GI pathology II Flashcards
what is peritonitis?
Inflammation of the peritoneum
what is the peritoneum?
a Thin layer of cells that covers the external surface of all abdominal and pelvic organs
In peritonitis what normally causes the damage to the peritoneum?
Bacterial Infection
what are typical clinical features of peritonitis?
- tachycardia
- pyrexia
- constant abdominal pain
- abdo tenderness and guarding
- rebound tenderness
- localised pain during distant palpitation
- abscent bowel sound
what investigations can be done for peritonitis?
- clinical history
- FBC
- serum amylase (will show if pancreatitis is a problem)
- X RAY
- CT
what are basic management principles for peritonitis?
- IV fluid
- antibiotic therapy
- gastric aspiration
what are the two types of intestinal obstruction?
- mechanical
2. paralytic
what is mechanical obstruction?
The luminal contents can’t pass through the intestine due to a physical blockage
what is paralytic obstruction of the intestine?
The luminal contents can’t pass due to cessatation of normal gut peristalsis
what is simple obstruction of the intestine?
obstruction refers to bowel obstruction without compromise to the blood supply of the affected segment
what is a strangulating obstruction of the bowel?
bowel obstruction with compromise to the blood supply
what is open loop obstruction?
The intestinal flow is blocked but proximal decompression is possible through vomiting.
what is a closed loop obstruction?
Both inflow and outflow are obstructed causing a build up of gas and secretion in the affected part
what are examples of closed loop obstruction?
- torsion of a loop of s.intestine around an adhesion
- incarceration of bowel in a hernia
- volvulus
what are common causes of small bowel obstruction?
- adhesions
- hernia
- intussusception
- volvulus
- crohns
what re common causes of large bowel obstruction?
- colorectal cancer
- diverticular strictures
- sigmoid volvulus
what is an adhesion?
A band of fibrous tissue that binds together normally separate anatomical structures
what is the first two common causes of bowel obstruction in the uk?
- adhesions
2. abdominal hernia
what is intussusception?
a segment of small bowel prolapses into the immediately adjoining bowel.
what is a volvulus?
An abnormal twisting of a segment of bowel around it’s site of mesenteric attachment.
what are precipitating factors for a volvulus?
- an abnormally mobile loop of intestine
- ## an abnormally loaded loop
where is the most common site for volvulus to form?
Sigmoid colon
what is the most common type of bowel cancer?
Adenocarcinoma
what are common causes of bowel obstruction in neonates?
- congenital stenosis
- volvulus
- hirschsprungs disease
- meconium ileus