Upper GI Flashcards
List the risk factors for upper GI Ca
Smoking
Alcohol
Barret’s
H.Pylori
Outline the histology of upper GI Ca
Adenocarcinoma
SCC (upper 2/3)
What is the 2WW referral criteria for suspected upper GI Ca?
Dysphagia
OR
> 55, weight loss + any of the following: upper abdo pain, reflux, dyspepsia
OR
Upper abdo mass
Red flags = epigastric mass, persistent vomiting, weight loss, melena
How should upper GI Ca be investigated?
OGD + biopsy
Staging CT TAP –> PET CT/staging laparoscopy
How is upper GI Ca managed?
Curative: radical oesophagectomy/gastrectomy, adjuvant radiotherapy (DXT)/chemo
Palliative: laser therapy, analgesia, stent, EtOH (ethanol) injection, radiotherapy
List the possible complications of upper GI Ca
UGIB
Obstruction
Perforation
What is succussion splash?
Sloshing sound heard through the stethoscope during sudden movement of the patient on abdominal auscultation
= presence of gas and fluid in an obstructed organ, as in gastric outlet obstruction
What is virchows node?
Supraclavicular LN on the L - associated with malignancy
What is sister Mary Josephs nodule?
Palpable nodule bulging into the umbilicus as a result of met Ca in the abdo/pelvis
How is stomach Ca staged?
TNM
- T1 = lamina propria, muscularis mucosae, submucosa
- T2 = muscularis propria
- T3 = through muscularis propria into subserosa
- T4 = perforates visceral peritoneum/other structures
- N1 = 1-2 nodes
- N2 = 3-6 nodes
- N3 = >7
- M0 = no mets
- M1 = mets
What is a GIST and how is it treated?
GI stromal tumour - type of soft tissue sarcoma
- can be malignant or benign
- surgery = excision
- growth inhibitors = tyrosine kinase inhibitors (TKIs)
How is the severity of dysphagia scored?
DOSS - dysphagia outcome and severity score
1 = no oral intake 7 = no swallowing deficit
What scoring systems are used in an UGIB?
Glasgow-Blatchford Bleeding Score = will the pt need medical intervention
Rockall score = identify pts at risk of adverse outcome
