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2010-07-14 #1.4
Small & Large bowel obstruction
| Question | Answer |
|---|---|
| MCC of SB obstruction: MCC? | adhesion; previous surgery |
| full-thickness inflammation of bowel wall > narrowing of lumen in terminal ileum: Dx? | Crohn's disease |
| associated with down syndrome; history of maternal polyhydramnios; vomiting of bile-stained fluid at birth: Dx? further characteristics? | duodenal atresia; distal to common bile duct; double bubble sign (air in sotmach & proximal duodenum) |
| underlying disease: chronic cholecystitis & cholelithiasis; air in biliary tree: Dx? pathogenesis? | gallstone ileus in elderly women; fistual between gallbladder & SB > stone into SB & lodges at ileocecal valve > obstruction |
| absence of ganglion cells in Meissner's submucosal plexus & Auerbach's myenteric plexus; X sympathetic neurons in aganglionic segment; constant contraction without relaxation = aperistalsis > obstruction: Dx? Ax? | hirschsprung's disease; chagas's > amastigotes > destruction of ganglion & down syndrome |
| Ax: down syndrome | hirschsprung's disease; duodenal atresia |
| chronic constipation without large stools of retentive encopresis in early life; absent stool on examining finger: Dx? | hirschsprung's disease |
| dilated portion of colon proximal to aganglionic segment, resulting in a 'transition zone': Dx? MC site? | hirschsprung's disease; distal sigmoid & rectum |
| 2nd MCC of SB obstruction | indirect inguinal hernia; bowel in inguinal canal |
| highest rate of bowel incarceration | femoral hernia |
| complication of newborn with CF; content lacking NaCl & obstructing the bowel lumen | meconium ileus |
| what is volvulus? | bowel twists around mesenteric root producing obstruction & "strangulation" |
| MC site of volvulus in elder, young adults | sigmoid colon (senile); cecum |
| MC risk factors for volvulus | chronic constipation |
| oblong mass palpated in midepigastrium (Dance's sign); rotavirus oral vaccine-related (Adenovirus); compromising blood supply: Dx? | intussusception; common in children; "telescoping" of 1 bowel segment into distal segment causing obstruction |
| risk factors for intrassusception in adults | polyp or cancer |
Created by:
mataos
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