Small Bowel Disease Flashcards Preview

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Flashcards in Small Bowel Disease Deck (25)
1

What are some luminal causes of small bowel obstruction?

Gallstone ileus
Food
Bezoar (lump of hair)

2

What is a gallstone ileus?

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

3

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

Cholecystoduodenal

4

What are some bowel wall causes of small bowel obstruction?

Tumours
Crohn's disease
Radiation enteritis

5

List some symptoms of small bowel obstruction

Colicky abdo pain
Absolute constipation (no flatus/burping)
Abdominal distention
Faeculent vomiting

6

What investigations are done for small bowel obstruction?

FBC, urinalysis, blood gases
AXR, contrast CT abdomen
Enema XR if necessary

7

Is surgery common for small bowel obstruction?

Not really as most settle with management

8

Outline general treatment of small bowel obstruction

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

9

When would surgery be done early for small bowel obstruction?

Strangulation
Perforation
Ischaemia
PREVENT DEAD GUTS

10

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

True
Marginal artery of Drummond provides collateral supply

11

What is the typical symptom of mesenteric ischaemia?

Cramping pain
Essentially "angina of the gut"

12

What is the first-line treatment for mesenteric ischaemia?

Surgery! No faffing around
PREVENT DEAD GUTS

13

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

Resected (up to a limit)

14

Where does Meckel's diverticulum occur?
How does it arise?

60cm from ileocaecal valve
Remnant of vitello-intestinal duct from development

15

When does Meckel's diverticulum present?

Usually before 2yrs of age

16

What is the most common cause of small bowel ischaemia?

Mesenteric atherosclerosis, thromboembolism

17

Which layer of the bowel is most sensitive to hypoxia? Why?

Mucosa
It is the most metabolically active part

18

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

True

19

List some complications of small bowel ischaemia

Resolution (if short-term ischaemia)
Scarring, fibrosis -> stricture
Gangrene
Perforation

20

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

False
Secondary tumours (metastases) are more common

21

List 3 primary tumours of small bowel

Lymphoma
Carcinoid tumours
Carcinoma

22

Which cells are lymphomas derived from?

B cells
T cells

23

What is coeliac disease?

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

24

What is the characteristic histological appearance of coeliac disease?

Villous atrophy
Flat mucosal biopsy

25

Which serology is used to investigate coeliac disease?

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