Flashcards in EXAM #1: SMALL BOWEL PATHOLOGY II Deck (42)
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?
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?
Where are most diverticula located?
How do multiple diverticula appear on a barium enema?
What are the complications of diverticular disease?
1) Inflammation i.e diverticulitis
3) Abscess formation
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?
What are the symptoms of intestinal obstruction?
- Failure to pass gas
What causes most of the cases of intestinal obstruction?
*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?
*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
What is the major complication of adhesions?
Bowel slips between fibrous bridges resulting in:
****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
What causes intussusception in adults?
What are the major complications of Intussusception?
- Infarction (mesenteric vessels become trapped)
What is volvulus?
Complete twisting of a loop of bowel
What are secondary causes of bowel obstruction?
1) Foreign body (drug mule)
How does malabsorption present in kids?
- Failure to thrive
What type of stool change is typical of malabsorption?
What are the three phases of nutrient absorption?
1) Intraluminal digestion (saliva, gastric enzymes, pancreatic enzymes...etc.)
2) Terminal digestion (hydrolysis at the brush border)
3) Transepithelial transport