EXAM #1: SMALL BOWEL PATHOLOGY II Flashcards
(42 cards)
What is diverticulosis?
Outpouching of the intestinal wall (mucosa and submucosa through the muscularis propria)
What is diverticulitis?
Inflammation of an outpouching of the intestinal wall
Which is more associated with bleeding, diverticulosis or diverticulitis?
Diverticulosis
Describe the pathogenesis diverticular disease.
- Focal weakness in colonic wall caused by:
1) Increased luminal pressure
2) Low fiber diet - Focal weakness where vasa recta enter muscularis propria
What intestinal wall layer is absent that leads to development of diverticula?
Muscularis propria
Where are most diverticula located?
Sigmoid colon
How do multiple diverticula appear on a barium enema?
“Sawtooth”
What are the complications of diverticular disease?
1) Inflammation i.e diverticulitis
2) Perforation
3) Abscess formation
4) Rupture
5) Fistula tract formation
What are the symptoms of diverticular disease?
- Abdominal cramping
- Lower abdominal pain
- Sensation of not being able to empty rectum
What part of the bowel is most commonly affected by intestinal obstruction?
Small bowel
What are the symptoms of intestinal obstruction?
- Pain
- Distention
- Vomiting
- Constipation
- Failure to pass gas
What causes most of the cases of intestinal obstruction?
1) Hernia
2) Adhesions
3) Intussusception*
4) Volvulus*
*These are medical emergencies
What is a hernia?
Outpouching of the peritoneum through a defect in the abdominal wall
What are the major complications of hernias?
1) Strangulation
2) Incarceration
This is a medical emergency when it occurs
What is an inguinal hernia?
Portion of the small intestine enters the inguinal hernia
What is a direct inguinal hernia?
Medial to the inferior epigastric artery
What is an indirect inguinal hernia?
Lateral to the inferior epigastric artery
- Through inguinal canal
- In testes
What are “adhesions?”
Fibrous bridges between bowel segments or abdominal wall
What are adhesions associated with?
1) Inflammation i.e. peritonitis
2) Surgery
3) Infection
4) Endometriosis
What is the major complication of adhesions?
Bowel slips between fibrous bridges resulting in:
- Obstruction
- Infarction
Note this is called an internal hernia*
What is Intussusception?
Telescoping of one segment of bowel into an immediately distal segment
What causes intussusception in kids?
1) Secondary lymphoid hyperplasia
2) Rotavirus
What causes intussusception in adults?
1) Mass
2) Tumor
What are the major complications of Intussusception?
- Obstruction
- Infarction (mesenteric vessels become trapped)
