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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
sonographic appearance of stomach tumor
-target pattern, circumscribed thickening, uniform widening of wall without layering
26
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
hypertrophic pyloric stenosis
27
- hereditary | - 4:1 male to female ratio
hypertrophic pyloric stenosis
28
clinical findings of hypertrophic pyloric stenosis
- projectile vomiting in a 3-6 week old infant | - palpable "olive-shaped" abdominal mass
29
a process in which a segment of intestine invaginates into the adjoining intestinal lumen (telescoping) causing a bowel obstruction
intussusception
30
** most common cause of obstruction in infants and typically occurs
intussusception
31
symptoms of intussusception
vomiting, abdominal pain, and rectal bleeding
32
a classic sign of a "sausage-shaped" mass in the right hypochondrium is a classic sigh of ...
intussusception
33
sonographic appearance of intussusception
presents as an oval, pseudokidney- appearing mass on transverse-concentric rings of folded bowel is typically seen
34
causes of small bowel obstruction and dilatation
-intraluminal (food bolus), bowel wall lesion (tumor, Crohn's disease) and extrensic (adhesions, hernia)- most common
35
prolonged bowel obstruction may result in ...
bowel ischemia or necrosis, septicemia, perforations, and peritonitis
36
symptoms of small bowel obstruction...
abdominal distension, pain, vomiting, hypotension (fluid depletion), and leukocytosis
37
sonographic appearance of small bowel obstruction
tubular (long axis) round (transverse) echo free appearance
38
**ultrasound is used to demonstrate loops of distended bowel, level of obstruction and peristalsis
.
39
- remnant of the apex of cecum - orifice opens into cecum - McBurney's Point - line extending from iliac spine to umbilicus
appendix
40
- 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
acute appendicitis
41
bacterial infections in acute appendicitis leads to gangrene and peroration -perforation in preschool children up to ___%
70
42
in female patients of child-bearing age, RLQ pain may be due to pathology of the appendix or gynecologic structures
acute appendicitis
43
symptoms of acute appendicitis
- periumbilical pain - leukocytosis - nausea, vomiting, and fever - RLQ pain with rebound tenderness** - McBurney's point
44
sonographic criteria for diagnosing an inflammatory appendix includes `
- non-compressable appendix - >6mm diameter - appendicolith (fecalith)
45
graded compression ultrasound is utilized to displace ______ and decrease the distance between the transducer and the appendix
bowel gas
46
color flow ______ cab be observed with an inflamed appendix
hyperemia
47
- lesion in RLQ with a target shaped appearance in trans view - non compressibility - calculus may be detected - appendicolith -sufficient to establish diagnosis
acute appendicitis
48
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
6, 6, 2
49
- distension of appendix with mucus | - rare
mucocele
50
causes of mucocele
-inflammatory scarring (most common), appendiceal polyps, obstructing fecalith, cecal carcinoma, carcinoma of the ascending colon
51
symptoms of mucocele
- RUQ pain, right iliac fossa mass, sepsis, urinary symptoms - 25% asymptomatic - palpable abdominal mass - appendix progressively distends
52
- RLQ well-defined predominately cystic or hyopechoic mass - may contain echogenic solid area with focal distal acoustic shadowing from fecalith - variable echogenicity - irregular wall
mucocele
53
- 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
Meckel's diverticulum
54
- 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
Crohn's disease
55
- symmetrically swollen bowel - target lesions - uniformly increased wall thickness - matted-loop pattern found in late stages - rigidity to pressure - peristalsis is absent or sluggish
Crohn's disease
56
- 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
lymphoma
57
intestinal blood loss, weight loss, anorexia, abdominal pain, and palpable mass
lymphoma
58
- large discrete mass with a target pattern | - mesenteric nodal involvement
lymphoma
59
10% of primary small bowel tumors | usually in 5th and 6th decade of life
leiomyoscaroma
60
leiomyosarcoma _____% occur in the duodenum _____% occur in the jejunum _____% occur in the ileum
10-30 30-45 35-55
61
-abdominal pain, palpable mass - large, solid mass - contained in necrotic areas
leiomyosarcoma
62
- 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
diverticulitits
63
- fever - leukocytosis - left lower quadrant pain
diverticulitis
64
- thickening of the bowel wall greater than 4mm - abscess formation - inflamed diverticula (round echogenic structures)
diverticulitis

Abdomen Pathology (9 decks)

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