Small Bowel 3 Flashcards
Causes of Meckel’s diverticulum?
failure of closure of omphalomesenteric duct (vitelline)
Two types of tissue seen in Meckels?
gastric
pancreatic
When do we perform a diverticulectomy in someone with a Meckels?
if base < 2 cm
if base > 2 cm, segmental resection of involved small intestine
***appendectomy should also be performed
Most common cause of intussusception in children?
lymphoid hyperplasia
We can reduce intussusceptions in children with air or water enemas in most cases, why?
most intussusception in kids is caused by lymphoid hyperplasia
Mainstay of treatment for T-cell lymphoma of small bowel?
chemo
**often present late
Primary fuel source for enterocytes vs colonocytes?
enterocytes–> glutamine
colonocytes–> short chain fatty acids
Pt’s with Crohn’s dx have a 10-12 fold increase risk of developing what type of Ca?
small bowel adenocarcinoma
mostly in ileum
Most common benign primary neoplasm of spleen?
hemangioma
What do we do with hemangiomas of the spleen?
typically asymptomatic
massive hamangiomas have risk of rupture (partial vs complete splenectomy recommended if rupture, capsular distention, pain)
Small bowel hemangiomas are rare benign small bowel tumors that present as occult GI bleeding, how do we commonly manage them?
endoscopically
Two mechanisms by which radiation therapy causes damage?
direct DNA damage
formation of oxygen free radicals
Describe luminal involvement in Crohn’s dx vs UC:
Crohns–> transmural involvement
UC–> mucosa only
Neutrophil infiltration of Crypts of Lieberkuhn is seen in?
UC
Carcinoids most commonly occur in appendix, followed by small bowel,what symptom do their present with if located in small bowel?
typically asymptomatic
most common presenting symptom is abd pain
