GI Emergencies Flashcards
Where is SBP commonly seen?
How is it diagnosed?
End stage liver disease patients (cirrhosis)
Aspiration of fluid - neutrophil >250 cells/mm3
Name 2 non-bacterial causes of secondary peritonitis.
Tubal pregnancy
Ovarian cyst
Give 2 possible lead points that can predispose to intussuscpetion.
Meckel’s diverticulum
Enlarged lymph node
What is the treatment for intussusception?
Air enema and surgery
Why do adhesions form post-operative infection and trauma?
Damage to mesothelium - capillary bleeding - exudation of fibrinogen
Name 5 types of mechanical obstruction.
Adhesion Tumour Intussuseption Hernia Volvulus
Name 2 functional/ psuedoobstruction.
Myopathy / neuropathy
Hirschrprung disease
(Distal end of colon)
Give 3 complications of bowel obstruction
Bowel ischaemia
Perforation
Sepsis
Why does a high fibre diet predispose to volvulus?
Increased sigmoidal loading - elongates the sigmoid which normally has a relatively small mesenteric attachmentment - predisposing to twisting
Give 5 things that can predispose to volvulus.
Pregnancy Constipation Abdominal adhesions Hirschprung diease Pelvic mass High fibre diet
Why is it bad to have a competent ileocaecal valve in the setting of large bowel obstruction?
Colon can not decompress proximally - closed loop obstruction - ischaemia and perforation are more likely. 1
What is the difference in pain presentation between large and small bowel obstruction?
Both are colicky but in small bowel - 3-4 mins large bowel - 10-15 mins
In what group of patients is acute mesenteric ischaemia most common?
Females with a history of peripheral vascular disease
What is the most common cause of acute mesenteric ischaemia?
Acute occlusion (arterial embolism in SMA of cardiac origin)
What is the presentation of pain in acute mesenteric Ischaemia?
Comes on 30 minutes after eating and lasts for 4 hours
