Pathology of the Small Bowel Flashcards
What can cause ischaemia of the small bowel?
Mesenteric artery occlusion or non-occlusive perfusion insufficiency
What can cause non-occlusive perfusion insufficiency?
Shock, strangulation obstructing venous return (hernia), drugs, hyperviscosity
What usually occurs after a mucosal infarct?
Regeneration and the mucosal integrity is restored
What usually occurs after a mural infarct?
Repair and regeneration leading to fibrosis and stricture
What usually occurs after transmural infarct?
Gangrene and death if not resected
Complications of ischaemia of the small bowel
Resolution, fibrosis, stricture, chronic ischaemia, ‘mesenteric angina’, obstruction, gangrene, perforation, peritonitis, death
Meckel’s diverticulum
Result of incomplete regression of vitello-intestinal tract
Describe structure and position of Meckel’s diverticulum
Tube structure, 2 inches long, 2 foot above ileocaecal valve in 2% of people
Complications of Meckel’s diverticulum
Bleeding, perforation or diverticulitis which mimics appendicitis
Primary tumours of the small bowel
Lymphomas, carcinoid tumours, carcinomas
Where can secondary tumours of the small bowel metastasise from?
Ovary, colon, stomach
What type of lymphoma is associated with the small bowel?
Hodgkins lymphoma
Treatment of lymphomas of the small bowel
Surgery and chemotherapy
Most common site of carcinoid tumours of the small bowel
Appendix
Describe carcinoid tumours of the small bowel
Small, yellow, slow growing, locally invasive
What can carcinoid tumours of the small bowel cause?
Intussusception
Symptoms of carcinoid tumours of the small bowel
Flushing and diarrhoea
Which diseases is carcinoma of the small bowel associated with?
Crohn’s and coeliac disease
Where can carcinoma of the small bowel metastasise to?
Lymph node and liver
Most common cause of acute abdomen
Appendicitis
Pathology of appendicitis
Acute inflammation by neutrophils, mucosal ulceration, serosal congestion, exudate, pus in lumen
Complications of appendicitis
- Peritonitis
- Rupture
- Abscess
- Fistula
- Sepsis and liver abscess
What is coeliac disease caused by?
Abnormal reaction to a constituent of wheat flour, gluten, which damages enterocytes and reduces absorptive capacity.