GI2 Flashcards
Crohn’s Disease
Chronic inflammatory disorder of unknown cause
Where is crohn’s usually located
terminal ileum of small bowel/proximal portion of colon
Which layers of the GI tract does crohn’s affect
All of the layers
What can diffuse inflammation from crohn’s cause in the bowel loops
It can cause the bowel loops to fuse together
How will crohn’s appear radiographically
Irregular thickened and distorted mucosal folds
STRING SIGN
Skip lesions
Small bowel obstruction
Blockage of the small intestine
What can be the cause of a small bowel obstruction
Adhesions from previous surgeries, peritonitis, hernias, intussusception, volvulus, tumors, or vascular insufficiency
What may be produced due to small bowel obstruction
Ischemia, necrosis of bowel segment, sepsis and peritonitis
Adynamic (Paralytic) Ileus
When the bowel contents do not progress normally through a non-obstructed bowel…peristalsis is not working
What is the treatment for adynamic paralytic ileus
NG tube, IV fluids
Localized Ileus
Isolated distended loop (sentinel loop)
Colonic Ileus
Excessive gasseous distention of bowel
Intussusception
Telescoping of one part of the intestinal tract into another due to peristalsis
What is the most common site of intussusception in children
ileocecal valve
What is the most concerning effect of intussusception
Compromised vascular supply which can lead to ischemic necrosis of the bowel
What is a major cause of bowel obstruction in children
Intussusception
How will intussusception appear in images
coiled string appeaance with a contrast enema… three concentric circles on a soft tissue mass in CT/ Donut shaped lesion in Ultrasound
Hemangioma
Benign Vascular tumor
Where are GI Hemangiomas usually found
Most often in small bowel, then large, but can occur anywhere
What may happen if a patient has a hemangioma
bleeding
Inguinal Hernia
Some abdominal contents (usually small bowel) protrude through weak area in abdominal wall… at inguinal canals (by groin)
What may happen to a patient with an inguinal hernia
constriction or ischemia of the protruding part
Diverticulum/Divertisulosis
Out-pouching of mucosa and submucosa through muscular layers where the abdominal wall is weak
What may lead to development of Diverticulum
Lack of fibre and water in the digestive tract
Diverticulosis
Many diverticula
What does diverticulum/osis look like on images
Round or oval outpouchings from bowel… sawtooth configuration
Diverticulitis
Complication of diverticular disease/diverticulosis…usually in sigmoid region
What may happen if fecal matter is trapped in a diverticulum
it can lead to inflammation and perforation
How may diverticulitis appear on an image
Outpouching beyond lumen, contrast leaking from the diverticula, abscess of a soft tissue mass, sawtooth configuration, narrowing and rigidity of the long section of the colon with a gradual transition back to normal
What are benign neoplasms that project into the lumen of the bowel
Polyps
Are all polyps cancerous
no, some may even be asymptomatic
What is a sessile polyp
a flat polyp; it may have an irregular or lobulated surface and lie flat against colon wall
When is a sessile polyp indicative of cancer
if it is over 2cm in diameter, causes puckering/indentation/retraction at the site, or if it grows more over various exams
What is a pedunculated polyp
a polyp with a stalk
Are pedunculated polyps more likely to be benign or malignant
benign
Ulcerative colitis
Inflammatory bowel disease that often begins in rectosigmoid area…can become cancerous
What does ulcerative colitis look like on an image
large nodular protrusions, mucosal thickening/thumbprint sign
lead pipe appearance from loss of haustral markings
Toxic megacolon is a complication of what
Ulcerative colitis
What is toxic megacolon
Extreme dilation of part or all the large colon
What can toxic megacolon lead to
spontaneous bowel perforation
What does toxic megacolon look like on an image
Huge air filled colon
Colorectal cancer
Cancer of colon and rectum
What is the peak age for colorectal cancer
50-70yrs
Annular Colorectal Carcinoma
Annular lesions surrounding the bowel from the outside
What is the most common type of bowel cancer
Annular colorectal carcinoma
How does Annular colorectal carcinoma start radiographically
from flat plaques of tumors/saddle lesions…they are easily missed on exams
How does annular colorectal carcinoma appear in an image
BE will show apple-core or napkin ring effect
What is the new gold standard for large bowel imaging
CT virtual colonoscopy
Large bowel obstruction
Blockage of large bowel
What are some causes of large bowel obstruction
diverticulitis or volvulus
Which is more severe: Small bowel obstruction or Large bowel obstruction?
Small bowel obstruction
Volvulus
twisting of the bowel on itself that may lead to abdominal obstruction
Malrotation of bowel/colon
Twisting of bowels… like volvulus but occurs in fetal development
What are some symptoms of malrotation of the bowel/colon
abdominal distention, pain, vomiting(bilious), constipation, bloody stools
Anal atresia
Imperforate anus/ congenital lack of anal opening
How may anal atresia appear on an image
Multiple dilated bowel loops filled with gas….absence of rectal gas
