GI Tract - Part 5 Flashcards

1
Q

Meckel diverticulum

A

Incomplete closure of the yolk stalk

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2
Q

What are the clinical findings of Meckel diverticulum? (3)

A
  1. Asymptomatic
  2. Abdominal or pelvic pain
  3. Rectal bleeding
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3
Q

What is the US appearance of Meckel diverticulum? (3)

A
  1. Anechoic or complex mass located slightly to the right of the umbilicus
  2. Thick wall margins
  3. Round or oval in shape
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4
Q

What are 3 differential diagnosis of Meckel diverticulum?

A
  1. Diverticular abscess
  2. Appendicitis
  3. Ovarian pathology
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5
Q

What causes acute appendicitis?

A

Obstructed appendix

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6
Q

What are the clinical findings for acute appendicitis? (5)

A
  1. Periumbilical or RLQ pain
  2. Fever
  3. Nausea/vomiting
  4. Leukocytosis
  5. McBurney sign
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7
Q

What is the US appearance for acute appendicitis? (6)

A
  1. Noncompressible tubular structure generally located in the RLQ
  2. Diameter of the appendix exceeding 6mm
  3. Wall thickness exceeding 2mm
  4. Hypervascular structure
  5. Rebound pain at McBurney point
  6. Fecalith or calculus formation
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8
Q

What are 5 differential diagnosis for acute appendicitis?

A
  1. Bowel obstruction
  2. Diverticulum
  3. Normal cecum
  4. Ovarian pathology
  5. Ectopic pregnancy
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9
Q

What is a cause of appendiceal abscess?

A

Infection

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10
Q

What are the clinical findings for appendiceal abscess? (5)

A
  1. Tender palpable 2. RLQ mass
  2. Spiking fever
  3. Marked leukocytosis
  4. McBurney sign
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11
Q

What is the US appearance for appendiceal abscess?

A
  1. Poorly defined hypo echoic mass

2. Non-compressible

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12
Q

What are 4 differential diagnosis for appendiceal abscess?

A
  1. Diverticular abscess
  2. Tuboovarian abscess
  3. Ovarian torsion 4. Ectopic pregnancy
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13
Q

Where is 50% of colon carcinoma located?

A

Rectum

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14
Q

Where is 25% of colon carcinoma located?

A

Sigmoid

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15
Q

What are the clinical findings for colon carcinoma? (3)

A
  1. Asymptomatic
  2. Rectal bleeding
  3. Change in bowel patterns
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16
Q

What is the US appearance for colon carcinoma? (2)

A
  1. Hypo echoic thickening of the bowel wall

2. Compressed wall layers

17
Q

What are 4 differential diagnosis for colon carcinoma?

A
  1. Polyp
  2. Diverticulum
  3. Abscess
  4. Crohn disease
18
Q

What is the cause of the diverticular abscess?

A

Infection

19
Q

What are the clinical findings for diverticular abscess? (5)

A
  1. Asymptomatic
  2. Lower abdominal pain
  3. Fever
  4. Leukocytosis
  5. Rectal bleeding
20
Q

What is the US appearance for diverticular abscess? (3)

A
  1. Hypo echoic circular or oval mass adjacent to the colon
  2. Thickening of the colon wall
  3. Hypervascular periphery
21
Q

What are 3 differential diagnosis for diverticular abscess?

A
  1. Neoplasm
  2. Appendicitis
  3. Lymphadenopathy
22
Q

What is the most common cause of mucocele?

A

Inflammatory scarring

23
Q

What are other causes of mucocele? (3)

A
  1. Neoplasm
  2. Fecalith
  3. Polyp
24
Q

What are the clinical findings for mucocele?

A
  1. Palpable abdominal mass

2. Abdominal pain

25
Q

What is the US appearance of mucocele? (4)

A
  1. Cystic to hypo echoic intraluminal bowel mass
  2. Posterior acoustic enhancement
  3. Irregular inner wall margin
  4. May demonstrate calcification(s)
26
Q

What are 4 differential diagnosis for mucocele?

A
  1. Cystadenoma
  2. Ovarian cyst
  3. Appendiceal abscess
  4. Diverticulum
27
Q

What are the causes of volvulus? (2)

A
  1. Torsion of a segment of bowel
    - emergent surgery
  2. Malrotation
28
Q

What is the most common cause of volvulus?

A

Colonic

29
Q

What are the clinical findings for volvulus? (2)

A
  1. Acute abdominal pain

2. Bilious vomiting

30
Q

What is the US appearance for volvulus? (2)

A
  1. Dilated loops of bowel
  2. SMV wraps around the SMA
    - whirlpool sign on colour Doppler at the level of the SMV and SMA
31
Q

What are 2 differential diagnosis for volvulus?

A
  1. Ileus

2. Intussusception

32
Q

What causes mesenteric ischemia? (3)

A
  1. Embolus
  2. Atherosclerosis
  3. Prolonged vessel
    constriction
33
Q

What are the clinical findings of mesenteric ischemia? (3)

A
  1. Acute abdominal pain
  2. Postprandial pain
  3. Weight loss
34
Q

What is the US appearance of mesenteric ischemia? (3)

A
  1. Celiac PSV greater than 200cm/s with post stenotic turbulence
  2. SMA PSV greater than 280cm/s with post stenotic turbulence
  3. Gray scale or colour Doppler evidence of celiac, SMA, or IMA stenosis
    - a minimum of two mesenteric vessels must demonstrate stenosis
35
Q

What is a differential diagnosis of mesenteric ischemia?

A

Tortuous vessels