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Abdomen Pathology > GI Tract Pathology Ch 13 > Flashcards

GI Tract Pathology Ch 13 Flashcards

1
Q

Normal intestinal wall has ___ layers and measurements for normal wall is ____ mm

A

5, 3-5mm

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2
Q

gut wall pathology will present as …

A

-target or bull’s eye
-pseudokidney
hypoechoic external rim is the thickened wall
hyperechoic inner portion

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3
Q
  • rare embryologic mistake
  • may arise from pancreas or duodenum
  • more common in females than males
  • usually located on greater curvature
A

duplication cyst

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4
Q

criteria for duplication cyst

A
  • cyst is lined with alimentary tract epithelium
  • cyst has a well-developed muscular wall
  • cyst is contiguous with the stomach
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5
Q

clinical symptoms of duplication cyst

A

-high intestinal obstruction, distension, vomiting, abdominal pain

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6
Q

sonographic appearance of duplication cysts

A
  • enechoic mass
  • thin inner echogenic rim (mucosa)
  • wider outer hypoechoic rim (muscle layer)
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7
Q

gastric bezoars are divided into three categories
________- hair balls in young women \
________- vegetable matter (unripe persimmon)
________- concreation- inorganic matter (sand, asphalt , and shellac)

A

trichobenzoars
phytobezoars
concretions

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8
Q

a small tumor-like growth that projects from a mucous membrane surface
small-asymptomatic and large may induce abdominal pain

A

polyps

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9
Q

out-growth of tissue from the gastric wall

A

gastric polyps

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10
Q

sonographic appearance of polyps

A
  • seen with fluid distention of the stomach and appear as solid masses attached to the gastric wall
  • variable echogenicity
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11
Q
  • most common tumor of the stomach
  • usually small and asymptomatic
  • -seen as a mass similar to carcinoma
A

leiomyomas

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12
Q

sonographic appearance of leiomyomas

A

-hyopechoic and continuous with muscular layer or solid cystic areas that represent necrosis

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13
Q
  • most malignant tumors of the carcinomas (90-95%)
  • 6th leading cause of death
  • occurs more in older males
  • lesions may be ulcerated, diffuse, polypoid, superficial or a combination of these
A

gastric carcinoma

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14
Q

50% of gastric carcinoma occurs in the ______, 25% in the body and fundus of the ______

A

pylorus, stomach

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15
Q

sonographic appearance of gastric carcinoma

A
  • look for the target or psuedokidney sign

- gastric wall thickening

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16
Q
  • may be a primary of the GI tract
    • occurs as a multifocal lesion in the GI tract
  • the stomach will shoe enlarge and thickened mucosal folds, multiple submucosal nodules, ulcerations and a large extraluminal mass
A

lymphoma

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17
Q

clincial symptoms of lymphoma

A

-nausea and vomiting, weight loss

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18
Q

sonographic findings of lymphoma

A

** Large, hypoechoic mass, thickened gastric walls, and a spoke-wheel pattern within the mass**

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19
Q

differential diagnosis of lymphoma

A
  • gastric cancer
  • leiomyosarcoma
  • metastasis
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20
Q

2nd most common malignant tumor leiomyosarcoma gastric sarcoma

A

leiomosarcoma

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21
Q
  • occurs in the 5th and 6th decades of life
  • generally globular or irregular
  • may become huge, outstripping its blood supply, with central necrosis
A

leiomosarcoma

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22
Q

sonographic appearance of leiomosarcoma

A
  • target lesion with variable pattern

- hemorrhage or necrosis may occur causing irregular echoes or a cystic cavity

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23
Q

metastatic disease to stomach is rare and originates from …

A

melanoma, lung or breast cancer

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24
Q

stomach tumor is found in the ________ layer

-forming circumscribed nodules or plaques

A

submucosal

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25
Q

sonographic appearance of stomach tumor

A

-target pattern, circumscribed thickening, uniform widening of wall without layering

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26
Q

characterized by hypertorphy of the circular muscles resulting in elongation of the pylorus and constriction of the canal
-** ther is an increase in the pyloric diameter and length

A

hypertrophic pyloric stenosis

27
Q
  • hereditary

- 4:1 male to female ratio

A

hypertrophic pyloric stenosis

28
Q

clinical findings of hypertrophic pyloric stenosis

A
  • projectile vomiting in a 3-6 week old infant

- palpable “olive-shaped” abdominal mass

29
Q

a process in which a segment of intestine invaginates into the adjoining intestinal lumen (telescoping) causing a bowel obstruction

A

intussusception

30
Q

** most common cause of obstruction in infants and typically occurs

A

intussusception

31
Q

symptoms of intussusception

A

vomiting, abdominal pain, and rectal bleeding

32
Q

a classic sign of a “sausage-shaped” mass in the right hypochondrium is a classic sigh of …

A

intussusception

33
Q

sonographic appearance of intussusception

A

presents as an oval, pseudokidney- appearing mass on transverse-concentric rings of folded bowel is typically seen

34
Q

causes of small bowel obstruction and dilatation

A

-intraluminal (food bolus), bowel wall lesion (tumor, Crohn’s disease) and extrensic (adhesions, hernia)- most common

35
Q

prolonged bowel obstruction may result in …

A

bowel ischemia or necrosis, septicemia, perforations, and peritonitis

36
Q

symptoms of small bowel obstruction…

A

abdominal distension, pain, vomiting, hypotension (fluid depletion), and leukocytosis

37
Q

sonographic appearance of small bowel obstruction

A

tubular (long axis) round (transverse) echo free appearance

38
Q

**ultrasound is used to demonstrate loops of distended bowel, level of obstruction and peristalsis

A

.

