GI3 Flashcards
Cholelithiasis
Gallstones
What are radiolucent stones made of
cholesterol
what are radioopaque stones made of
calcium
Acute Cholecystitis
Inflammation of the gallbladder
When does cholecystitis usually occur
after an impacted gallstone obstructs the cystic duct
Emphysematous cholecystitis
when gallstones injure mucosal wall and bacteria enters… creating an acute infection of gallbladder wall by gas forming organisms
Does emphysematous cholecystitis require surgery
yes it is a surgical emergency
Choledocholithiasis
Presence of at least one gallstone within common bile duct
Cholangitis
Inflammation of entire bile duct system
List in order of most to least severe:
Cholecystitis
Cholangitis
Cholelithiasis
Choledocolthiasis
Least
1)Cholelithiasis
2)Cholecystitis
3)Choledocholithiasis
4)Cholangitis
Most
Hepatitis
Inflammation of the liver
What is hepatitis usually from
viral infection
What types of hepatitis is from fecal-oral route
Hep A (HAV) and Hep E (HEV)
What type of hepatitis is contracted from exposure to contaminated blood or sexual contact
Hep B (HBV)
What type of hepatitis is the common cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Contracted via blood transfusion or through sexual contact
Hep C (HCV)
Is early hepatitis seen on imaging
no
What may an enlarged liver be indicative of on images
advancing hepatitis
What complications of Hepatitis show up on imaging
Cirrhosis and hepatocellular carcinoma/liver cancer show up on US, CT, MRI
What condition is Cirrhosis indicative of
End stage liver disease
What is a major cause of liver cirrhosis
Chronic alcoholism (10-20yrs+)
OR viral hepatitis
What type of tissue will cirrhosis have
Scar tissue
What causes edema of lower limbs when in conjunction with cirrhosis
Decreased albumin production which causes fluid to leak out of circulation
What condition can cirrhosis cause dues to increased venous pressure
Ascites
Portal vein obstruction in cirrhosis can lead to what
Collateral circulation
What common indication of cirrhosis is from destruction of liver cells and blockage of bile ducts
Jaundice
How may cirrhosis appear radiographically
Fatty liver, portal veins may stand out more, enlarged spleen
Ascites
Accumulation of fluid in peritoneal cavity
Along abdominal distention, what other symptoms may ascites produce
Tight hard abdomen
What may you need to change about technical factors in a patient with ascites
Increase technical factors to penetrate through the fluid
How may ascites look on images
Haziness/graying, fluid will pool as gravity moves, “dog ear” on supine images as fluid collects on both sides of bladder
Hepatocellular carcinoma
Liver cancer
How does hepatocellular carcinoma appear on images
Large mass on CT, with contrast it may be dense or diffuse enhancment (usually non uniform)
Hemangioma
Benign Vascular tumor
Are Liver Hemangiomas usually symptomatic
no
What makes a liver hemangioma “giant”
being 10cm or greater in size
What can Liver hemangiomas cause symptomatically
Edema and jaundice
How may liver hemangiomas appear on images
As hypodense lesions on unenhanced images, may also have persistent enhancement on delayed phase
Pancreatitis
Inflammation of the pancreas
What makes it ACUTE pancreatitis
When enzymes within the pancreas begin to digest the organ itself
What is a common resultant of chronic pancreatitis to the tissue
Scar tissue
In chronic pancreatitis what is the consequence to its enzymes
It cannot produce the digestive enzymes insulin and glucagon
What may appear on an image of acute pancreatitis
Sentinel loop of bowel from an adynamic ileus…but mostly non specific on plain xray
ON CT may have enlarged pancreas and obscured peripancreatic soft tissue
What may appear on an image of acute pancreatitis
Calcification of the pancreas
What is the most common type of pancreatic carcinoma
adenocarcinoma (or cancer that starts in the glands)
How may the pancreas’ shape alter when there is cancer
the head may enlarge, the bile duct may be blocked, and there may be jaundice
What is the most effective modality to diagnose pancreatic carcinoma
CT
What will a BE study show for pancreatic carcinoma
Distortion of mucosal pattern and duodenal configuration
What type of disorder is diabetes mellitus
an endocrine disorder
What is diabetes mellitus
When the pancreas fails to secrete insulin/when target cells fail to respond to the hormone
What can diabetes mellitus lead to
hyperglycemia since the glucose is staying in the blood. Also acidosis and dehydration
Symptoms of diabetes mellitus
polyuria, polydipsia, glycosuria
What can diabetes mellitus lead to (think about the feet)
Peripheral vessel calcification, severe osteomyelitis, neuropathic joints, gas gangrene, ischemic gangrene
Hypoglycemia
Low blood sugar
Symptoms of hypoglycemia
lightheaded/faint, shaky, sweaty
Should you give insulin to someone with hypoglycemia?
No, give them sugar
Pneumoperitoneum
Free air in the peritoneal cavity
What is often the cause of pneumoperitoneum
A perforation of the GI tract (like from a peptic ulcer)
Does pneumoperitoneum resolve on its own?
No, it is a surgical emergency
Can you image pneumoperitoneum in a supine position
No, upright or decubitus is needed
How long do you let a patient sit when evaluating for pneumoperitoneum
10min (though in practice often only 5)
How may air appear radiographically in pneumoperitoneum
air under diaphragm may appear as a sickle shaped lucency
