GI Tract - Part 5 Flashcards
Meckel diverticulum
Incomplete closure of the yolk stalk
What are the clinical findings of Meckel diverticulum? (3)
- Asymptomatic
- Abdominal or pelvic pain
- Rectal bleeding
What is the US appearance of Meckel diverticulum? (3)
- Anechoic or complex mass located slightly to the right of the umbilicus
- Thick wall margins
- Round or oval in shape
What are 3 differential diagnosis of Meckel diverticulum?
- Diverticular abscess
- Appendicitis
- Ovarian pathology
What causes acute appendicitis?
Obstructed appendix
What are the clinical findings for acute appendicitis? (5)
- Periumbilical or RLQ pain
- Fever
- Nausea/vomiting
- Leukocytosis
- McBurney sign
What is the US appearance for acute appendicitis? (6)
- Noncompressible tubular structure generally located in the RLQ
- Diameter of the appendix exceeding 6mm
- Wall thickness exceeding 2mm
- Hypervascular structure
- Rebound pain at McBurney point
- Fecalith or calculus formation
What are 5 differential diagnosis for acute appendicitis?
- Bowel obstruction
- Diverticulum
- Normal cecum
- Ovarian pathology
- Ectopic pregnancy
What is a cause of appendiceal abscess?
Infection
What are the clinical findings for appendiceal abscess? (5)
- Tender palpable 2. RLQ mass
- Spiking fever
- Marked leukocytosis
- McBurney sign
What is the US appearance for appendiceal abscess?
- Poorly defined hypo echoic mass
2. Non-compressible
What are 4 differential diagnosis for appendiceal abscess?
- Diverticular abscess
- Tuboovarian abscess
- Ovarian torsion 4. Ectopic pregnancy
Where is 50% of colon carcinoma located?
Rectum
Where is 25% of colon carcinoma located?
Sigmoid
What are the clinical findings for colon carcinoma? (3)
- Asymptomatic
- Rectal bleeding
- Change in bowel patterns
What is the US appearance for colon carcinoma? (2)
- Hypo echoic thickening of the bowel wall
2. Compressed wall layers
What are 4 differential diagnosis for colon carcinoma?
- Polyp
- Diverticulum
- Abscess
- Crohn disease
What is the cause of the diverticular abscess?
Infection
What are the clinical findings for diverticular abscess? (5)
- Asymptomatic
- Lower abdominal pain
- Fever
- Leukocytosis
- Rectal bleeding
What is the US appearance for diverticular abscess? (3)
- Hypo echoic circular or oval mass adjacent to the colon
- Thickening of the colon wall
- Hypervascular periphery
What are 3 differential diagnosis for diverticular abscess?
- Neoplasm
- Appendicitis
- Lymphadenopathy
What is the most common cause of mucocele?
Inflammatory scarring
What are other causes of mucocele? (3)
- Neoplasm
- Fecalith
- Polyp
What are the clinical findings for mucocele?
- Palpable abdominal mass
2. Abdominal pain
What is the US appearance of mucocele? (4)
- Cystic to hypo echoic intraluminal bowel mass
- Posterior acoustic enhancement
- Irregular inner wall margin
- May demonstrate calcification(s)
What are 4 differential diagnosis for mucocele?
- Cystadenoma
- Ovarian cyst
- Appendiceal abscess
- Diverticulum
What are the causes of volvulus? (2)
- Torsion of a segment of bowel
- emergent surgery - Malrotation
What is the most common cause of volvulus?
Colonic
What are the clinical findings for volvulus? (2)
- Acute abdominal pain
2. Bilious vomiting
What is the US appearance for volvulus? (2)
- Dilated loops of bowel
- SMV wraps around the SMA
- whirlpool sign on colour Doppler at the level of the SMV and SMA
What are 2 differential diagnosis for volvulus?
- Ileus
2. Intussusception
What causes mesenteric ischemia? (3)
- Embolus
- Atherosclerosis
- Prolonged vessel
constriction
What are the clinical findings of mesenteric ischemia? (3)
- Acute abdominal pain
- Postprandial pain
- Weight loss
What is the US appearance of mesenteric ischemia? (3)
- Celiac PSV greater than 200cm/s with post stenotic turbulence
- SMA PSV greater than 280cm/s with post stenotic turbulence
- Gray scale or colour Doppler evidence of celiac, SMA, or IMA stenosis
- a minimum of two mesenteric vessels must demonstrate stenosis
What is a differential diagnosis of mesenteric ischemia?
Tortuous vessels
