GI TRACT Flashcards

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1
Q

is US modality of choice for GI

A

nope

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2
Q

what probe do we use for GI

A

high freq linear probe (still need to apply pressure to distend bowel

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3
Q

normal thickness of gastric wall

A

2.5-3.5mm

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4
Q

does water change wall thickening

A

no

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5
Q

gastric wall thickening can be caused by (3)

A

Gastritis
Gastric Ulcer
Lymphoid hyperplasia

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6
Q

what is Hypertrophic Pyloric Stenosis

A

Abnormal thickening of the antropyloric region of the stomach

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7
Q

Hypertrophic Pyloric Stenosis mainly affects

A

first-born male infants

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8
Q

clinical presentation of Hypertrophic Pyloric Stenosis (4)

A

Dehydration
Frequent episodes of projectile nonbilious vomiting
Failure to thrive
Thickening palpated as the “olive-shaped” epigastric mass.

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9
Q

Hypertrophic Pyloric Stenosis sono (its a fucking paragraph)

A

We can visualize
pyloric muscle
lack of passage of fluid through pylorus
stomach is often filled with water even with fasting
The trv plane demonstrates the long axis of the pylorus
The sag plan demonstrates the transverse axis of the pylorus
If the pylorus is not visualized, give the child water to display gastric lumen
Thick displaced pylorus is medial to GB.

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10
Q

2 main sign of Hypertrophic Pyloric Stenosis

A

doughnut sign
An anechoic/hypoechoic muscle mass with a central echogenic lumen

string sign (barium)

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11
Q

3 Small Bowel abnormalities

A

Bowel obstruction
Meconim ileus
Midgut malrotation

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12
Q

4 intrinsic causes of bowel obstruction

A

Duodenal Atresia (assoc. w. Trisomy 21)
Duodenal Stenosis
Duodenal Web
Jejunal and ileal atresia

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13
Q

4 extrinsic causes of bowel obstruction

A

Malrotation
Choledochal Cyst
Duodenal duplication cyst
Annular Pancreas

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14
Q

SONO of Bowel obstruction (3)

A

hyperactive, dilated bowel loops
bowel wall thickening in some cases
duoden. & stomach seen as large anechoic structures

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15
Q

what is Meconium ileus

A

Abnormally thick meconium in the distal small bowel

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16
Q

Meconium ileus associated with

A

cystic fibrosis

17
Q

Meconium ileus sono

A

echogenic bowel content
dilated bowel loops
decreased peristalsis

18
Q

2 complications of meconium ileus

A

Peritonitis
Calcifications develop within 12h, notes as echogenic ascites in fetal scan
Pseudocyst
A walled-off collection of meconium often with calcifications
possibly with air (shadows/ring-down artifact).

19
Q

what is Midgut malrotaton

A

Congenital anomaly that results from an abnormal rotation of the gut as it returns to the abdominal cavity during embryogenesis

20
Q

what is midgut malrotaton associated with

A

omphalocele, gastroschisis, duodenal atresia

21
Q

midgut malrotaton (4)

A

Reversed SMA and SMV
SMV directly anterior to SMA
SMA pulled to right, anterior to IVC
SMA right to aorta

22
Q

what sign is seen with midgut malrotaton

A

Whirlpool sign with volvulus, which is malrotation of the midgut volvus

23
Q

what is Intussusception

A

Telescoping of bowel

A segment of bowel prolapses into a more distal segment

24
Q

increase incidence of inssuception

A

child has lead point

25
Q

most common type of intussusception

A

ileocolic

26
Q

intussusception clinical presentation (5)

A
Abdominal pain, intermittent
Currant-jelly (dark red) stool
Palpable abdo mass
Abdo distention
Vomiting
27
Q

intussusception sono appearance (3)

A

Target pattern
Multiple concentric anechoic rings surrounding a dense echogenic center
Doughnut sign
An anechoic ring surrounding echogenic center
Pseudokidney appearance

28
Q

Intussusception complications (4)

A

Bowel obstruction
Perforation
Peritonitis
Vascular compromise which leads to edema of bowel and gangrene

29
Q

Intussusception treatment (2)

A

Enema
(Barium, Other solutions - saline, Air insufflation)
Surgery.