the air filled closed loop of distended colon with loss of haustral markings.
Sigmoid vlvulus
Vird-beak or coffee bean sign.
TX. endoscopic decompression with proctosigmoidoscopy.
Acute abdominal pain with rectal bleeding, commonly due to transient systemic hypotension or atherosclerosis.
MC to the splenic flexure and rectosigmoid junction.
CT shows segmental bowel wall thickening.
Ischemic colitis
Tx for ischemic colitis
Restore perfusion, bowel rest, IV fluids.
