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Gastrointestinal Disorders: Esophagus, Stomach, Liver, Pancreas
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- 1Hiatal HerniaHerniation of a portion of the GI tract through a weakened esophageal hiatus; caused from increased abdominal pressure; Major concern is strangulation conservative treatment with change in diet, and decreasing pressure.
- 2Types of Hiatal HerniaDirect/Sliding: cardiac sphincter popping above diaphragm
Paraesophageal/Rolling: portion of the fundus above the diaphragm
Intrathoracic: entire stomach protruded above the diaphragm. - 3Schatzki's RingFibrous ring appears above the cardiac sphincter; evidence of a hiatal hernia; can lead to stenosis, dysphagia, reflux, heartburn
- 4Esophageal VaricesVaricose veins of the distal esophagus; complication process not a disease; resistance of vascular flow through the liver; various vasculature surrounding liver gets backed up; first sign is hemoptysis, major concern is hemorrhage; looks like wave-like filling defects; identified with endo
- 5Esophageal DiverticulaOutpouching of one or more layers of the esophageal wall; seen with UGI; treated conservative, changing diet, chewing thoroughly etc
- 6Types of Esophageal DiverticulumPulsion: 1 layer is poking out,food can get stuck; Traction: pulling of all 3 layers, usually in thoracic portion, develops from fibrous adhesions; Zenker's: weakening in the area surrounding the upper esophageal sphincter where food enters the esophagus, called "true diverticula"; Epiphrenic: outpouching above cardiac sphincter
- 7Esophageal Fistulas(Atresia=No passage)
Abnormal passage most commonly between the esophagus and the trachea; from incomplete formation of esophagus; can become infected because one is "sterile"; mucous material can't descend so pt. drools a lot; will encounter an obstruction when placing an NG tube; resp distress; use gastro not barium! - 8Esophageal LeiomyomaBenign tumor; will see an unusual filling effect; no esophageal destruction; Narrowed lumen; causes dysphagia, heartburn etc; can be surgically resected, can cause stenosis. Usually in distal portion of esophagus
- 9Esophageal CarcinomaOccurs in distal 1/3, causes destruction of esophagus, major sign is dysphagia; will look marbly, filling defects, and deterioration of lumen; alcohol/smoking related; people w/ reflux more prone to develop; surgical resection if caught early, chemo, CT helps find this problem
- 10Peptic UlcersInflammatory process caused by acid secreted in stomach; damages the mucosal lining, can be anywhere in stomach/duodenum; excessive H-pylori bacteria; can cause hemorrhage, perforation, stenosis; can block pyloric sphincter, 80% will stop randomly; treat: vagotomy, antibiotics, resection.
- 11Gastric UlcersAppear in stomach, most common lesser/greater curvature, sometimes hard to distinguish from heart attack, burning sensation, appears as retention of CM after peristalsis; treat-diet, vagotomy, surgical resection, affects people with Type A blood.
- 12Duodenal UlcersMost common form of peptic ulcers, appears in duodenum, are almost always benign, appears as collection of barium and mucosal folds that radiate to edge of ulcer, affects people with Type O blood.
- 13Billroth I and IIBillroth 1: portion of stomach removed and hooked back up to duodenum.
Billroth 2: portion of stomach and all of duodenum removed and hooked up to jejunum. - 14Small Bowel ObstructionCaused by fibrous adhesions from previous surgery, scar tissue adhering to abdominal tract reducing peristaltic activity, will see gas proximal to obstruction, "stepladder sign", treat: decompression, therapeutic BE, potential surgery, KUB
- 15IleusImmobility of the intestines without obstruction or twisting; very common post surgery-why you stay in recovery until pass air; Adynamic: overall reduced peristalsis; Localized: just one part isn't working; Colonic: just in the colon. treat: induce peristalsis by giving gastro
- 16Crohn's DiseaseAutoimmune disorder where mucosal lining is attacked by self, can affect any part of GI tract; common in young adults, most often found in distal ileum and proximal ascending colon; "cobblestone appearance"; remove what is causing irritation, restrictive diet, immunosuppressants.
