GI - Pathology (GI Diverticula, Intussuception, & volvulus) Flashcards Preview

FA - Gastrointestinal > GI - Pathology (GI Diverticula, Intussuception, & volvulus) > Flashcards

Flashcards in GI - Pathology (GI Diverticula, Intussuception, & volvulus) Deck (33)
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1
Q

What defines diverticulum?

A

Blind pouch protruding from the alimentary tract that communicates with the lumen of the gut

2
Q

How do most diverticula arise, in what parts of the GI tract, and what kind of diverticula are they? Where do diverticula most often arise?

A

Most diverticula (esophagus, stomach, duodenum, colon) are acquired and are termed “false” in that they lack or have an attenuated muscularis externa. Most often in sigmoid colon.

3
Q

What defines a “true” diverticulum? Give an example.

A

“True” diverticulum - all 3 gut wall layers outpouch (e.g., Meckel)

4
Q

What defines a “false” diverticulum? What is another name for this? Where do these diverticula especially occur?

A

“False” diverticulum or Pseudodiverticulum - only mucosa and submucosa outpouch. Occur especially where vasa recta perforate muscularis externa.

5
Q

What defines diverticulosis, and where is it commonly found?

A

Many false diverticula of the colon, commonly sigmoid

6
Q

How common is diverticulosis, and in what age group does it frequently occur?

A

Common (in ~50% of people > 60 years)

7
Q

What causes diverticulosis? With what behavior/condition is it associated?

A

Caused by increased intraluminal pressure and focal weakness in colonic wall. Assoicated with low-fiber diets.

8
Q

How does diverticulosis often present? Of what symptom/sign is it a common cause?

A

Often asymptomatic or associated with vague discomfort. A common cause of hematochezia.

9
Q

What are 2 complications of diverticulosis?

A

Complications include diverticulitis, fistulas.

10
Q

What is diverticulitis, and what are 3 signs/symptoms classically associated with it?

A

Inflammation of diverticula classically causing LLQ pain, fever, leukocytosis.

11
Q

What are 2 possible complications of diverticulitis? What may result from each?

A

(1) May perforate => peritonitis, abscess formation, or bowel stenosis (2) May also cause colovesical fistual (fistual with bladder) => pneumaturia

12
Q

How is diverticulitis treated?

A

Give antibiotics

13
Q

What stool finding(s) is (are) common in diverticulitis?

A

Stool occult blood is common +/- hematochezia

14
Q

What is diverticulitis sometimes called with regard to its presentation, and why?

A

Sometimes called “left-sided appendicitis” due to overlapping clinical presentation

15
Q

What kind of diverticulum is Zenker diverticulum?

A

Pharyngoesophageal false diverticulum.

16
Q

What causes Zenker diverticulum, and where exactly does it occur?

A

Herniation of mucosal tissue at Killian triangle between the thyropharyngeal and cricopharyngeal parts of the inferior pharyngeal constrictor

17
Q

What are 3 presenting symptoms of Zenker diverticulum?

A

Presenting symptoms: dysphagia, obstruction, foul breath from trapped food particles (halitosis).

18
Q

In what patient population is Zenker diverticulum most common?

A

Most common in elderly males

19
Q

What may Zenker diverticulum show on barium swallow?

A

Barium swallow shows contrast filling false diverticulum originating from posterior esophagus

20
Q

What kind of diverticulum is Meckel diverticulum?

A

True diverticulum

21
Q

What causes Meckel diverticulum? What may it contain?

A

Persistence of vitelline duct. May contain ectopic acid-secreting gastric mucosa and/or pancreatic tissue.

22
Q

What is the most common congenital anomaly of the GI tract?

A

Meckel diverticulum

23
Q

What are 5 signs/symptoms/results of Meckel diverticulum?

A

Can cause melana, RLQ pain, intussusception, volvulus, or obstruction near the terminal ileum

24
Q

To what other abnormality of the vitelline duct can meckel diverticulum be contrasted, and what defines this other abnormality?

A

Contrast with omphalomesenteric cyst = cystic dilation of vitelline duct

25
Q

How is Meckel diverticulum diagnosed?

A

Diagnosis: pertechnetate study for uptake by ectopic gastric mucosa

26
Q

What is the mnemonic associated with Meckel diverticulum?

A

Think: “The FIVE 2’s: 2 inches long, 2 feet from the ileocecal valve, 2% of population, commonly presents in first 2 years of life, may have 2 types of epithelial (gastric/pancreatic).”

27
Q

What is intussusception, and where does it commonly occur?

A

“Telescoping” of 1 bowel segment into distal segment, commonly at ileolcecal junction

28
Q

How does intussusception often present, and what causes this?

A

Compromised blood supply => intermittent abdominal pain often with “currant jelly” stool

29
Q

In what patient populations is intussusception unusual versus common? For each of these populations, with what is intussusception associated?

A

Unusual in adults (associated with intraluminal mass or tumor that acts as a lead point that is pulled into the lumen). Majority of cases occur in children (usually idiopathic; may be associated with recent enteric or respiratory viral infection).

30
Q

How is the clinical approach to intussusception in children?

A

Abdominal emergency in early childhood

31
Q

What is volvulus? What complications can it cause?

A

Twisting of portion of bowel around its mesentery; can lead to obstruction and infarction

32
Q

Where in the GI tract can volvulus occur?

A

Can occur throughout the GI tract.

33
Q

Which type of volvulus is more in common in infants and children versus the elderly?

A

Midgut volvulus more common in infants and children. Sigmoid volvulus more common in elderly.