GI Embryology and Anatomy Diseases Flashcards
Remnant of Vitelline Duct (duct that connects yolk sac to GI) sits where and is known as what? What rule is it famous for?
What is the Omphomesanthalic Cyst?
Rule of 2’s. Behind umbilicus within 2 feet of ileocecal valve. 2% of population. 2x more in males. 2 inches long. True diverticulum with 2 other types of tissue mucosa - ectopic gastric and pancreatic. Usually asymptomatic unless gastric tissue is dumping acid into the ileum, which then leads to bleeding and abdominal pain.
Melena or Hematochezia, depending on how much blood gets digested.
Fun fact: Kids have more bowel motility so they tend to get hematochezia whereas adults get melena.
Pyloric Stenosis
First born males.
If Meckel diverticulum gets inflamed, it can cause SBO just like in normal diverticulitis. What other dangerous complication can occur?
Intussusception or Volvulus, as the Meckel can be a lead point.
Where is the pain from a Meckel and how is it confirmed?
M99 Pertechnitate study taken up in gastric mucosa. It often presents with RLQ pain, making you think it could be appendicitis.
Is bilious emesis better or worse than nonbilious?
Unequivocally worse! Green vomit suggests a need for surgical intervention. Hospital, pronto.
Hirschsprung disease - kid can’t poop disease.
Failure of nerve plexus to migrate to parts of colon. Constricted useless areas of colon with distended megacolon above.
Hirschsprung occurs most often where in the colon and what genetic associations does it have?
Rectosigmoid, just like Volvulus and Diverticulitis. Associated with low alpha fetoprotein Down Syndrome and mutations in the RET gene.
Failure of meconium in first 48 hours of life should prompt workup for what? What obstruction presents 2 to 6 weeks after birth?
Hirschsprung disease. 2 to 6 weeks with nonbilious and little olive tummy should lead to Pyloric Stenosis.
Diagnosis of Hirschsprung is…
Treatment is…
Rectal Suction Biopsy of ALL layers.
Avoid DRE squirt test :)
You have to resection the colon. It will never work properly.
Bilious emesis big bad 4.
Hirschsprung, Malrotation, Intussusception, Volvulus.
Malrotation can kill kids pretty quickly! Where are the structures in Malrotation?
What’s the age distribution for Malrotation?
Colon is on the left and Small Bowel is on the right! Oops! Laxity of bowel which can allow it to twist leading to Midgut Volvulus strangling.
Children under the age of 5 yo.
Can also have duodenal obstruction from Ladd bands.
At what age does ileal telescoping sometimes present in children?
In adults, what is the usual lead point?
6 mos to 2 yo. Lead point (lympathic hypertrophy) is how it starts but 75% idiopathic.
In adults, think cancer - a tumor for a lead point!
Most common disease associations with intussuception are…
Meckel diverticulum. HSP and viral infections can cause enough transient inflammation of Peyer’s Patches to cause telescoping. Polyp also can do it.
What are some buzzwords associated with Intussuception?
Red currant jelly mucus stool from the ischemia. Intermittent pain. Sausage shaped mass from the thickened 8 layers with some mesentery dragged in…instead of the normal 4 layers of the intestine.
How is telescoping diagnosed and why is this also the treatment?
Air enema. Yay! To push it back where it’s supposed to go.
