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GIT cours Flashcards

1
Q

what are the pathologies that can affect the esophagus?

A

-tumors: benign, cancer
-Esoghagitis: peptic, caustic
-Megaesophagus
-Esophageal deverticula

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2
Q

EXPLORATION TECHNIQUES FOR THE
ESOPHAGUS?

A

-Endoscopy+++: we can’t in case of stenosis
-contrast Xray: internal visualisation wa can’t see the environment
-Sonography and endoscopic ultrasound
-Computed tomography
-*Other: MRI, PHmetry, manometry, scintigraphy

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3
Q

type of esophageal cancer:

A
  • squamous cell carcinoma
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4
Q

Patient profile of esophageal cancer?

A
  • Male, alcohol and tobacco consumption
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5
Q

Clinical presentation of esophageal cancer?

A
  • dysphagia, retrosternal pain
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6
Q

diagnosis of esophageal cancer?

A
  • Endoscopy
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7
Q

technics for staging of esophageal cancer?

A
  • ct scan +++
  • endoscopic ultrasound (EUS),
    bronchoscopic examination.
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8
Q

what are the things that we look for in the staging of esophageal cancer in the thoracic area?

A
  • Extension to the tracheobronchial axis
  • Extension to the aorta
  • Mediastinal lymphadenopathy
  • Pulmonary metastases
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9
Q

what are the things that we look for in the staging of esophageal cancer in the abdominal area?

A
  • Involvement of the cardia
  • Coeliac lymphadenopathy
  • Hepatic metastases
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10
Q

what are the two types of esophageal benign tumors?

A
  • Intra-luminal tumors
  • Intra-mural tumors= the esophagus wall
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11
Q

intramural tumors of esophagus examples

A
  • Léiomyomas= smooth muscle tumor
  • schwannomas
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12
Q

the characteristics of intramural tumors?

A
  • Preserved mucosal relief
  • Mimic extrinsic compression
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13
Q

intraluminal tumors of esophagus examples?

A
  • Polyp
  • angiomyolipoma= hamartoma made up of blood vessels, muscle cells and fat cells.
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14
Q

the characteristics of intraluminal tumors?

A
  • rare
  • benign in nature
  • sessile or pedunculated
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15
Q

the cause of peptic esophagitis?

A

gastroesophageal reflux

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16
Q

clinical presentation of peptic esophagitis?

A
  • Heartburn/pyrosis
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17
Q

diagnosis of peptic esophagitis?

A
  • Endoscopy
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18
Q

Imaging characteristics of peptic esophagitis?

A
  • Circumferential, centrally located stenosis
    in the lower 1/3 of the esophagus.
  • Symmetrical with smooth margins.
  • short in length
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19
Q

the cause of caustic esophagitis?

A
  • to accidental or intentional ingestion of caustic
    substances (e.g., bleach, bases)
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20
Q

Imaging characteristics of caustic esophagitis?

A
  • Parietal rigidity- the wall : extended narrowing of the esophagus (lower 1/3 or 2/3)
  • Centrally located, with smooth contours
  • Gently tapers-emerges into the healthy esophagus
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21
Q

why caustic esophagitis requires monitoring?

A
  • risk of malignant degeneration
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22
Q

the definition of megaesophagus?

A
  • Global dilation with elongation of the
    esophagus.
  • Primary or secondary
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23
Q

clinical presentation of megaesophagus?

A
  • dysphagia
  • regurgitation: the spitting up of food from the esophagus without nausea or forceful contractions of the abdominal muscles
  • retrosternal pain
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24
Q

risk related to megaesophagus?

A
  • Malignancy
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25
Q

The imaging charactaristics of the Megaesophagus?

A
  • Mediastinal widening, occasionally with
    air-fluid levels.
    -Right paracardiac opacity.
    -Absence of gastric air bubble.
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26
Q

what is an esophageal transit test?

