Upper GI Flashcards
Surgery for GERD
Nissen fundoplication
Most common location for a bleeding peptic ulcer
Duodenal ulcer
4 Impt investigations in achalasia
- OGD tro malignancy/ mechanical obstruction
- Barium/gastrografin swallow
- High Resolution Esophageal manometry
- ? Video fluoroscopic examination of swallowing(VFES)
Indications for Percutaneous Endoscopic Gastrostomy
Functional causes
- Neuromuscular dysphagia and risk of aspiration
Mechanical causes
- Post surgical eg fundoplication
- Unresectable esophageal, CEJ cancers
- Gastric volvulus
Advantages of PEG over NGT
- Lower aspiration risk
- Easier to nurse
- Less discomfort, better tolerated
Hereditary syndromes a/w Gastric Ca
- Hereditary Diffuse Gastric Cancer
- HNPCC
- FAP
Symptoms of Gastric Ca
- Epigastric pain
- Dyspepsia
- Dysphagia( Cardia tumors)
- Bloating
- LOA/LOW
- N/V, early satiety if GOO
- IO Sx
- Malnutrition
- BGIT: Coffee ground vomitus, hematemesis, melena, hematochezia
- Anemia Sx
- Early Satiety
- Peritonism if perforated
Signs of Gastric ca
- Cachexia
- Palpable mass if advanced
- Anemia signs
- Peritonism if perforated
- Hepatomegaly if mets
- Sister Mary Joseph nodule and virchow’s node if mets
Scoring system for UBGIT
Rockall and Blatchford score
Scoring for peptic Ulcer Disease
Forrest classification
I: Active bleeding
Ia: Spurting hemorrhage
Ib: Oozing hemorrhage
II: Recent bleeding
IIa: Visible vessel, non bleeding
IIb: Adherent clot on lesion
IIc: Hematin covered lesion
III: Non bleeding lesion, flat spot and clean base
Stage where esophageal cancer can be endoscopically resected
T1a
Stage where esophageal cancer will require trimodal mx(chemoRT plus surgery)
T2 or N1
Stage where gastric cancer can undergo ESD( Endoscopic Submucosal Dissection) or EMR( Endoscopic Mucosal Resection)
T1a
