Flashcards in GI Deck (143):
Where are cholesterol deposits located in GB adenomyomatosis?
Rokitanksy aschoff sinuses
Where is cholesterol in GB cholesterolosis?
What is Mirizzi Syndrome?
Common hepatic duct is obstructed secondary to impacted cystic stone
Direct signs of stenosis Within vessel (2)
Elevated peak systolic velocity
Indirect signs of vessel stenosis (3)
Tardus parvus downstream
Low RI downstream
High RI upstream
Two causes of pulsatile hepatic vein
D vs s
Decreased hv pulsatility 2
Hepatic venous outflow obstruction
Two causes of lipomatous pseudohypertrophy of the pancreas
Larger calculi in dilated pancreatic duct
Sausage shaped pancreas
True simple cysts are associated with what three syndromes?
Microcystuc mutilocular lobulated lesion with central calcification in the pancreatic head
Serous cyst adenoma
Mucinous cystic neoplasm
Unilocular lesion with peripheral calcs in body/tail
Large lesion in tail with thick capsule
Three signs seen in pancreatic adenocarcinoma
Frostburg inverted 3
Wide duodenal sweep
Increases risk of pancreatic ampullary carcinoma in what syndrome
What are the three borders of the gastrinoma triangle
Superior: junction of cystic and CBD
Inferior: start of the third portion of the duodenum
Medial: start of the body of the pancreas
Two sources of blood supply in pancreatic transplant and what they supply
Sma: inferior pancreaticoduodenal artery and donor splenic artery to head
Donor splenic artery to body and tail
What are the two Venous drainage in pancreatic transplant
Donor portal vein and recipient smv
What are gamma gandy bodies
Hemorrhagic foci in spleen associated with portal hypertension
What is peliosis?
Multiple blood filled spaces in spleen and liver
What is the triad of felty syndrome?
What's the most common splenic infection in the us and what does it look like
Multiple rounded calcs
What does splenic brucellosis look like on ct
Bulls eye calcification
What is the muscular ring above the vestibule?
What is the muscular ring below the vestibule?
Where does a Zenker diverticulum occur?
Where does a killian jamieson diverticulum occur?
reticular mucosal esophageal pattern
What defines T3 vs T4 esophageal cancer?
Adventitia vs invasion into adjacent structures
Multiple elevated benign nodules in an asymptomatic patient
multiple small esophageal ulcers with halo of edema
large flat esophageal ulcer (2)
What is the site of weakness where zenker diverticula arise?
killian triangle (posterior)
Multiple small esophageal outpouchings
chronic reflux- esophageal pseudodiverticulosis
What is dysphagia lusoria?
compression of esophagus from aberrant right subclavian artery
What three things are seen in Scleroderma?
lower 2/3 esophageal dysmotility, NSIP, small bowel with hide bound valvulae conniventes
What four things are seen in Gardner Syndrome?
FAP, desmoid tumors, osteomas, papillary thyroid cancer
What three things are associated with Turcots
FAP gliomas medulloblastomas
What is associated with Peutz Jeghers? (3)
small/large bowel CA, pancreatic CA, GYN CA
What three things are seen in Cowden?
Breast CA, Thyroid CA, Lhermitte Duclos
What two things are seen in Cronkhite Canada?
Stomach/SB/LB CA, Ectodermal disease
WHat is Carneys triad?
Extra adrenal pheo, GIST, Pulmonary chondroma
What is done in Billroth 1?
pylorus removed, proximal stomach sewed directly to the duodenum
carmen meniscus sign=
malignant stomach ulcer
benign stomach ulcer
Linitis plastica can be the result of what three things?
scirrhous adenocarcinoma, breast or lung mets
What is the most common met to the stomach?
What is Menetrier's Disease?
idiopathic gastropathy with rugal thickening involving fundus, sparing antrum
What is a rams horn deformity?
tapering of the antrum
What is the differential for a rams horn deformity?
peptic ulcer scarring, granuloamtous disease, scirrhous carcinoma
What is the most common GI tract location for sarcoid?
What is done in billroth 2?
partial gastrectomy, stomach attached to duodenum
What is done in roux en y?
gastric pouch attaced to jejunum, excluded stomach to duodenum, jejunum attached to other jejunum to form bottom of Y
Clover leaf sign=
healed peptic ulcer of duodenal bulb
Sand like jejunal nodules=
Pseudo whipples is caused by?
What is Lane Hamilton Syndrome?
celiac sprue + idiopathic pulmonary hemosiderosis
What are the CT findings of Celiac Sprue? (2)
fold reversal and cavitary lymph nodes
dilated bowel with effaced folds seen in Celiac sprue
graft vs host
Chronic dialysis patients may have what finding?
thickened dudodenal folds
Most common primary location of GI carcinoid?
NM for carcinoid?
MIBG or octreotide
Which hernia is medial to inferior epigastric artery?
What causes a direct inguinal hernia?
defect in hesselbachs triangle
Which hernia is covered by internal spermatic fascia?
What causes an indirect hernia?
failure of processus vaginalis to close
What is a superior lumbar hernia called?
