Upper GI Flashcards
Triad of
- forceful vomiting
- lower chest pain
- subcutaneous emphesyma
Boerhaave syndrome
(Esophageal perforation)
[…] may present with difficulty breathing (dec breath sound) and voice change or abdominal pain post esophageal procedure
Boerhaave syndrome
(Esophageal perforation)
Depending on site of perforation
- upper part near larynx: voice change
- lower part: epigastric pain
Vomiting + Hematemesis
Mallory Weiss
Require urgent EGD
Hematemesis in patient with liver disease
+ Dilated esophageal vessels
Esophageal varices
Fresh blood & coffee ground aspirate from NGT= […]
UGIB » Upper GI endoscopy
In any case of UGIB go for […]
EGD (endoscopy)
- GERD not responding to PPI (recurrent reflux)
- Metallic taste
Key signs for […]
Esophagitis
Most common cause of UGIB : […]
PUD
Suspect PUD if there is history of […] use
Along with elevated serum […] level and anemia
NSAID
Urea
In patient with PUD &
- diffuse tenderness
- regidity
- elevated amylase / WBC
You suspect […] so initial step is […]
Perforated PUD
Initial step: Erect CXR
Always confirm H.Pylori eradication with […] test
Urea breath
In case of failure of H.Pylori eradication with multiple ulcers in the antrum
Your next step is :
Partial distal gastrectomy (anterectomy)
+ H.Pylori
+ MALT (mucosa-associated Lymphoid tissue)
Your management is:
Eradicate H.P
Duodenal ulcer with anterior perforation:
Omental patch
Duodenal ulcer with posterior bleeding:
Ligation of gastroduodenal artery & truncal vagotomy
Hematemesis in acutely ill patient with brain injury
Acute gastritis
“Cushing ulcer”
Progressive dysphagia
- In young patient
- 🔝ESR
Achalasia
Progressive dysphagia
- old age
- anemia
Esophageal SCC
Most common type of esophageal cancer worldwide […]
SCC
Strongest risk factor for SCC is […]
Followed by […]
Achalasia (x10)
Smoking (x9)
Strongest risk factor for adenocarcinoma
is […]
Followed by […]
Barret’s (x10)
GERD (x5-7)
Most common risk factor of eaophageal cancer overall […]
Smoking
Most significant risk factor of eaophageal cancer overall […]
Barret’s metaplasia
Need follow up unlike smoking
Achalasia
Initial management
Pneumatic dilatation
Achalasia
Best management
Myotomy
To diagnose gastric cancer […]
Endoscopy with biopsy
To stage gastric cancer […]
Endoscopic us
Collection in the peritoneum from posterior gastric ulcer most likely be located in the […]
Lesser sac
small bowel tumor with calcification on CT
Carcinoid
Duodenal ulcer sign of radiology
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