Small and Large Bowel Flashcards
Loss of propulsive function in the bowel in the absence of mechanical obstruction is called a…
Ileus
A defect in the wall of the peritoneal cavity leading to a protrusion is called a…
Hernia
Where are the most common sites for a hernia?
Inguinal or femoral canal, umbilicus, or surgical scars
Fibrous bands of scar tissue between bowel segments, the abdominal wall, or operative sites is called a…
Bowel adhesions
A complete twisting of loop of bowel at its mesenteric base is called a…
Volvulus
When a segment of bowel telescopes into an immediately distal segment, it’s called a…
intussusception
What is the difference between stenosis and atresia?
Stenosis: lumen decreased in caliber
Atresia: Complete block of lumen
An incomplete closure of ventral abdominal musculature leading to a sac protrusion is called a…
Omphalocele
A defect involving all layers of abdominal wall leading to a visceral herniation is called a…
Gastroschisis
How many patients with Meckel’s diverticulum have symptoms?
4%
What are the 5 rules of 2?
Meckels Diverticulum 2% of population 2 feet of ileocecal valve 2 inches long 2x as common in males as females Occurs by age of 2
How does Hirchsprung’s disease present?
Failure to pass meconium in neonatal period
Obstructive constipation
Abnormal distention
Vomiting
What is the pathological abnormality in Hirschsprung disease?
Abnormal migration of neural crest cells from cecum to rectum, or when the ganglion cells prematurely die
Which plexi lack ganglion cells in Hirschsprung disease?
Submucosal and myenteric
What are some causes of ischemic bowel disease?
Arterial thrombosis/obstruction
Mesenteric venous thrombosis
Hypoperfusion
Which bowel segments are most likely to be affected by ischemia?
Splenic flexure (SMA and IMA watershed) Sigmoid and rectum (IMA, pudenda, aliac artery watershed)
What is a watershed zone?
Initial intestinal segments located at the end of the arterial supply
What are some complications to transmural bowel necrosis?
Sepsis due to breakdown of mucosal barrier. SUDDEN
A lesion of malformed submucosal and mucosal blood vessels in the cecum and right colon is called…
Angiodysplasia
How does angiodysplasia present?
Acute and massive GI bleed or chronic intermittent GI bleed
What is the difference between global and isolated diarrhea?
Global: Disease associated with reduced absorptive surface (celiac disease)
Isolated: Reduced absorption of specific nutrients
What are the four kinds of diarrhea?
Secretory diarrhea
Osmotic diarrhea
Malabsorptive diarrhea
Exudative diarrhea
What immune mediated disease is associated with moderate to marked villous atrophy of the small bowel?
Celiac disease
What skin problem is associated with celiac disease?
Dermatitis herpetiformis
What lab tests help for diagnosis of celiac sprue?
Serology IgA deficiency or TTGA
Small bowel Bx
What is abetalipoproteinemia?
Mutation in the microsomal triglyceride transfer protein leading to an accumulation of triglycerides in the cytoplasm
What are not formed in abetalipoproteinemia?
Chylomicrons
What is the inheritance pattern of abetalipoproteinemia?
Autosomal recessive
What cells are seen in the peripheral blood smear in abetalipoproteinemia?
Burr cells
What is whipple disease caused by?
Gram positive actinomycete, Tropheryma whippelii
What do you see on H&E stain for Whipple disease?
Effacement of normal lamina propria by a sheet of swollen macrophages
What is the most common cause of acute diarrhea?
Infectious diarrhea
What is the key diagnostic test for C. dif?
Toxin producing strain detection of C. difficile typically with PCR assay
