Other Intestinal Diseases Flashcards
What is protein-losing enteropathy?
The term referring to intestinal conditions that lead to protein loss
What do protein-losing enteropathy conditions usually manifest with?
Hypoalbuminaemia
What is the most common abnormality of the GI tract?
Meckel’s diverticulum
Where is Meckel’s diverticulum usually located?
About 60cm from the ileocaecal valve
What complications can Meckel’s diverticulum cause?
About half contain gastric mucosa that secretes HCl, which can cause peptic ulcers which can bleed or perforate Acute inflammation (clinically indistinguishable from acute appendicitis) Obstruction from an associated band (rare)
What is management of Meckel’s diverticulum?
Surgical removal, often laparoscopically
What are the clinical features of TB affecting the intestines?
Abdominal pain Weight loss Anaemia Fever with night sweats Obstruction Right iliac fossa pain Palpable mass
Which area of the small intestine is most commonly affected by TB?
Ileocaecal area
What investigations are done to diagnose intestinal TB?
Small bowel follow through
US, MRI or CT
Histology and culture of tissue
How can systemic amyloidosis affect the GI tract?
Amyloid deposits can occur as polypoid lesions
What does intestinal ischaemia result from?
Occlusion of arterial flow, occlusion of venous outflow or failure of perfusion
What can cause arterial inflow obstruction?
Atheroma
Thrombosis
Embolism
Which patients tend to have venous outflow occlusion?
Sick patients with circulatory failure
What can cause intestinal infarction without occlusion?
Reduced cardiac output, hypotension and shock, all causing reduced intestinal blood flow
What is the most common cause of acute small intestinal ischaemia?
Embolus from the heart
How do patients present with acute small intestinal ischaemia?
Sudden abdominal pain and vomiting, with a distended and tender abdomen and absent bowel sounds
What is chronic small intestinal ischaemia usually caused by?
Atheromatous occlusion or cholesterol emboli of the mesenteric vessels
What is the characteristic symptom of chronic small intestinal ischaemia?
Postprandial abdominal pain and weight loss
How is chronic small intestinal ischaemia dignosed?
Angiography
What is eosinophilic gastroenteritis?
Eosinophilic infiltration and oedema of any part of the GI mucosa
How is diagnosis of eosinophilic gastritis made?
Endoscopic biopsy
How is eosinophilic gastroenteritis treated?
Corticosteroids, particularly if peripheral oedema is present
What is lymphangiectasia?
Dilation of the lymphatics
What is the main feature of intestinal lymphangioectasia?
Hypopoteinaemia
How is intestinal lymphangiectasia diagnosed?
Capsule endoscopy
Serology
How is intestinal lymphangiectasia managed?
Low-fat diet, fat-soluble vitamin supplements
Octreotide is used in primary cases
What is abetalipoproteinemia?
Rare congenital disorder that means chylomicrons are not formed
What are the clinical features of abetalipoproteinemia?
Anacthocytosis (spiky red cells owing to membrane abnormalities)
A form of retinitis pigmentosa
Mental and neurological abnormalities