A

use of contrast agents (such as barium) or radioactive tracers to visualize how food or liquids pass through the esophagus during series of x ray. the first image: remplire 50%, the second image: remplire 100%; the third: 50% vide

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27
Q

what are the stages that appear in the imaging for the megaesophagus

A
  • Early stage
    -chronic stage
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28
Q

early stage of megaesophagus charaxteristics?

A
  • Moderate dilation of the proximal esophagus.
  • Distal esophagus tapered- thin (“bird’s beak”
    appearance)
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29
Q

the chronic stage of megaesophagus characteristics?

A
  • Severe dilation and elongation of the esophagus
  • Lower part lying against the diaphragm
    (sock-like appearance)
  • Liquid and food stasis
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30
Q

what are the two types of esophagus diverticula?

A
  • congenital
  • acquired
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31
Q

congenital deverticula of the esophagus - Example?

A
  • Zenker’s diverticulum: Outpouching, located at the posterior pharyngoesophageal junction.
32
Q

Acquired deverticula of the esophagus?

A
  • Outpouchings of varying size and shape- middle esophagus
33
Q

Diagnostic techniques of the stomach?

A
  • Endoscopy+++
  • Abdominal plain radiography (ASP)
  • Computed tomography (CT) scan: gastric filling
    assessment
  • +/- Upper gastrointestinal series (TOGD): contrast, MRI
  • Capsule endoscopy
  • Interventional radiology: Percutaneous gastrostomy- feeding tube insertion, Embolization- using tiny particles for gastrointestinal bleeding
34
Q

the most common type of stomach cancer?

A
  • adenocarcinoma
35
Q

how to diagnose the stomach cancer?

A
  • Endoscopy + biopsy
36
Q

role of Ct in stomch cancer?

A
  • Extensions and staging
37
Q

what are the parameters that we relay on to stage the stomach cancer?

A

-Perigastric fat extensio
* Lymphadenopathy Peritoneal carcinomatosis
* Liver metastases
* Ovarian metastases: Krukenberg

38
Q

diagnosis of gastric lymphoma?

A

Ultrasound and CT scan

39
Q

what are the imaging characteristics of the lymphoma?

A
  • Localized or diffuse thickening of the gastric wall
  • Non-obstructive+++
40
Q

what are the parameters to stage the gastric lymphoma?

A
  • Lymphadenopathy
  • Other visceral sites: liver, spleen
41
Q

characteristics of gastrointestinal stromal tumors?

A
  • cancer of cells of enteric nervous system- Cajal cells
  • submucosal location
  • Endoluminal or exoluminal development
  • Risk of malignant degeneration
42
Q

what are the benign tumors of the stomach?

A
  • Rare
  • Polyps, lipomas, leiomyomas, and
    schwannomas
43
Q

the role of ct scan in the tumoral pathology of the small intestine?

A
  • diagnosis and staging
44
Q

what the malignant tumors of the small intestines?

A

*Adenocarcinomas
* Lymphomas
*Epitheliomas
*Carcinoid tumors: Secretory tumors-flush syndrome ,Potential for malignancy

45
Q

what the benign tumors of stomach?

A
  • rare
  • Adenoma, fibroma, angioma, lipoma
46
Q

What is the crohn’s disease?

A
  • Chronic inflammatory enterocolitis, granulomatous, of unknown etiology, transmural, segmental (skipped areas of healthy
    mucosa)
47
Q

location of the crohn’s disease?

A
  • The entire GIT: Ileum+++, colon: rare
48
Q

what is the imaging the technique used to diagnose the crhon?

A
  • US, CT scan
49
Q

the role of MRI in crohn?

A
  • follow up
  • High inflammatory activity
50
Q

the imaging characteristics of the crhon in US?

A
  • Thickening of the ileocecal wall
  • Abscess
  • mesenteric lymph nodes
  • Ascites
51
Q

the imaging characteristics of the chron’s disease in entero CT and entero MRI?

A
  • Wall thickening: * Targeted enhancement: inflammatory
  • Homogeneous enhancement: fibrous
  • Stenosis, upstream dilation
  • Vascular hyperemia (comb sign)
  • Sclerolipomatosis (fat hypertrophy)
  • Mesenteric lymphadenopathy
  • Abscess
  • Enteric and perineal fistulas (MRI+++)
52
Q

the differential diagnosis of crhon’s disease?