39
Q
  • remnant of the apex of cecum
  • orifice opens into cecum
  • McBurney’s Point
    • line extending from iliac spine to umbilicus
A

appendix

40
Q
  • most common cause of an acutely painful abdomen
  • more prevalent in young adults
  • caused by the obstruction of the appendiceal lumen by a fecalith or hyperplasia of the submucosa
  • mucosal secretions increases the intraluminal pressure and comprosise venous and lymphatic drainage
A

acute appendicitis

41
Q

bacterial infections in acute appendicitis leads to gangrene and peroration
-perforation in preschool children up to ___%

A

70

42
Q

in female patients of child-bearing age, RLQ pain may be due to pathology of the appendix or gynecologic structures

A

acute appendicitis

43
Q

symptoms of acute appendicitis

A
  • periumbilical pain
  • leukocytosis
  • nausea, vomiting, and fever
  • RLQ pain with rebound tenderness**
    • McBurney’s point
44
Q

sonographic criteria for diagnosing an inflammatory appendix includes `

A
  • non-compressable appendix
  • > 6mm diameter
  • appendicolith (fecalith)
45
Q

graded compression ultrasound is utilized to displace ______ and decrease the distance between the transducer and the appendix

A

bowel gas

46
Q

color flow ______ cab be observed with an inflamed appendix

A

hyperemia

47
Q
  • lesion in RLQ with a target shaped appearance in trans view
  • non compressibility
  • calculus may be detected
    • appendicolith -sufficient to establish diagnosis
A

acute appendicitis

48
Q

in acute appendicitis, the appendix is greater than ____ mm in diameter
-normal can measure up to _____mm
hypoechoic part of wall greater than _____mm in thickness

A

6, 6, 2

49
Q
  • distension of appendix with mucus

- rare

A

mucocele

50
Q

causes of mucocele

A

-inflammatory scarring (most common), appendiceal polyps, obstructing fecalith, cecal carcinoma, carcinoma of the ascending colon

51
Q

symptoms of mucocele

A
  • RUQ pain, right iliac fossa mass, sepsis, urinary symptoms
  • 25% asymptomatic
  • palpable abdominal mass
  • appendix progressively distends
52
Q
  • RLQ well-defined predominately cystic or hyopechoic mass
  • may contain echogenic solid area with focal distal acoustic shadowing from fecalith
  • variable echogenicity
  • irregular wall
A

mucocele

53
Q
  • located aprox. 2 feet from the ileoceccal valve
  • affects 2% of the population
  • adults may have intestinal obstruction, rectal bleeding, or diverticular inflammation
  • cannot clinically distinguish between acute appendicitis
A

Meckel’s diverticulum

54
Q
  • chronin inflammatory disorder of the GI tract of unclear etiology
  • effects terminal ileum, colon or both at an level
  • reactions involves the entire thickness of the bowel wall
  • patient presents with diarrehea, fever and RLQ pain
A

Crohn’s disease

55
Q
  • symmetrically swollen bowel
  • target lesions
  • uniformly increased wall thickness
  • matted-loop pattern found in late stages
  • rigidity to pressure
  • peristalsis is absent or sluggish
A

Crohn’s disease

56
Q
  • usually occurs late in life-near 6th decade
  • most common tumor of GI in children younger than 10
  • frequently involve the mesenteric vessels that encase them
A

lymphoma

57
Q

intestinal blood loss, weight loss, anorexia, abdominal pain, and palpable mass

A

lymphoma

58
Q
  • large discrete mass with a target pattern

- mesenteric nodal involvement

A

lymphoma

59
Q

10% of primary small bowel tumors

usually in 5th and 6th decade of life

A

leiomyoscaroma

60
Q

leiomyosarcoma
_____% occur in the duodenum
_____% occur in the jejunum
_____% occur in the ileum

A

10-30
30-45
35-55

61
Q

-abdominal pain, palpable mass

  • large, solid mass
  • contained in necrotic areas
A

leiomyosarcoma

62
Q
  • inflammation of diverticulum (colon outpouchings)
  • pouch-like herniation through the muscular wall of a tubular organ that occurs in the stomach, the small intestine, or the colon
  • most commonly involves the sigmoid colon
A

diverticulitits

63
Q
  • fever
  • leukocytosis
  • left lower quadrant pain
A

diverticulitis

64
Q
  • thickening of the bowel wall greater than 4mm
  • abscess formation
  • inflamed diverticula (round echogenic structures)
A

diverticulitis

Abdomen Pathology (9 decks)

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