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GIT cours Flashcards

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1
Q

what are the pathologies that can affect the esophagus?

A

-tumors: benign, cancer
-Esoghagitis: peptic, caustic
-Megaesophagus
-Esophageal deverticula

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2
Q

EXPLORATION TECHNIQUES FOR THE
ESOPHAGUS?

A

-Endoscopy+++: we can’t in case of stenosis
-contrast Xray: internal visualisation wa can’t see the environment
-Sonography and endoscopic ultrasound
-Computed tomography
-*Other: MRI, PHmetry, manometry, scintigraphy

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3
Q

type of esophageal cancer:

A
  • squamous cell carcinoma
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4
Q

Patient profile of esophageal cancer?

A
  • Male, alcohol and tobacco consumption
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5
Q

Clinical presentation of esophageal cancer?

A
  • dysphagia, retrosternal pain
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6
Q

diagnosis of esophageal cancer?

A
  • Endoscopy
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7
Q

technics for staging of esophageal cancer?

A
  • ct scan +++
  • endoscopic ultrasound (EUS),
    bronchoscopic examination.
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8
Q

what are the things that we look for in the staging of esophageal cancer in the thoracic area?

A
  • Extension to the tracheobronchial axis
  • Extension to the aorta
  • Mediastinal lymphadenopathy
  • Pulmonary metastases
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9
Q

what are the things that we look for in the staging of esophageal cancer in the abdominal area?

A
  • Involvement of the cardia
  • Coeliac lymphadenopathy
  • Hepatic metastases
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10
Q

what are the two types of esophageal benign tumors?

A
  • Intra-luminal tumors
  • Intra-mural tumors= the esophagus wall
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11
Q

intramural tumors of esophagus examples

A
  • Léiomyomas= smooth muscle tumor
  • schwannomas
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12
Q

the characteristics of intramural tumors?

A
  • Preserved mucosal relief
  • Mimic extrinsic compression
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13
Q

intraluminal tumors of esophagus examples?

A
  • Polyp
  • angiomyolipoma= hamartoma made up of blood vessels, muscle cells and fat cells.
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14
Q

the characteristics of intraluminal tumors?

A
  • rare
  • benign in nature
  • sessile or pedunculated
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15
Q

the cause of peptic esophagitis?

A

gastroesophageal reflux

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16
Q

clinical presentation of peptic esophagitis?

A
  • Heartburn/pyrosis
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17
Q

diagnosis of peptic esophagitis?

A
  • Endoscopy
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18
Q

Imaging characteristics of peptic esophagitis?

A
  • Circumferential, centrally located stenosis
    in the lower 1/3 of the esophagus.
  • Symmetrical with smooth margins.
  • short in length
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19
Q

the cause of caustic esophagitis?

A
  • to accidental or intentional ingestion of caustic
    substances (e.g., bleach, bases)
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20
Q

Imaging characteristics of caustic esophagitis?

A
  • Parietal rigidity- the wall : extended narrowing of the esophagus (lower 1/3 or 2/3)
  • Centrally located, with smooth contours
  • Gently tapers-emerges into the healthy esophagus
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21
Q

why caustic esophagitis requires monitoring?

A
  • risk of malignant degeneration
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22
Q

the definition of megaesophagus?

A
  • Global dilation with elongation of the
    esophagus.
  • Primary or secondary
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23
Q

clinical presentation of megaesophagus?

A
  • dysphagia
  • regurgitation: the spitting up of food from the esophagus without nausea or forceful contractions of the abdominal muscles
  • retrosternal pain
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24
Q

risk related to megaesophagus?