A
  • Ileocecal tuberculosis
53
Q

the imaging characteristics of ileocecal tuberculosis?

A
  • Thickening of the terminal ileum wall
  • Necrotic mesenteric lymph nodes
  • Collections
  • Ascites
54
Q

is the small intestine accessible for the endoscopy?

A

No

55
Q

Exploraation thechniques of the colon?

A
  • endoscopy
  • Ct
  • MRI
  • ASP
  • Barium enema
56
Q

What are the two types colonic pathologies?

A
  • Anomalies of position
  • Anomalies of length and caliber
57
Q

anomalie sof position of colon?

A
  • Common mesentery: abnormal rotation of intestinal loops during embryonic development.
58
Q

Anomalies of length and caliber?

A
  • Dolichocolon: elongation, often partial, of a colonic segment (typically sigmoid), often constitutional- Genetic factors
  • Shortening: acquired.
  • Megacolon:(especially sigmoid), acquired or
    congenital.
  • Megadolichocolon
59
Q

the risk factor of Diverticulosis and diverticular sigmoïditis?

A
  • +++ Age
60
Q

the imaging characteristics of Diverticulosis and diverticular sigmoïditis?

A
  • Round or oval-shaped additional images
  • Regular contours
  • Location: sigmoid colon
61
Q

the complications of Diverticulosis and diverticular sigmoïditis?

A
  • Inflammation,
  • Infection
  • Abscess
  • Perforation
  • Hemorrhage
62
Q

what are the benign tumors of the colon?

A
  • Solitary polyp: Adnoma+++: can give cancer
  • fibroma, lipoma, angioma: rare
63
Q

what are the characteristics of benign colonic tumors?

A
  • round
  • Sessile or pedunculated
  • Risk of cancer: endoscopy resection
64
Q

characteristics of Rectocolic polyposis?

A
  • Familial condition
  • Many lesions
  • Progresses invariably to malignancy
  • secreening
65
Q

diagnosis of rectocolic polyposis?

A
  • fecal occult blood test
  • colonoscopy
  • Air contrast CT colonography
66
Q

what are the causes of intestinal intussusception?

A
  • polyp
  • tumor
  • lymphoma
  • lipoma
67
Q

diagnosis of rectcolic cancer-Adenocarcinoma?

A
  • Endoscopy
  • biopsy
68
Q

what is the role of imaging in case of rectocolic cancer?

A
  • Diagnosis
  • staging: post therapeutic
  • surveillance
69
Q

what are the imaging characteristics of Adenocarcinoma- rectocolic cancer?

A
  • Thickening of the wall
  • Luminal stenosis
  • Digestive mass
70
Q

staging of colon cancer?

A
  • Abdominopelvic CT scan: Local and distant
    extension :
    *Infiltration of pericolic fat
  • Localized(surgery) or diffuse( no surgery) peritoneal-thick wall+ ascites+ nodules carcinomatosis
  • Lymphadenopathy
  • Distant metastases
71
Q

assess the parietal extension of rectal cancer?

A
  • endoscopic ultrasound
72
Q

assess the locoregional extension of the rectal cancer?

A
  • MRI
73
Q

what the things that MRI assess in the rectal cancer?

A
  • Location of the tumor
  • Distance from the anal margin
  • Infiltration of mesorectal fat
  • Circumferential resection margin
  • Involvement of the sphincter
  • Lymphadenopathy
74
Q

imaging thechnique to assess the Distant metastasis- liver, Peritoneum?

A
  • US
    -CT
75
Q

when we use ASP?

A
  • emergency
76
Q

when we use CT scan?

A
  • Locoregional and distant staging of cancers
  • Inflammatory pathology (initial assessment)
  • Emergency
77
Q

when we use MRI?

A
  • Locoregional staging of rectal cancer
  • Surveillance of inflammatory bowel disease (Crohn’s
    disease)

radiology (3 decks)

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