Pathology Exam-colic Flashcards
What is colic?
Acute abdominal pain, originated from abdominal cavity
“True” (inv. GI-tract) or false of origin
Syndrome
How is pain mediated by SN?
-intestinal distention
-mesenteric root stretch
-ischemia and inflammation
Acute, chronic or recurrent
What are the causes regarding stomach?
- gastric ulcers
- gastric impaction, dilation (rupture)
What are the causes regarding small intestine?
- spasmodic
- simple obstruction=parasites, impaction
- strangling obstruction= volvulous, hernia, strangulating lipoma, intussusception
- inflammatory= enteritis
What are the causes regarding large colon?
- timpanism
- simple obstruction= impaction, enterolith, L/R dorsal displacement
- strangulating obstruction= volvulous, intussusception
- inflammatory= colitis
What are the consequences of intestinal distention?
If obstruction proximal to intestine:
- secretions
- gas
- fluid
- digesta
What are the consequences of intestinal ischemia?
- compromise of blood supply=damage to mucosa epithelial cells
- cell necrosis
- loss of villus
- hemorrhage
- epithelium sloughing
What is endotoxemia?
Lipopolysacharide of gram- bacteria gains access to circulation due to destruction of integrity of intestinal epithelial barrier
- massive inflammatory response
- acute phase response+fever due to cytokines
What is repercussion injury?
- exabercation of tissue damage when ischemic tissue is reoxygenated
- reactive oxygen metabolites and neutrophil damage
What is the diagnostic approach to colic?
- an amnesias
- physical exam=rectal palpation, nasogastric intubation
- laboratory finding
- complementary tests= trans abdominal ultrasound, abdominocentesis
