Chapter 13: GI Misc disorders Flashcards
A patient with a history of chronic anthracene laxative use (cascara sagrada, rhubarb, senna, aloe).
Melanosis coli - mucosa is dark brown.
Pigment is lipofuscin-like, from breakdown of cellular membranes.
Macrophages in lamina propria have brown pigment granules in lysosomes.
How does appendicitis present?
Obstruction of its orifice, secondary distention of the lumen and bacterial invasion of its wall. Intraluminal pressure exceeds venous pressure - venous stasis with ischemia, mucosal ulceration, invasion. Microabscesses with neutrophils.
Tense, congested appendix, covered by fibrinous exudate, lumen with purulent material, fecalith may be evident.
Appendectomy protects from development of ulcerative colitis.
Complications: Periappendiceal abscesses, fistulous tracts, pylephlebitis with secondary hepatic abscesses, diffuse peritonitis and septicemia, wound infection.
A patient presents with a mucus-filled appendix.
Mucocele. Caused by a mucinous cystadenoma or mucinous cystadenocarcinoma.
Can become secondarily infected and rupture.
Pseudomyxoma peritonei - seeding of peritoneum by mucus-secreting tumor cells.
