GI System (Power Point I)

Question 1

How are the pathologies characterized?

Answer 1

• Congenital
• Inflammatory
• Neoplastic

Question 2

Esophagus fails to develop past some point resulting in a pouch

Answer 2

Esophageal Atresia (EA)

Question 3

Failure of the esophagus to develop completely separate from the trachea

Answer 3

Tracheoesophageal Fistula (TEF)

Question 4

Esophagram showing a fistula arising from the anterior portion of the esophagus and passing to the posterior portion of the trachea

Answer 4

Tracheoesophageal Fistula

Question 5

What are the causes of Acquired Esophageal Fistula:

Answer 5

• Mediastinum Malignancy (50%)
• Infectious process (2)
• Trauma (2)
• Perforation from an endoscopy procedure
• Insertion of NG tube
• Late complication of esophageal cancer

Question 6

CXR images show a perforation causing air within the mediastinum & soft tissue (traumatic perforation)

Answer 6

Acquired Esophageal Fistula

Question 7

What is GERD?

Answer 7

• Reflux of gastric acid contents

- Most common cause of acute esophagitis

Question 8

Superficial ulcerations are typical of reflux, dilated esophagus with loss of effective peristalsis

AKA: Corkscrew esophagus

Answer 8

Esophagitis

Question 9

Outer border of barium filled esophagus appears hazy & serrated

Answer 9

Reflux Esophagitis

Question 10

Normal lining of lower esophagus is replaced by tissue similar to stomach

Answer 10

Barrett’s Esophagus

Question 11

Occurs most often @ EG junction

Answer 11

Esophageal Cancer

Question 12

Related to long standing reflux esophagitis

Answer 12

Barrett’s Esophagus

Question 13

Appearance (infiltrating carcinoma):

• Flat plaque like lesion (one wall)
• Infiltrating lesion (irregular wall with mucosal dest)
• Polypoid lesion (deep ulceration)

Answer 13

Esophageal Cancer

Question 14

Progressive swallowing difficulty

Over 40 years of age

Answer 14

Esophageal Cancer

Question 15

Mucosal outpouchings, generally asymptomatic

Answer 15

Esophageal Diverticula

Question 16

What are the two Primary types of Esophageal Diverticula?

Answer 16

1. Pulsion (false)

2. Traction (true)

Question 17

What is False Esophageal Diverticula?

Answer 17

Pulsion

• Results from motility disorder
• Rounded projection with narrow neck
• Contains the mucosa & submucosa
• Zenker @ Pharyngoesophageal junction
• Epiphrenic @ distal esophagus

Question 18

What is True Esophageal Diverticula?

Answer 18

Traction

• Contains all the layers of the wall
• Develops in response to the pulling of adhesions after infection of lymph nodes
• Found opposite of bifurcation of trachea

Question 19

What are Varicose veins?

Answer 19

Dilated veins in the esophageal wall caused by increased pressure due to portal hypertension (associated with cirrhosis)

Question 20

Serpiginous thickening of folds

• Round or oval filling defects
• Wormlike defect, rosary beads

Answer 20

Esophageal Varices

Question 21

What is the most common abnormality seen on UGI’s?

Answer 21

Hiatal Hernia

Question 22

Half of the population over 50 years of age have…

Answer 22

A Hiatal Hernia

Question 23

Weakness of esophageal hiatus permitting a portion of stomach to emerge into thoracic cavity

Answer 23

Hiatal Hernia

Question 24

Hiatal Hernia’s are mostly ______ with complications associated with reflux.

Answer 24

Asymptomatic

Question 25

_______ Hiatal Hernia's account for majority of hernias.

Answer 25

Sliding

Question 26

Associated with Schataki's ring (mucosal ring protruding into lumen)

Answer 26

Sliding Hiatal Hernia

Question 27

What is a rolling or Paraesophageal Hernia?

Answer 27

Portion of stomach slides above diaphragm leaving GE junction below diaphragm

Question 28

Predisposes to volvulus

Answer 28

Rolling or Paraesphageal Hernia

Question 29

What is Achalasia?

Answer 29

Failure of lower esophageal sphincter to relax leading to dysphagia

Question 30

What has a beck or rat tail appearance and happens at 20-40 years of age.

Answer 30

Achalasia

Question 31

What does foreign bodies require?

Answer 31

2 projections

Question 32

What is a complication of esophagitis, peptic ulcer, neoplasm, trauma and instrumentations?

Answer 32

Perforation of Esophagus

Question 33

Severe vomiting or coughing can cause…

Answer 33

A perforation of the Esophagus

Question 34

What is the name for inflammation of the stomach?

Answer 34

Gastritis

Question 35

Erosive or acute Gastritis is the result of...

Answer 35

- Alcohol | - Corrosive agents and infection

Question 36

Gastritis changes the normal surface pattern of the gastric ________.

Answer 36

Mucosa

Question 37

What is Peptic Ulcer Disease?

Answer 37

Group of inflammatory processes involving the stomach and duodenum.

Question 38

Where do Peptic Ulcers occur most frequently?

Answer 38

At the lesser curvature

Question 39

What are some complications of Peptic Ulcer Disease?

Answer 39

- Hemorrhage | - Gastric outlet

Question 40

What is the most common type of Peptic Ulcer?

Answer 40

Duodenal Ulcer - Occurs in duodenal bulb (95%) - Benign

Question 41

What type of Peptic Ulcers are malignant 5% of the time?

Answer 41

Gastric Ulcers