itis of the GI tract Flashcards
pathology of appendicitis
obstruction
bacterial invasion
necrosis
signs of appendicitis
anorexia
pyrexia
pain radiating from umbilicus to McBurney’s point
bowel habit change
complications of appendicitis
perforation
peritonitis
diagnosis of appendicitis
CT
treatment of appendicitis
fluid resuscitation
laparoscopic appendicectomy
risk factors for diverticulitis
low fibre diet - leads to pressure changes in sigmoid colon
pathology of diverticulitis
abrasion or perforation of herniated mucosa
inflammation and granulation tissue
symptoms of diverticulitis
altered bowel habit
abdominal pain
complications of diverticulitis
fistula into vagina, bladder, or small bowel
per-colic abscess
diagnosis of diverticulitis
barium enema
endoscopy
treatment of diverticulitis
surgery
antibiotics
risk factors for acute gastritis
drugs (e.g. NSAIDs)
excessive alcohol consumption
causes of acute gastritis
chemical injury
Helicobacter infection
inhibition of prostaglandin synthesis
Diminished mucous secretion
pathology of acute gastritis
surface epithelial degeneration leads to regenerative hyperplasia of pit-lining epithelium
vasodilation/congestion
neutrophil polymorph response
symptoms of acute gastritis
indigestion
gnawing or burning stomach pain
nausea and vomiting
feeling full after eating
diagnosis of acute gastritis
blood test (check for H.pylori) endoscopy gastric tissue biopsy
treatment of gastritis
antacids (magnesium triscillicate mixture)
H2 blockers (ranitidine)
PPIs (omeprazole)
antibiotics (amoxicillin, tetracycline)
risk factors for chronic gastritis
B12 deficiency
Helicobacter infection
pathology of chronic gastritis
can be autoimmune process or vitamin B12 deficiency lymphocyte and plasma cell response glandular atrophy laminar propria fibrosis intestinal metaplasia
signs of chronic gastritis
hypochlorhydria
pernicious anaemia
nausea
indigestion
diagnosis of chronic gastritis
occult blood test
FBC
endoscopy
gastric biopsy
risk factors for ischaemic colitis
hypotension
thrombosis
pathology of ischaemic colitis
restriction of blood flow to colon due to low systemic bp, restriction, or occlusion
signs of ischaemic colitis
abdominal tenderness/pain low bp tachycardia lower GI bleeding fever
complications of ischaemic colitis
peritonitis
sepsis
diagnosis of ischaemic colitis
test bowel blood O2 sats by light spectroscopy (via endoscopy)
endoscopy with biopsy
treatment of ischaemic colitis
IV fluids to treat dehydration
antibiotics
what causes peritonitis?
anything that shouldn't be in the peritoneal cavity inflamed organ pus air faeces blood
where is visceral peritoneum pain localised to?
nerve roots
where is parietal peritoneum pain localised to?
where the problem is
complications of peritonitis
sepsis
multi-organ failure
cardiovascular events
respiratory complications (due to pressure on diaphragm)
hypovolaemic shock and renal failure (disturbed electrolyte balance)
abscess
diagnosis of peritonitis
CT
treatment of peritonitis
IV fluids and catheter
broad spectrum antibiotics
surgery - wash out peritoneal cavity and remove dead/inflamed tissue
mortality rate of peritonitis
15%
what is peritonism?
tensing of muscles to prevent movement of peritoneum
how many hospital admissions a year in the UK for peritonitis?
370,000
risk factors for peritonitis
male ruptured sexual organs ectopic pregnancy trauma surgery ascites
signs of peritonitis
sudden acute onset of abdominal pain pain exacerbated by movement pain is generalised and becomes localised shock fever washboard rigidity fever sinus tachycardia nausea and vomiting abdominal swelling
treatment of peritonitis
IV fluids
IV antibiotics
wash out abdominal cavity with 6L warm saline and take out dead or inflamed tissue
physiotherapy to help patients take deep breaths
nutritional support (to stop patient getting an ileus)
