Pyloric Stenosis & Gastric Neoplasms Flashcards
acquired condition caused by hypertrophy and spasm of pyloric sphincter leading to gastric outlet obstruction
pyloric stenosis
when does pyloric stenosis most commonly occur?
in first weeks of life
exposure to what would make infants more at risk for pyloric stenosis?
macrolides
what is the cause of primary adult pyloric stenosis?
idiopathic
what is the cause of secondary adult pyloric stenosis?
local inflammation
what are the main symptoms present in pyloric stenosis? (3)
forceful + projectile vomit
very hungry
visible peristaltic waves
what is a physical finding in pyloric stenosis?
hypertrophied pylorus (olive)
what can repetitive vomiting in a patient with pyloric stenosis lead to?
metabolic alkalosis
what lab will be present in pyloric stenosis?
elevated BUN
an abdominal xray shows dilated stomach with little to no gas in intestines. Dx?
pyloric stenosis
what is the imaging of choice for pyloric stenosis? what will be seen?
ultrasound
elongated, thick pylorus
what will be seen in a barium swallow if a patient has pyloric stenosis?
string sign
what is the treatment for pyloric stenosis?
surgical pyloromyotomy
what are the 2 types of gastric adenocarcinoma?
intestinal type
diffuse
resembles intestinal cellular cancers with glandular structures
intestinal type gastric adenocarcinoma
poorly differentiated, without glandular formations
diffuse gastric adenocarcinoma
a patient presents with dyspepsia, vague MEG pain/tenderness, anorexia, early satiety, and weight loss. Dx?
gastric adenocarcinoma
what is the diagnostic for gastric adenocarcinoma?
upper EGD + biopsy
what diagnostic can be used after the initial diagnosis of gastric adenocarcinoma to determine depth of tumor?
endoscopic US
what is the only curative option of gastric adenocarcinoma?
surgical resection
what are treatment options for gastric adenocarcinoma in patients with non-curative disease? (2)
palliative surgery
chemotherapy
what is the 2nd most common type of gastric cancer?
primary gastric lymphoma
what is the largest risk factor for primary gastric lymphoma?
H pylori
a patient presents with vague MEG pain and tenderness, weight loss, early satiety, and melena. Dx?
gastric lymphoma
what is the diagnostic for gastric lymphoma? (2)
upper EGD + biopsy
lymph node biopsy
what are 2 diagnostics that can be done after the initial diagnosis of gastric lymphoma?
CT scan
bone marrow bx
what is the treatment for gastric lymphoma? (2)
treat H pylori
+/- radiation and chemo
most gastric carcinoid tumors occur with what?
pernicious anemia
what do gastric carcinoid tumors cause?
carcinoid syndrome
what is the diagnostic for gastric carcinoid tumors?
upper endoscopy + biopsy
what is the treatment for small local single gastric carcinoid tumors?
resection
what is the treatment for localized multiple gastric carcinoid tumors? (2)
radical gastrectomy + regional lymphadenectomy
