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GI System AB > S9.2 GI Emergencies > Flashcards

S9.2 GI Emergencies Flashcards

1
Q

What is peritonitis?

A

Inflammation of the serosal membrane that lines the abdominal cavity.

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2
Q

Outline the pathophysiology of peritonitis

A

Can occur spontaneously (primary), or from breakdown of peritoneal membranes leading to foreign substances entering (secondary).

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3
Q

What are the symptoms and treatments of peritonitis?

A

Abdominal pain

Surgery

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4
Q

What is primary peritonitis and in which disease does it occur?

A

Aka spontaneous bacterial peritonitis
Commonly occurs in patients with cirrhosis, this is an infection of ascitic fluid (in cirrhosis, ascites is fluid in the peritoneal cavity)

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5
Q

What is secondary peritonitis?

A

An inflammatory process in the peritoneal cavity secondary to perforation of an intra-abdominal structure, which allows bacteria to enter

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6
Q

What are some causes of secondary peritonitis?

A

Peptic ulcer, appendicitis, diverticulitis, surgery, ovarian cyst

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7
Q

What are some causes of bowel obstruction in children and adults?

A

Children: Intussusception, Intestinal atresia
Adults: Adhesions, Incarcerated hernias

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8
Q

What is intussusception?

A

When one part of the gut tube telescopes (moves) into an adjacent section.
Can be from a motility issue or a mass

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9
Q

What are the symptoms and treatment of intussusception?

A

Abdominal pain, vomiting, haematochezia

Air enema, surgery

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10
Q

Describe the main features and symptoms of small bowel obstruction

A

More common in younger people
Colicky abdominal pain (3-4 min)
Early vomiting
Late constipation

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11
Q

Describe the main features and symptoms of large bowel obstruction

A

More common in elderly
Colicky abdominal pain (10-15 min)
Late vomiting
Early constipation

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12
Q

How do you differentiate between small and large bowel obstruction on an X-ray?

A

Small bowel: should be able to see plicae circulares

Large bowel: should be able to see haustra

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13
Q

Name 3 causes of small bowel obstruction

A

Intra-abdominal adhesions
Hernias
IBD

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14
Q

What are intra-abdominal adhesions?

A

Fibrous band which connect organs/tissues

Commonly arise after surgery

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15
Q

How do hernias cause small bowel obstruction?

A

Narrow the lumen of the bowel

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16
Q

How can IBD cause small bowel obstruction?

A

In Crohn’s repeated inflammation/healing causes narrowing of the bowel

17
Q

Name some causes of large bowel obstruction

A

Colon cancer, diverticular disease, volvulus

18
Q

What is a volvulus?

A

Part of the colon twists around its mesentery, most common in sigmoid, but also in caecum.
Caused by overloaded sigmoid (constipation).

19
Q

What is acute mesenteric ischaemia?

A

Symptomatic reduction in blood supply to the GI tract

20
Q

Describe the 3 types of acute mesenteric ischaemia

A

Acute occlusion - Arterial embolism in SMA
Non occlusive mesenteric ischaemia - Low cardiac output
Mesenteric venous thrombosis - malignancy

21
Q

What are the symptoms of acute mesenteric ischaemia?

A

Abdominal pain 30 min after eating, vomiting, left sided pain

22
Q

What are the investigation and treatments of acute mesenteric ischaemia?

A

Investigations: bloods, CXR, CT angiography
Treatment: surgery, angioplasty

23
Q

Give two causes of major upper GI bleeds

A

Peptic ulceration

Oesophageal varices

24
Q

What are the two most common sites for peptic ulcers, and what arteries are affected?

A 
Duodenal ulcer (gastro-duodenal artery)
Gastric (splenic artery)
25
Q

Why do varices occur at the oesophagus?

A

As the oesophagus has venous drainage through portal vein and systemic veins, allowing Porto-systemic anastomosis to occur in it

26
Q

Outline the portal and systemic drainage of the oesophagus

A

Portal drainage - Oesophageal veins drain into left gastric vein then portal vein
Systemic drainage - Oesophageal veins drain into azygous vein then SVC

27
Q

What is the treatment for oesophageal varices?

A

Banding

TIPS

28
Q

What is an abdominal aortic aneurysm?

A

A permanent pathological dilation of the aorta with a diameter >1.5x the norm

29
Q

What causes AAA?

A

Caused by degradation of the elastin and collagen in tunica media.

30
Q

Which region is most common for AAA to occur?

A

Infrarenal

31
Q

What are the symptoms of AAA?

A

First asymptomatic, but when ruptured causes abdo + back pain, pulsatile abdo mass, hypotension, cardiovascular collapse

32
Q

How do you diagnose AAA?

A

Presence of a pulsatile mass
CT
X-ray

33
Q

What is the treatment for AAA?

A

Surgery if >5.5cm
Endovascular repair
Stop smoking

GI System AB (17 decks)

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