overview of GIT pathology Flashcards
haematemensis
vomiting blood
melaena
black, malodorous
altered blood in the stool, indicates bleeding proximally lower
haematochezia
bright red blood
indicates bleeding distally or massive blood
occult blood
not visible blood
detectable biochemically
may have occult anaemia
abdominal distension
intra,uminal or free peritoneal gas
peritonitis
redness/swelling of abdomen
caplet meduse
spiderweb looking marks
vessels radiating
occlusion of arteries cause
ischaemia and infarction
occlusion of arteries may be due to
thrombosis, embolism, vasculitis
5 causes of obstruction of the bowel
obsruction herniation adhesions intussusception vovolus
intussusception
part of the tube goes into the other part
telescoping
herniation
can cause part of ischaemia
adhesion
two loops of bowel sticking together due to inflammation or some other damage process
volvulus
twisting
consequences of inflammation
ulceration
haemorrhage
perforation
chronicity of inflammation
architectural changes in epithelium
fibrosis/scarring of lamina proprietary and muscle
hyperplasia of muscle wall
acute appendicitis
inflammation of the vermiform appendix
epidemiology of acute appendicitis
slightly more common in males
aetiology of acute appendicitis
obstruction of the lumen by: idiopathic faecalith normal stool lymphoid hyperplasia neoplasm
pathophysiology of acute appendicitis
obstruction leads to stasis, increase in intraluminal pressure
bacterial multiplication with pus formation
distension of lumen
involvement of the wall by acute inflammation may resolve, but often local ischaemia occurs and appendix becomes necrotic, leading to perforation, leaking of the bowel contents with peritonitis, abscess formation and severe systemic illness
presentation of acute appendicitis
onset over hours constant mid abdominal pain shifts to right lower quadrant worse on movement loss of appetite (anorexia) nausea and vomiting commonly teens to middle aged
clinical signs acute appendicitis
low grade fever
diminished bowel sounds, tachycardia, leukocytosis
Rovsing sign
press on left side of the abdomen and pain occurs on the right lower quadrant
mallory-weiss tear, boerhaave syndrome
tear or perforation of oesophagus due to vomiting
iatrogenic
as a result of treatment
psuedomembranous colitis
overgrowth of C. difficile due to treatment with antibiotics
