Small Bowel Disease Flashcards

1
Q

What is a gallstone ileus?

A

Large gallstone migrates via fistulas into the small intestine and become lodged

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2
Q

What is the most common fistula associated with the gall bladder and small intestine?

A

Cholecystoduodenal

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3
Q

List some symptoms of small bowel obstruction

A

Colicky abdo pain (sudden, cramp like)
Absolute constipation (no flatus/burping)
Abdominal distention
Faeculent vomiting

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4
Q

Is surgery common for small bowel obstruction?

A

Not really as most settle with management

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5
Q

Outline general treatment of small bowel obstruction

A

Analgesia
Fluids + potassium (lose K in vomit)
NG tube draining
Anti-embolism measures

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6
Q

When would surgery be done early for small bowel obstruction?

A

Strangulation
Perforation
Ischaemia
PREVENT DEAD GUTS

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7
Q

In mesenteric/small bowel ischaemia, the colon is usually unaffected. True/False?

A

True
Marginal artery of Drummond provides collateral supply

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8
Q

What is the typical symptom of mesenteric ischaemia?

A

Cramping pain
Essentially “angina of the gut”

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9
Q

What is the first-line treatment for mesenteric ischaemia?

A

Surgery! No faffing around
PREVENT DEAD GUTS

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10
Q

Upon surgery, if part of the intestine is necrotised, what is done?

A

Resected (up to a limit)

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11
Q

Where does Meckel’s diverticulum occur?

A

60cm from ileocaecal valve

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12
Q

When does Meckel’s diverticulum present?

A

Usually before 2yrs of age

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13
Q

What is the most common cause of small bowel ischaemia?

A

Mesenteric atherosclerosis, thromboembolism

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14
Q

Increasing the time of ischaemia increases the depth of small bowel infarction. True/False?

A

True

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15
Q

List some complications of small bowel ischaemia

A

Scarring, fibrosis -> stricture
Gangrene
Perforation

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16
Q

Primary tumours of small bowel are commoner than secondary tumours. True/False?

A

False
Secondary tumours (metastases) are more common

17
Q

List 3 primary tumours of small bowel

A

Lymphoma
Carcinoid tumours
Carcinoma

18
Q

Which cells are lymphomas derived from?

A

B cells
T cells

19
Q

What is coeliac disease?

A

Abnormal reaction to gluten + wheat products resulting in enterocyte damage + reduced absorption

20
Q

Which serology is used to investigate coeliac disease?

A

Anti-TTG, anti-endomesial, anti-gliadin antibodies