GI Tract - Part 3 Flashcards
What should the stomach not exceed in thickness when distended?
5mm
What should normal bowel not exceed in thickness?
4mm
What should a normal appendix not exceed in wall thickness and in diameter?
Wall thickness = 2mm
Diamater = 6mm
What normally happens to the small intestines from the pylorus to the ileocecal valve?
It decreases in size
What is the US appearance of the wall of the GI tract?
Alternating hyper echoic and hypo echoic circular echo patterns
- mucosal layer appears hyper echoic
What does the gastroesophageal junction look like on US?
Target structure lying posterior to the liver and slightly to the left of midline
What is the US appearance of the stomach when empty?
Target structure
What is the US appearance of the stomach when distended with fluid?
Anechoic structure with swirling hyper echoic echoes
What are small intestines usually filled with?
Gas
What are the small folds in the wall of the jejunum and ileum termed as?
Keyboard sign
How are the ascending and transverse colon identified by?
Haustral wall markings
What does the descedning colon appear as on US?
A tubular structure with echogenic wall margins
Where should peristalsis be observed? (3)
- Stomach
- Small intestines
- Large intestines
How is the rectum best evaluated?
With an endorectal transducer
What is impossible to perceive in the normal bowel wall?
Vascularity
What is helping when evaluating for a pyloric stenosis in the stomach?
Fluid
What are indications for a GI tract exam? (8)
- Abdominal or RLQ pain
- Leukocytosis
- Vomiting
- Weight loss
- Fever
- Abdominal mass
- Diarrhea
- Absence of bowel sounds
What is the main cause of stomach carcinoma?
Adenocarcinoma
- 80% of cases
Is stomach carcinoma more common in males or females?
Male
What are the clinical findings for stomach carcinoma? (6)
- Upper abdominal discomfort
- Nausea/vomiting 3. Decrease in appetite
- Fatigue
- Weight loss
- Abdominal mass
What is the US appearance for stomach carcinoma? (4)
- Target tumour of the stomach
- Hypervascular mass
- Gastric wall thickening
- LUQ mass
What are 4 differential diagnosis for stomach carcinoma?
- Polyp
- Ulcer
- Lymphoma
- Metastases
What are the causes for gastric dilatation? (8)
- Gastric obstruction
- Gastroparesis
- Duodenal ulcer
- Inflammation
- Pylorospasm
- Neurological disease
- Neoplasm
- Medication
What are the clinical findings for gastric dilatation? (3)
- Abdominal pain
2. Nausea/vomiting 3. Bloating
What is the US appearance for gastric dilatation? (4)
- Fluid-filled mass in the LUQ
- Swirling hyper echoic interluminal echoes
- Decrease or lack of forward peristalsis of stomach contents
- Thin gastric wall margins
What are the 4 differential diagnosis for gastric dilatation?
- Omental cyst
- Renal cyst
- Liver cyst
- Pancreatic pseudocyst
What is the main cause of gastric ulcer?
Bacterial infection
- 75%
What are other causes of gastric ulcers? (2)
- Stress
2. Malignant neoplasm
What are the clinical findings of gastric ulcers? (5)
- Epigastric pain
- Postprandial pain 3. Bloating
- Nausea
- Heartburn
What is the US appearance of gastric ulcers? (2)
- Thick gastric wall margins
2. Hypervascular gastric wall
Where are gastric ulcers most commonly located?
In the lesser curvature of the stomach
What are 2 differential diagnosis for gastric ulcers?
- Gastritis
2. Neoplasm
What are the causes of gastritis? (5)
- Bacterial infection 2. Bile reflux
- Smoking
- Excessive alcohol
consumption - Radiation
What are the clinical findings of gastritis? (6)
- Upper abdominal discomfort
- Decrease in appetite
- Belching
- Nausea/vomiting 5. Fatigue
- Fever
What is the US appearance of gastritis? (2)
- Diffuse or localized thickening in the gastric wall
2. Enlarged and prominent rugae
What are 2 differential diagnosis of gastritis?
- Gastric ulcer
2. Neoplasm
