Small Bowel Disease Flashcards Preview

Y1 GASTROENTEROLOGY > Small Bowel Disease > Flashcards

Flashcards in Small Bowel Disease Deck (27)
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1
Q

What are some luminal causes of small bowel obstruction?

A

Gallstone ileus
Food
Bezoar (lump of hair)

2
Q

What is a gallstone ileus?

A

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

3
Q

What are some bowel wall causes of small bowel obstruction?

A
Tumours
Hernia
Volvulus
Crohn's disease
Radiation enteritis
4
Q

List some symptoms of small bowel obstruction

A
Colicky abdo pain
Absolute constipation (no flatus/burping)
Abdominal distention
Faeculent vomiting (ESP. SMALL BOWEL)
5
Q

What investigations are done for small bowel obstruction?

A

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

6
Q

Is surgery common for small bowel obstruction?

A

Not really as most settle with management

7
Q

Outline general treatment of small bowel obstruction

A

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

8
Q

When would surgery be done early for small bowel obstruction?

A

Strangulation
Perforation
Ischaemia
PREVENT DEAD GUTS

9
Q

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

A

True

Marginal artery of Drummond provides collateral supply

10
Q

What is the typical symptom of mesenteric ischaemia?

A

Cramping pain

Essentially “angina of the gut”

11
Q

What is the first-line treatment for mesenteric ischaemia?

A

Surgery!
No faffing around
PREVENT DEAD GUTS

12
Q

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

A

Resected (up to a limit)

13
Q

Where does Meckel’s diverticulum occur?

How does it arise?

A

60cm from ileocaecal valve

Remnant of vitello-intestinal duct from development

14
Q

When does Meckel’s diverticulum present?

A

Usually before 2yrs of age

15
Q

What is the most common cause of small bowel ischaemia?

A

Mesenteric atherosclerosis, thromboembolism

16
Q

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

A

Mucosa

It is the most metabolically active part

17
Q

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

A

True

18
Q

List some complications of small bowel ischaemia

A

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

19
Q

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

A
False
Secondary tumours (metastases) are more common
20
Q

List 3 primary tumours of small bowel

A

Lymphoma
Carcinoid tumours
Carcinoma

21
Q

Which cells are lymphomas derived from?

A

B cells

T cells

22
Q

What is coeliac disease?

A

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

23
Q

What is the characteristic histological appearance of coeliac disease?

A

Villous atrophy

Flat mucosal biopsy

24
Q

Which serology is used to investigate coeliac disease?

A

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

25
Q

What is adynamic bowel obstruction?

A

Bowel doesn’t peristalise (no obstruction)
Paralytic ileus - usually from surgery
Pseudoobstruction - in acutely unwell patients

26
Q

What are the symptoms of coeliac disease?

A
Weight loss and reduced appetitie
Mouth ulcers
Abdominal pain and bloating
Dermatitis herpetiforms
Steatorrhoea (malabsorption)
Anaemia
Vitamin deficiences
27
Q

What are the complications of coeliac disease?

A

Malignancy
Malabsorption
Osteoporosis