- 17IntussusceptionTelescoping of part of bowel into distal portion, common in children, etiology unknown, low mortality rate, presents: severe abd. pain, vomitting, abnormal stool, tender abdomen, appears as "coiled-spring" sign, treat: BE, air retrograde to push out intestine and uncoil. common in ileocecal valve
- 18Stomach CancerAdenocarcinoma is most significant tumor of stomach, Types: polypoid, ulcerating, superficial, diffuse. Radical gastrectomy, potential chemo, gastrectomy can lead to pernicious anemia (lack of B-12) because of lack of B-12 absorption. verify pt is NPO so don't mistake unusual filling from eating.
- 19AppendicitisInflammation of the appendix, will see trapped air inside appendix or cecum area, rebound pain, hard time straightening legs, RLQ pain, caused by fecoliths, treat: laparoscopically, or open surgery if bursts.
- 20DiverticulosisOutpouchings or sac-like herniations of the mucous membrane of the intestinal wall, mostly found in sigmoid colon, treat: none, unless becomes infected with food/fecal matter, increase fiber intake
- 21DiverticulitisComplication of the diverticula, infection from fecal matter that has caused necrosis. has a "sawtooth appearance", can cause perforations which are a major concern. treat: antibiotics, surgery, antiinflammatory
- 22Ulcerative ColitisAutoimmune disorder affecting just the colon, affects mucosa and submucosa of rectosigmoid area, fibrosing of mucosal lining, No retention of fluid causing dehydration, bloody stool, increased CA risk, appears as strong signs and loss of haustral markings, "Stovepipe sign", treat: remove colon, control w/ diet, surgery.
- 23Large Bowel ObstructionCaused by cancerous growth or abnormalities, 70% are result of colonic carcinoma with perforation as mejor problem, treat: decompression (NG tube inserted to relieve backed up air)
- 24VolvulusTwisting of bowel on itself. most common in colon area, can cause strangulation and necrosis, looks like "twisted sausage", loss of haustral markings, abnormal air fluid levels, vomitting, bowel dilation. sigmoidscope can see and maybe untwist it. treat: BE with gastro, sigmoidscope
- 25Colon CancerCommon in rectum and sigmoid area, caused from heredity + environmental factors, hx of ulcerative colitis, polyps, diet, 70% dx by colonoscopy, "Apple-core appearance" to lumen, treat: surgical resection, rad therapy, involvement dictates chemo.
- 26CholecystitisInflammation of the gallbladder, US is modality of discovery.
- 27CholelithiasisStones or caliculi in the gallbladder, Obstructs biliary tract with stones, can cause complications with other organs in biliary tree, abdominal pain, treat: cholecystectomy, cholelithotripsy,
- 28Gallstonescause destruction to neck of gallbladder, made of: cholesterol, pigment, mixed. Types: solitary, multiple, gravel, sistene stones- fat instead of calcium, breakdown of protein.
- 29CirrhosisHardening of the liver, diffuse destruction and necrosis of hepatocytes with fibrotic regeneration, Liver cells>fatty cells>fibrosed scar tissue, decreases vascular flow, signs-ascites, hyperplasia (liver gets bigger), esophageal varices, unusual absorption patterns, treat: diet, paracentesis, palliative treatments.
- 30Hepatocellular CarcinomaCarcinoma that 70% of pts with cirrhosis form. Usually 1 large tumor in liver, causes alcoholism and Hepatitis C, Treat: surgical resection, difficult to resect whole thing due to vasculature, possible transplant, radiothermal ablasion can kill cell, but won't permit regrowth.
- 31Hepatic MetastasisLiver is a major recipient of metastasis from many common malignant tumors due to vascularity. Dx requires CT, US, MRI or NUC MED
- 32Acute PancreatitisInflammation of the pancreas. Obstruction in the biliary tree, ampulla of vater is clogged and digestive enzymes are backed up (pseudocysts) and begin to digest the pancreas itself. common cause is alcoholism, will have air in bowel that loops around head of pancreas, treat: palliative, diet
- 33Chronic PancreatitisCalcifications often present, major concern is development of pseudocysts.
- 34Pancreatic CancerExtremely poor prognosis, asymptomatic until well advanced, usually in head of pancreas, marbly appearance, hard to resect because head interferes with renal vessels and major vascular structures, smokers have a 2x chance to develop
- 35Major concern with abdominal surgery?scar tissue development
- 36Time required to establish air fluid levels?10-15 minutes
- 37Symptoms of CancerInsomnia
Weight Loss
Decreased Appetite/Lethargy
Painful discomfort
Night Sweats
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- Fichas sobre Sin título, creado por sdfsdf wdfdf el 17/03/2016.
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