SMALL INTESTINES Flashcards
Triad of radiographic findings in SBO (sensitivity - 70-80%; low specificity)
dilated small bowel loops >3 cm
differential air fluid levels
paucity of air in colon
Radiographic findings in STRANGULATED SBO
thickened small bowel loops
mucosal “thumb printing”
pneumatosis intestinalis - gas within the bowel wall
free peritoneal air
Preferred methods in patients with history of abdominal malignancy
CT scan with water soluble contrast
Contraindications to non-operative management
suspected ischemia
large bowel obstruction
closed loop obstruction
strangulated hernia
perforation
Assessment of bowel viability during surgery
color
peristalsis
marginal arterial pulsations
necrosis
perforations
Temporal sequence of GI motility
SI - 24 hrs
Gastric - 24 - 48 hrs
Colon - 2-5 days
Postoperative Ileus
Interval from surgery until passage of flatus/stool AND tolerance of an oral diet
Prolonged Postoperative Ileus
> 5 days postoperatively
OR
2 OR MORE OF THE FF OCCURING ON OR AFTER DAY 4 POST OP:
N/V
inability to tolerate oral diet over 24 h
(-) flatus over 24 h
distension
radiologic confirmation occurring on or after day 4 postoperatively w/o prior resolution of postoperative ileus
Factors that INHIBIT Spontaneous Closure of Fistulas
FRIEND
Foreign body within the fistula tract
Radiation enteritis
Infection/Inflammation at the fistula origin
Epithelialization of the fistula tract
Neoplasm at the fistula origin
Distal obstruction of the intestine
Definitive diagnosis of Intussusception
Air contrast enema
Diagnosis of Meckel’s
Technetium-99m pertechnetate scan
MC and lethal GI disorder affecting preterm neonate
Necrotizing Enterocolitis (NEC)
Stage I - NEC scare
Stage II - Established NEC
Stage III - Advanced NEC
The largest number of hormone producing cells in the body
SMALL INTESTINES
