Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
What might gastric carcinoma spread to?
lymph nodes can involve the left supraclavicular node (Virchow node).
For gastric carcinoma what does distant metastasis most commonly involve?
For the intestinal type of gastric carcinoma what does distant metastasis involve?
Periumbilical region (Sister Mary Joseph nodule)
For the diffuse type of gastric carcinoma what does distant metastasis involve?
Bilateral ovaries (Krukenberg tumor)
What is duodenal atresia?
Congenital failure of duodenum to canalize;
What is duodenal atresia associated with?
What are the clinical features for duodenal atresia?
1. Polyhydramnios 2. Distension of stomach and blind loop of duodenum (double bubble) 3. Bilious vomiting
What is meckel diverticulum?
Outpouching of all three layers of the bowel wall (true diverticulum)
Why does meckel diverticulum arise?
due to failure of the vitelline duct to involute
For meckel diverticulum what is the rule of 2s?
1) Seen in 2% of the population 2) 2 inches long and located in the small bowel within 2 feet of the ileocecal valve 3) during the first 2 years of life with bleeding, volvulus, intussusception, or obstruction (mimics appendicitis); however, most cases are asymptomatic
What is the most common congenital anomaly of the GI tract?
How long is the meckel diverticulum?
2 inches long
Where is the meckel diverticulum located?
in the small bowel within 2 feet of the ileocecal valve
How can meckel diverticulum present?
during the first 2 years of life with bleeding, volvulus, intussusception, or obstruction (mimics appendicitis); however, most cases are asymptomatic
Why is there bleeding during the presentation of meckel diverticulum?
Its due to heterotopic gastric mucosa
What is volvulus?
Twisting of bowel along its mesentery
What does volvulus result in?
obstruction and disruption of the blood supply with infarction
What are the most common locations for a volvulus?
sigmoid colon in the elderly and cecum in young adults
What is intussusception?
Telescoping of proximal segment of bowel forward into distal segment
How does intussusception work?
Telescoped segment is pulled forward by peristalsis, resulting in obstruction and disruption of blood supply with infarction.
What is intussusception associated with?
a leading edge (focus of traction)
What is the most common cause of intussusception in children?
lymphoid hyperplasia (e.g., due to rotavirus) which usually arises in the terminal ileum, leading to intussusception into the cecum
What is the most common cause of intussusception in adults?
What is small bowel infarction?
Small bowel is highly susceptible to ischemic injury.
When does transmural infarction occur?
with thrombosis/embolism of the superior mesenteric artery or thrombosis of the mesenteric vein.
When does mucosal infarction occur?
with marked hypotension
What are the clinical features for small bowel infarction?
they include abdominal pain, bloody diarrhea, and decreased bowel sounds,
What is lactose intolerance?
Decreased function of the lactase enzyme found in the brush border of enterocytes
What is the normal function of lactase?
It normally breaks down lactose into glucose and galactose.