Small & Large Intestine Flashcards
SMAD4 mutation syndrome
Juvenile polyposis
STK11 mutation syndrome
Peutz-Jeghers syndrome
Syndrome: mesenteric desmoid tumors, osteomas of mandible or skull, sebaceous cysts
Gardner syndrome
Syndrome: malignant central nervous system tumors (medulloblastoma, etc), gastrointestinal polyps, colon cancer
Turcot syndrome
Coloplasty
Longitudinal colotomy that is closed transversely to create more reservoir capacity for reconstruction after rectal cancer resection
Management of desmoid tumor
Sulindac and tamoxifen
Surveillance with MRI in 3-6mo intervals
(Avoid surgery if possible because tissue manipulation can cause formation of additional desmoid tumors)
Features of fistulas that are likely to close spontaneously
low output (<200/day), distal fistula, longer tract (>2cm)
Impediments to spontaneous closure of fistulas
FRIEND
Foreign body, radiation, inflammation/infection, epithelialization, neoplasia, distal obstruction
Kulichitsky cells
Interstitial cells of cajal (origin cells for GI stromal tumors)
Best test to diagnose colovesical fistula
CT with oral/rectal contrast
Causes of primary pneumatosis intestinalis
Asthma, COPD, IBD, or immunosuppressive agents - creates cystic pattern in intestinal wall, benign
Management of Stage 1 rectal cancer
Tis, T1, or T2 with no nodal involvement -> surgery
When to give neoadjuvant chemo for rectal cancer?
T3 or higher, with/without nodes
When can you do a transanal local excision for rectal cancer
T1 rectal cancer
<8cm from anal verge
<3cm in size
Well-differentiated
<30% of circumference involved
Mobile
Which layer maintains the tensile strength of bowel
Submucosa
Indications for radical resection (APR or LAR) of NET in hindgut
> 2cm in size
Invasion into muscularis propria (T2 or higher)
Lymphovascular invasion
Elevated mitotic rate/Ki67
Mutations associated with Lynch syndrome
MLH1, MSH2, MSH6, PMS2, EPCAM
Manifestations of Lynch syndrome
Keratoacanthomas, sebaceous adenoma/adenocarcinoma
Endometrial, stomach, small bowel, and ureter cancers
MUTYH-associated polyposis: inheritence
Autosomal recessive
MUTYH-associated polyposis manifestations
Adenomatous polyps
Colon, duodenal, bladder, ovarian, skin, and endometrial cancers
FAP manifestations
Desmoid tumors, osteomas, epidermoid cysts
Gastric and small intestine polyps
Hepatoblastoma
Papillary thyroid cancer variant
Gene associated with Peutz-Jegher
STK11
Mutation associated with Cowden syndrome
PTEN
Cowden syndrome manifestations
Gastric and small intestinal polyps, hereditary hemorrhagic telangiectasias
