GI Module 3B Flashcards
What is infantile hypertrophic pyloric stenosis?
- Congenital narrowing of pylorus
- Infant at 2-3 wks begins to vomit for no apparent reason
- Hormones to allergic reactions MAY be a cause
- Tx is pyloromyotomy
What is an adult pyloric obstruction?
- Aka gastric outlet obstruction
- Usually caused by severe peptic ulcer or tumor in area
What are adhesions?
- Mechanical intestinal obstruction
- Fibrous scar tissue adheres to intestinal loops
- Common complication of abdominal surgeries
What is a herniation?
- Mechanical intestinal obstruction
- Intestine protrudes through abdominal wall
What is an intussusception?
- Mechanical intestinal obstruction
- Telescoping of 1 part of an intestine on another portion
- MC in ileocecal area
What is the MC bowel obstruction in infants/young children?
Intussusception
What is a volvulus?
- Mechanical intestinal obstruction
- Intestine twists upon itself (torsion)
- MC in LI in elderly population
What is the MC cause of LI obstructions?
Colon/rectal cancer
What is a paralytic ileus?
- Functional intestinal obstruction
- Obstruction that results when peristalsis stops
What is Hirschsprung’s disease?
- Megacolon
- Birth defect (ganglion cells of colon fail to develop)
- Causes 25% of all infant obstructions
- Impaired motility of colon
What are the types of Hirschsprung’s disease?
- Short Segment (rectosigmoid colon, milder)
- Long Segment (regions proximal to rectosigmoid as well)
What is IBD?
- Chronic inflammatory disease that damages/ulcerates GI tract
- Abnormal response to immune system
- Two forms (Crohn’s, ulcerative colitis)
Crohn’s disease location
- Can affect any part of GI tract
- Though commonly at terminal end of ileum and in cecum of LI
When is the peak onset of Crohn’s? Males or females?
15-25 yo
Females more than males
Pathophys of Crohn’s
- Inflammation extends through all layers of intestinal wall
- Chronic granulomatous inflammation
What are skip lesions?
2 or more inflamed areas in Crohn’s with healthy bowel in between
What is a stricturoplasty?
Surgical tx option for chronic narrowing of intestinal lumen
What is ulcerative colitis?
- Chronic inflammatory disease that affects LI
- Inflammation extends to mucosa ONLY
- Always involves rectum
What are the different regional patterns of LI in ulcerative colitis?
- Ulcerative proctitis (distal 12 cm of colon)
- Proctosigmoiditis (rectum to splenic flexure)
- Pancolitis (rectum to cecum, “everything”)
What is a total colectomy and ileorectal anastamosis?
- Colon is removed except last 5 inches of rectum
- SI is then surgically joined to upper rectum
What is a colectomy with ileoanal pouch?
- Aka restorative proctocolectomy
- Colon and rectum removed
- “New rectum” is made from SI and attached to anal canal
- Sometimes an ileostomy is created and then closed later on
What is an ileostomy (or stoma)?
- Temporary opening in abdomen
- After operation has healed, it is closed to restore normal bowel function
What is a proctocolectomy and ileostomy?
- Both colon and rectum removed
- Permanent ileostomy
- Recommended for pts with rectal cancer or who cannot have other operations
Is obstruction MC in Crohn’s or ulcerative colitis?
Crohn’s
Are abscesses and fistulas MC in Crohn’s or ulcerative colitis?
Crohn’s
Are bloody stools MC in Crohn’s or ulcerative colitis?
Ulcerative colitis
What is diverticulosis?
- Weakening of intestinal wall
- Out pockets created
- 85% pts are asymp
Where are diverticuli MC found?
Sigmoid colon
How to treat diverticulosis?
- High fiber diet
- Avoid high residue foods (seeds, corn, nuts)
What is diverticulitis?
- Inflammation of colonic diverticula
- Impacted w/fecal material
- Perforations d/t inflammation
What is simple diverticulitis?
Inflammation is contained in intestinal wall
What is complicated diverticulitis?
Inflammation penetrates into peritoneal space
How do most colorectal cancers develop?
From adenomatous (glandular) polyp
What is the screening tool for colorectal cancer?
Colonoscopy
Which is more thorough - colonoscopy or sigmoidoscopy?
Colonoscopy
What is hepatitis and what is its pathology?
- Inflammation of the liver
- Virus or agent
- Kupffer cell hyperplasia
What is fulminating hepatitis?
- Rare complication of hepatitis
- Massive hepatic cell death and liver failure
What is cirrhosis?
- Irreversible inflammatory condition of liver
- Hepatic cell death causes diffuse scarring of liver
What is the pathology of cirrhosis?
- Dependent on cause
- Hepatic tissue becomes nodular and fibrotic
- Liver may expand or shrink in size
What is alcoholic cirrhosis?
- Enlarged liver
- Initially fatty accumulation in hepatocytes (reversible)
How does the chronic metabolism of alcohol cause cirrhosis?
- Produces acetaldehyde which disrupts hepatocyte function/metabolism
- Inflammatory response and necrosis
- Fibrotic accumulation/scarring
Define fatty liver, fibrosis, and cirrhosis in terms of reversibility
Fatty liver = reversible
Fibrosis = reversible w/scarring
Cirrhosis = irreversible
What is primary biliary cirrhosis?
- Autoimmune disease
- Attacks small intrahepatic bile ducts
What is secondary biliary cirrhosis?
- Chronic obstruction of biliary flow
- Leads to fibrotic changes