A
  • Malignancy
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25
The imaging charactaristics of the Megaesophagus?
- Mediastinal widening, occasionally with air-fluid levels. -Right paracardiac opacity. -Absence of gastric air bubble.
26
what is an esophageal transit test?
use of contrast agents (such as barium) or radioactive tracers to visualize how food or liquids pass through the esophagus during series of x ray. the first image: remplire 50%, the second image: remplire 100%; the third: 50% vide
27
what are the stages that appear in the imaging for the megaesophagus
- Early stage -chronic stage
28
early stage of megaesophagus charaxteristics?
- Moderate dilation of the proximal esophagus. - Distal esophagus tapered- thin ("bird's beak" appearance)
29
the chronic stage of megaesophagus characteristics?
- Severe dilation and elongation of the esophagus - Lower part lying against the diaphragm (sock-like appearance) - Liquid and food stasis
30
what are the two types of esophagus diverticula?
- congenital - acquired
31
congenital deverticula of the esophagus - Example?
- Zenker's diverticulum: Outpouching, located at the posterior pharyngoesophageal junction.
32
Acquired deverticula of the esophagus?
- Outpouchings of varying size and shape- middle esophagus
33
Diagnostic techniques of the stomach?
- Endoscopy+++ - Abdominal plain radiography (ASP) - Computed tomography (CT) scan: gastric filling assessment - +/- Upper gastrointestinal series (TOGD): contrast, MRI - Capsule endoscopy - Interventional radiology: Percutaneous gastrostomy- feeding tube insertion, Embolization- using tiny particles for gastrointestinal bleeding
34
the most common type of stomach cancer?
- adenocarcinoma
35
how to diagnose the stomach cancer?
- Endoscopy + biopsy
36
role of Ct in stomch cancer?
- Extensions and staging
37
what are the parameters that we relay on to stage the stomach cancer?
-Perigastric fat extensio * Lymphadenopathy Peritoneal carcinomatosis * Liver metastases * Ovarian metastases: Krukenberg
38
diagnosis of gastric lymphoma?
Ultrasound and CT scan
39
what are the imaging characteristics of the lymphoma?
- Localized or diffuse thickening of the gastric wall - Non-obstructive+++
40
what are the parameters to stage the gastric lymphoma?
* Lymphadenopathy * Other visceral sites: liver, spleen
41
characteristics of gastrointestinal stromal tumors?
- cancer of cells of enteric nervous system- Cajal cells - submucosal location - Endoluminal or exoluminal development - Risk of malignant degeneration
42
what are the benign tumors of the stomach?
- Rare - Polyps, lipomas, leiomyomas, and schwannomas
43
the role of ct scan in the tumoral pathology of the small intestine?
- diagnosis and staging
44
what the malignant tumors of the small intestines?
*Adenocarcinomas * Lymphomas *Epitheliomas *Carcinoid tumors: Secretory tumors-flush syndrome ,Potential for malignancy
45
what the benign tumors of stomach?
- rare - Adenoma, fibroma, angioma, lipoma
46
What is the crohn's disease?
- Chronic inflammatory enterocolitis, granulomatous, of unknown etiology, transmural, segmental (skipped areas of healthy mucosa)
47
location of the crohn's disease?
- The entire GIT: Ileum+++, colon: rare
48
what is the imaging the technique used to diagnose the crhon?
- US, CT scan
49
the role of MRI in crohn?
- follow up - High inflammatory activity
50
the imaging characteristics of the crhon in US?
- Thickening of the ileocecal wall - Abscess - mesenteric lymph nodes - Ascites
51
the imaging characteristics of the chron's disease in entero CT and entero MRI?
- Wall thickening: * Targeted enhancement: inflammatory * Homogeneous enhancement: fibrous - Stenosis, upstream dilation - Vascular hyperemia (comb sign) - Sclerolipomatosis (fat hypertrophy) - Mesenteric lymphadenopathy - Abscess - Enteric and perineal fistulas (MRI+++)
52
the differential diagnosis of crhon's disease?
- Ileocecal tuberculosis
53
the imaging characteristics of ileocecal tuberculosis?
- Thickening of the terminal ileum wall - Necrotic mesenteric lymph nodes - Collections - Ascites
54
is the small intestine accessible for the endoscopy?
No
55
Exploraation thechniques of the colon?
- endoscopy - Ct - MRI - ASP - Barium enema
56
What are the two types colonic pathologies?
- Anomalies of position - Anomalies of length and caliber
57
anomalie sof position of colon?
- Common mesentery: abnormal rotation of intestinal loops during embryonic development.
58
Anomalies of length and caliber?
- Dolichocolon: elongation, often partial, of a colonic segment (typically sigmoid), often constitutional- Genetic factors - Shortening: acquired. - Megacolon:(especially sigmoid), acquired or congenital. - Megadolichocolon
59
the risk factor of Diverticulosis and diverticular sigmoïditis?
- +++ Age
60
the imaging characteristics of Diverticulosis and diverticular sigmoïditis?
- Round or oval-shaped additional images - Regular contours - Location: sigmoid colon
61
the complications of Diverticulosis and diverticular sigmoïditis?
* Inflammation, * Infection * Abscess * Perforation * Hemorrhage
62
what are the benign tumors of the colon?
- Solitary polyp: Adnoma+++: can give cancer - fibroma, lipoma, angioma: rare
63
what are the characteristics of benign colonic tumors?
- round - Sessile or pedunculated - Risk of cancer: endoscopy resection
64
characteristics of Rectocolic polyposis?
- Familial condition - Many lesions - Progresses invariably to malignancy - secreening
65
diagnosis of rectocolic polyposis?
- fecal occult blood test - colonoscopy - Air contrast CT colonography
66
what are the causes of intestinal intussusception?
- polyp - tumor - lymphoma - lipoma
67
diagnosis of rectcolic cancer-Adenocarcinoma?
- Endoscopy - biopsy
68
what is the role of imaging in case of rectocolic cancer?
- Diagnosis - staging: post therapeutic - surveillance
69
what are the imaging characteristics of Adenocarcinoma- rectocolic cancer?
* Thickening of the wall * Luminal stenosis * Digestive mass
70
staging of colon cancer?
- Abdominopelvic CT scan: Local and distant extension : *Infiltration of pericolic fat * Localized(surgery) or diffuse( no surgery) peritoneal-thick wall+ ascites+ nodules carcinomatosis * Lymphadenopathy * Distant metastases
71
assess the parietal extension of rectal cancer?
- endoscopic ultrasound
72
assess the locoregional extension of the rectal cancer?
- MRI
73
what the things that MRI assess in the rectal cancer?
- Location of the tumor - Distance from the anal margin - Infiltration of mesorectal fat - Circumferential resection margin - Involvement of the sphincter - Lymphadenopathy
74
imaging thechnique to assess the Distant metastasis- liver, Peritoneum?
- US -CT
75
when we use ASP?
- emergency
76
when we use CT scan?
- Locoregional and distant staging of cancers - Inflammatory pathology (initial assessment) - Emergency
77
when we use MRI?
- Locoregional staging of rectal cancer - Surveillance of inflammatory bowel disease (Crohn's disease)

radiology (3 decks)

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