GI TRACT Flashcards
is US modality of choice for GI
nope
what probe do we use for GI
high freq linear probe (still need to apply pressure to distend bowel
normal thickness of gastric wall
2.5-3.5mm
does water change wall thickening
no
gastric wall thickening can be caused by (3)
Gastritis
Gastric Ulcer
Lymphoid hyperplasia
what is Hypertrophic Pyloric Stenosis
Abnormal thickening of the antropyloric region of the stomach
Hypertrophic Pyloric Stenosis mainly affects
first-born male infants
clinical presentation of Hypertrophic Pyloric Stenosis (4)
Dehydration
Frequent episodes of projectile nonbilious vomiting
Failure to thrive
Thickening palpated as the “olive-shaped” epigastric mass.
Hypertrophic Pyloric Stenosis sono (its a fucking paragraph)
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.
2 main sign of Hypertrophic Pyloric Stenosis
doughnut sign
An anechoic/hypoechoic muscle mass with a central echogenic lumen
string sign (barium)
3 Small Bowel abnormalities
Bowel obstruction
Meconim ileus
Midgut malrotation
4 intrinsic causes of bowel obstruction
Duodenal Atresia (assoc. w. Trisomy 21)
Duodenal Stenosis
Duodenal Web
Jejunal and ileal atresia
4 extrinsic causes of bowel obstruction
Malrotation
Choledochal Cyst
Duodenal duplication cyst
Annular Pancreas
SONO of Bowel obstruction (3)
hyperactive, dilated bowel loops
bowel wall thickening in some cases
duoden. & stomach seen as large anechoic structures
what is Meconium ileus
Abnormally thick meconium in the distal small bowel
Meconium ileus associated with
cystic fibrosis
Meconium ileus sono
echogenic bowel content
dilated bowel loops
decreased peristalsis
2 complications of meconium ileus
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).
what is Midgut malrotaton
Congenital anomaly that results from an abnormal rotation of the gut as it returns to the abdominal cavity during embryogenesis
what is midgut malrotaton associated with
omphalocele, gastroschisis, duodenal atresia
midgut malrotaton (4)
Reversed SMA and SMV
SMV directly anterior to SMA
SMA pulled to right, anterior to IVC
SMA right to aorta
what sign is seen with midgut malrotaton
Whirlpool sign with volvulus, which is malrotation of the midgut volvus
what is Intussusception
Telescoping of bowel
A segment of bowel prolapses into a more distal segment
increase incidence of inssuception
child has lead point
most common type of intussusception
ileocolic
intussusception clinical presentation (5)
Abdominal pain, intermittent Currant-jelly (dark red) stool Palpable abdo mass Abdo distention Vomiting
intussusception sono appearance (3)
Target pattern
Multiple concentric anechoic rings surrounding a dense echogenic center
Doughnut sign
An anechoic ring surrounding echogenic center
Pseudokidney appearance
Intussusception complications (4)
Bowel obstruction
Perforation
Peritonitis
Vascular compromise which leads to edema of bowel and gangrene
Intussusception treatment (2)
Enema
(Barium, Other solutions - saline, Air insufflation)
Surgery.
