GI Mod 3B Flashcards
two forms of pyloric obstruction
- infantile hypertrophic pyloric stenosis
2. adult/acquired pyloric obstruction
what is IHPS
infantile hypertrophic pyloric stenosis: aka congenital pyloric stenosis
s/s of IHPS
infant at 2-3 weeks begins to vomit for no apparent reason
projectile vomiting - several feet
frequency of IHPS
infant disorder - 3/1000 births
pathophys of IHPS
pyloric sphincter is hypertrophied
etiology of IHPS
not fully established
hormones to allergic rxns have been suggested as potential cause
treatment of IHPS
surgery - pyloromyotomy
adult/acquired pyloric obstruction
- cause
- s/s
- tx
caused by severe peptic ulcer or tumor in area
vague s/s of epigastric discomfort/fullness with eating that progresses to severe epigastric discomfort
gastric distention, nausea, progress to vomit and acute distress as obstruction develops over time
-tx: address cause of obstruction
types of mechanical obstructions
- adhesions
- herniation
- intussusception
- vulvulus (torsion)
- tumor growth
what are adhesions
fibrous scar tissue adheres to intestinal loops
common complication of abdominal surgeries
what are herniations
intestine protrudes thru abdominal wall
intestine may strangulate thru the opening…inguinal ring, umbilical hernia, hiatal hernia
what is intussusception
telescoping of one part of an intestine on another portion
more common in ileocecal area
what is volvulus (torsion)
intestine twists upon itself
the mesentary twists around strangulating the blood supply to the intestine
MC cause of LI obstruction d/t tumors
colon/rectal cancer is MC cause of LI obstruction
what causes functional obstruction in GI
paralytic ileus
what is paralytic ileus
obstruction that results when peristalsis stops
possible causes of ileus
certain drugs (narcotics or HTN drugs) abdominal, spine or joint surgery injury/trauma infections/peritonitis heart attack imbalance of electrolytes disorders that affect muscle function low blood supply to parts of intestine (mesenteric ischemia)
treatment strategies of paralytic ileus
NG tube to decompress pressure within GI tract
address the underlying cause
if unsuccessful - surgery may be considered
Hirschsprung’s dz
aka congenital aganglionic megacolon
- birth defect: ganglion nerve cells of the colon fail to develop
- functional result: impaired motility of colon due to poor coordination/ability to contract intestinal musculature; impacted/trapped stool, infection, inflammation, and constipation
categories/types of Hirschprung’s dz
short - segment - rectosigmoid colon
long - segment - regions proximal to rectosigmoid are also involved
treatment strategies of Hirschsprung’s dz
decompress the colon (serial rectal irrigation) and surgical removal of involved intestinal segment
- mild-mod cases (short seg dz)
- severe cases (enterocolitis)
IBD - what is it
chronic autoimmune inflammatory dz that damages/ulcerates GI tract
two forms of IBD
- Chrohns dz
2. ulcerative colitis
what is Crohn’s dz
Crohn’s dz can affect any part of the GI tract, though it commonly occurs at the terminal end of the ileum of the SI and in the cecum of the LI
- stress may exacerbate s/s but is considered a cause of the dz
- s/s may be mild to severe
