Small Bowel Flashcards
Percentage of SBO cured with bowel rest, NGT?
65% of pSBO
20% of complete SBO
Effect of terminal ileum resection
Decreased bile salt absorption –> less colon H20 absorption –> diarrhea
Decreased B12/Intrinsic factor absorption
decr binding of oxalate -> more oxalate absorbed in colon -> more oxalate stones
Crohn’s disease preferred surgery
Avoid resection (leads to short gut) Stricturoplasties preferred
Carcinoid hormone
tryptophan -> serotonin -> 5-HIAA (measure in urine)
MC location for carcinoid tumors
ileum > jejunum > duodenum
Carcinoid crisis treatment
Octreotide
sx: facial flushing, diarrhea, tachycardia, arrhythmias, hypotension, mental status
Tx of SMA syndrome
Attempt conservative management first
Surgery - duodenojejunostomy
MC location of small bowel adenocarcinoma
duodenum
Acute ileitis
Ok to proceed with lap appy if there is no cecal involvement
Malabsorption complications following ileal resection
vitamin B12 absorption problems steatorrhea from loss of bile salts gallstones oxalate kidney stones fat soluble vitamin deficiencies
Primary fuel source of small bowel enterocytes
Glutamine
Where does most protein digestion and absorption occur?
Jejunum
GIST tx
Endoscopic resection for small tumors ok
R0 resection for most tumors
Imatinib for unresectable or metastatic GIST or as adjuvant treatment for tumors at high risk of recurrence
Fibrosis of the mesentery causing SBO
Classic for NET
tx: en bloc resection with the mesentery
Treatment of small bowel intussusception in the adults
small bowel resection
MC caused by tumor
