small intestine resection Flashcards
what does leaving less than 1m of small bowel cause
short bowel syndrome
where in the small intestine is resection best tolerated
jejunum
what is glucagon-like peptide 2
specific growth hormone for the enterocyte
what can short bowel syndrome lead to
- depleted of electrolytes
- develop malnutrition
what can treatment of short bowel syndrome
- loperamide
- codeine
- high dose PPI to reduce gastric secretion
- oral rehydration solution
what is the ileum the site of
specific mechanisms for the absorption of bile salts and vitamin B12
what does the loss of the ileal break lead to
diarrhoea
what happens when bile salts and fatty aids enter the colon
cause malabsorption of matter and electrolytes
what does bile salts in the colon cause
increased oxalate absorption
investigations for short bowel syndrome
- imaging
- measure B12
- bile salt retention
treatment if steatorrhoea
low fat diet
what compensate for loss of jejunal absorptive function
ileum
what can jejunal resection lead to
- gastric hyper secretion
- high gastrin levels
what does intestinal failure result from
- obstruction
- dysmotility
- surgical resection
- congenital defect
- loss of absorption
when does intestinal failure usually occur
following resection from Crohn’s, mesenteric vessel occlusion, radiation enteritis or trauma
what can sodium losses be minimised by
increasing salt intake
what is Whipple’s disease
rare infectious bacterial disease caused by Tropheryma whipplei
who most likely gets Whipple’s disease
men
white middle-aged
what does Whipple’s present with
- arthritis
- arthralgia
over the years: - weight loss
- diarrhoea
- abdominal pain
- fever
what do blood tests show for Whipple’s disease
chronic inflammation and malabsorption
what does endoscopy show in Whipple’s
- pale, shaggy duodenal mucosa
- eroded, red, friable patches
how is Whipple’s diagnosed
small bowel biopsy
treatment of Whipple’s
antibiotics that cross the blood-brain barrier
e.g. trimethoprim daily for 1 year