What is an inferior lumbar hernia called?
WHere is a spigelian hernia located?
along semilunar line through transversus abdominis aponeurosis
What does a littre hernia contain?
What does an amyand hernia contain?
Which hernia is at a very high risk of strangulation?
Richter due to only one bowel wall involved
What is a Petersen hernia?
behind roux limb mesentery may be retro or antecolic
What and where is hte most common type of internal hernia?
paraduodenal, on the left at the duodenojejunal junction/fossa of landzert
Where are right sided paraduodenal hernias located?
fossa of waldeyer
What is an onion sign?
on ultrasound, layering within a cystic mass= mucocele
What two signs are seen in sigmoid volvulus?
coffee bean, inverted 3
What is the buzzword for sigmoid volvulus?
frimann dahl sign
Cecal volvulus points where?
What is Behcet's
penile and oral ulcers with pulmonary artery aneurysms
What is colitis cystica?
Cystic dilation of the mucous glands
What two syndromes are associated with rectal cavernous hemangioma?
Klippel Trenaunay-Weber and Blue Rubber Bleb
What three findings are seen in Entamoeba Histolytica?
conced cecum, flask shaped ulcers, spares terminal ileum
What three findings are seen in colonic TB?
coned cecum, fleishcner sign (enlarged gaping IC valve), stierlin sign (TI narrowing)
c diff, contrast trapped inside mucosal folds
Where does typhilitis occur?
What ic McKittrick Wheelock Syndrome?
Villous adenoma leading to mucous diarrhea
What is stage T3 rectal CA?
breaks out of rectum into perirectal fat
What is Cantlie's line?
right and left hepatic lobes (functioning)
What is the most common hepatic vascular variant?
replaced right hepatic from SMA
What ist he most common biliary variant?
right posterior segmental branch emptying into the left hepatic duct
What are the MRI characteristics of a regenerative nodule?
T1 and T2 Dark, no enhancement
What are the MRI characteristics of a dysplastic nodule?
T1 bright, T2 dark, no enhancement
What are the MRI characteristics of a HCC?
T2 bright, enhances
NM for FNH?
Characteristics of FNH scar?
T2 Bright, delayed enhancement
When multiple hepatic adenomas think...
Liver adenomatosis or von gierke
What is the most common location for hepatic adenoma?
right hepatic lobe
NM for fibrolamellar HCC?
Fibrolamellar HCC characteristics
T2 dark, no enhancement
What encases the portal vein?
What are the four classic features of cholangio?
Delayed enhancement, peripheral biliary dilation, liver capsule retraction, no tumor capsule
In what two diseases may hepatic angiosarcoma be seen?
What feature does hepatic Kaposi Sarcoma have?
diffuse periportal hypoechoic infiltration
What is Kasabach Merritt?
sequestration of platelets from giant cavernous hemangioma
What disease is hepatic angiomyolipoma associated with?
What defines a Type I Hiatal hernia
sliding. GEJ above diaphgram
What defines a type II hiatal hernia?
paraesophageal, fundus above diaphragm. GEJ normal position
What defines a Type III hiatal hernia?
elevation of GEJ with herniation of fundus
What defines a type IV hiatal hernia?
Large with other organs herniated
What is an inflammatory eosphagogastric polyp?
fixed thickened gastric fold at GE junction seen in GERD
At what diameter do patients become symptomatic to esophageal stenosis?
EBV esophageal ulcers look like what?
What is Macklin Phenomenon?
alveolar rupture in PIE
Where does an esophageal tear most commonly occur?
Left posterolateral wall
What does the esophagus look like in caustic ingestion?
What is best positioning to view esophageal varices on upper GI?
RAO semiprone collapsed esophagus
Three causes of high esophageal web formation
Plummer vinson, bullous pemphigoid, ectopic gastric mucosa
Normal angle in gastric lap band
What is the Borchardt triad?
sudden epigastric pain, retching, cant pass NG, seen in gastric volvulus
What are the findings on SBFT of celiac?
widened thin folds, transient jejunojenual intussecption
What is the most common malignancy in untreated Celiac?
T cell lymphoma
What is cavitary lymph node syndrome?
in celiac, villous atrophy, nodal masses, splenic atrophy
What worm causes cholangitis/pancreatitis?
What worm causes anemia?
What work comes from sushi?
What worm causes rectal prolapse?
What are the borders of hesselbachs triangle?
inguinal ligament inferiorly, IEV superolaterally, conjoined tendon medially
Duodenal windsock sign
=intraluminal duodenal diverticulum
What is Griffiths critical point?
anastomsis between left colic and marginal artery of drummond
What is Sudeck point?
Watershed area at anastomosis between superior rectal artery and last sigmoid branch of IMA
De Garengeot hernia?
appendix in a femoral hernia
Collar button ulcer=
What is the enhancement pattern in peliosis hepatitis?
What bacteria is associated with peliosis hepatitis?
What is the triad of Klippel Trenaunay?
port wine, limb hemihypertrophy, hemagiomatosis