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What is an adhesion?
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- fibrous band of scar tissue that binds normally separated anatomical structures
- bowel may eventually become trapped beneath band, resulting in obstruction or infarction - most common cause of bowel obstruction |
What is appendicitis?
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- acute inflammation of appendix which could lead to perforation of wall and subsequent peritonitis
- commonmst acute abdominal condition requiring surgery - usually between 10 and 25 - usually lumen is obstructed by fecalith - mucus continues to be produced in obstructed appendix, leading to increase in pressure, compression of veins, ischemic injury - bacterial proliferation and ischemica increases inflammation - inflammation starts within mucosa and then ulceration occurs - inflammation spreads to involve entire wall (transmural acute inflammation) and purulent exudate forms on outer surface - wall becomes necrotic and appendix may perforate, spilling pus and fecal material into peritoneal cavity - pain first felt in umbilicus, and then moves to low right side |
What is Crohn's disease?
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- transmural inflammatory disease that affects principally small intestine (terminal ileum) and occasionally the colon
- segmental manner with "skip" areas - affects all lauers of wall and produces inflammation and scarring - granulomas present - early lesions are tiny ulcers and they eventually enlarge and become long, serpentine, and fissuring - bowel wall thickens, and narrowing of lumen (stenosis) - fissures lengthen to form sinuses leading to abscesses or fistulas to other bowel loops or other organs - episodes of diarrhea, pain, fever - overt or occult blood in stools, massive bleeding uncommon - anti-inflammatory agents, but cannot be cured by surgery |
What is a diverticulum?
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- pouch branching out from hollow organ or structure
- referred to as diverticulosis |
What is diverticulitis?
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- inflammation of diverticula which causes pain and stagnation of fecal matter
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What is a fistula?
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- abnormal duct or passage connecting abscess, cavity or hollow organ to body surface or to another hollow organ
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What is helicobacter pylori?
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- bacteria that appears as small curved rods found in surface mucosal layer of epithelial cells in people affected by peptic ulcer disease
- causes 80% of gastric ulcers and 90% of duodenal ulcers - acquired in early childhood by transmission from mother to child, remains in stomach for rest of life - identified in saliva, feces, vomit - always results in inflammation of stomach lining, but most people are asymptomatic and only 10-15% will develop an ulcer - ulceration due to increased gastric acid production - strain of organism and variety of host factors determine outcome of infection - infection diagnosed by antibody tests, endoscopic biopsies, breath test - |
What is hematemesis?
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- vomiting of blood
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What is a hernia?
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- protrusion of an organ or other structure through wall of cavity
- most commn in the groin, umbilicus, and old abdominal surgical scars - if a loop of small bowel enters hernia, it becomes obstructed or trapped (incarcerated) or infarcted (strangulated) due to compression of blood vessels |
What is IBD?
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- includes crohn's and ulcerative colitis
- inflammation of bowel - inheritable - unknown casual agent - peak onset of 15-35 - lifelong exacerbations and remissions, and problems involving liver, joints, skin, eye - due to unregulated and exaggerated immune response to gut microbes in genetically susceptible individuals - microbes trigger abnormal immune response - exaggerated immune response due to too much T cell activation and too little control by regulatory T cells |
What is intussusception?
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- when segment of small bowel becomes telescoped into immediately distal bowel
- peristalsis propels it further - causes obstruction and eventually infarction due to compression of blood supply - benign and malignant polyps are most common cause |
What is melena?
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- black blood in stool from stomach or duodenum
- black because it's acted upon by digestive enzymes |
What is occult bleeding?
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- blood in stools not visible to naked eye
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What is a peptic ulcer?
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- break in mucosal lining of GI tract produced by action of gastric secretions (acid and pepsin)
- usually in stomach and duodenum - result when mucosa is damaged leaving it susceptible to acid and pepsin - affect 10% of population - two major causes are helicobacter pylory and NSAIDs - more risk factors are smoking and genetic predisposition |
What is peritonitis?
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- inflammation of peritoneum (membrane lining walls of abdominal and pelvic cavities)
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