Radpatho Midtermszx

Digestive System

alters the chemical and physical composition of food so that it can be absorbed and used by body cells.

Mastication (chewing)

mechanical breakdown of food.

Deglutition ( swallowing )

• is a complex process that requires coordination of head, neck and the precise opening/closing of esophageal sphincters.

Esophagus

• is a vertical tube about 10inches long. It extends to C6, inferior of pharynx to the stomach at the level of T11.

Stomach

is a large inflatable sac that is located in the left upper quadrant of the abdomen. It is the most dilated portion of digestive tract; it can hold almost 1.5 quarts (qt) of food and liquid.

Small Bowel

Extends from the pyloric sphincter to the cecum. It is called small bowel because it is short (measures 18-23 feet) but because its lumen is smaller than the large bowel.

Large intestine

average 5-6 feet in length. It extends from cecum to anus.

Three division of small intestine

Duodenum, Jejunum, Ileum

Large intestine divide into?

Ascending colon, descending colon, transverse colon, sigmoid colon, rectum and anal canal

Esophageal atresia

refers to an absence in the continuity of the esophagus

Clinical manifestations of esophageal atresia

inability to swallow saliva or milk, aspiration during early feedings

Tracheosophageal Fistula

• Failure of a satisfactory esophageal lumen to develop completely separate from the trachea.

Gastroesophageal Reflux Disease

spectrum of disease that occurs when gastric acid refluxes from the stomach into the lower end of the esophagus 

Atresia

• This is the most common congenital anomaly of the esophagus. 

Barrett’s esophagus

normal squamous lining of the lower esophagus is destroyed and replaced by columnar epithelium similar to that of the stomach.

Adenocarcinoma

high susceptibility for development of malignancy in the columnar cell-lined portion. These tumors are almost always

Candida and Herpes virus

organisms most responsible for infectious esophagitis,

Appearance of candida infectious

Irregular cobblestone pattern with a marginal contour

Ingestion of corrosive agents

produces acute inflammatory changes in the esophagus

Esophageal Cancer

• is a relatively uncommon tumor that occurs within the esophagus of affected individuals.

Clinical manifestations of esophageal cancer

• Increasing dysphagia

• worsening reflux

• hoarseness and cough

Radiographic appearance esophageal cancer

• irregular wall

• 3 to 5 mm

Esophageal Diverticula

Are common lesions that either contain all layers of the wall

Zenker’s diverticula

esophageal diverticula found in the top area of the esophagus.

Mid-esophageal diverticula

• Pouches occur in the middle of the esophagus.

Ephiphrenic diverticula

• Pouches occur at the base of the esophagus.

Traction diverticula

An esophageal diverticulum known as a traction diverticulum occurs when there is an external force on the wall of the esophagus that creates the pouch.

Traction diverticula

This most commonly occurs in the middle area of the esophagus.

Pulsion diverticula

these pouches occur in the lower part of the esophagus

Pulsion diverticula

The sphincter is a ring made of muscle that helps connect the esophagus with the stomach.

Zenker’s diverticulum

caused by abnormal tightening of the upper esophageal sphincter between the lower pharynx (throat) and the upper esophagus

Zenker’s diverticulum

This is the most common type of esophageal diverticulum.

Esophageal varices

most commonly the result of increased pressure in the portal venous system

Cirrhosis

portal hypertension), which is in turn usually a result of

Two types of esophageal varices

Uphill esophageal varices and Down hill esophageal varices

Uphill esophageal varices

most common form, typically caused by portal hypertension,

Downhill esophageal varices

typically caused by superior vena cava obstruction,

Appearance of esophageal varices

Serpiginous or resembling a beads of rosary

Hiatal Hernia

occur in about half of the population over age 50 years.

Two types of Hiatal Hernia

• Sliding Hiatal Hernia

• Rolling Hernia

Achalasia

combined failure of peristalsis to pass food down the esophagus and failure of relaxation of the cardia.

Appearance of hiatal hernia

Rat tail or bird beak sign.

Mallory welss syndrome

refers to a tear or laceration of the mucous membrane, most commonly at the point where the esophagus and the stomach meet

Gastritis

Inflammation of the stomach

3 types of gastritis

Alcoholic, corrosive, phlegmonous

Alcoholic gastritis

may produce thickening of gastric folds, multiple superficial gastric erosions, or both.

Corrosive gastritis

the acute inflammatory reaction heals by fibrosis and scarring, which result in severe narrowing of the antrum and may cause gastric outlet obstruction.

Bacterial gastritis

inflammatory thickening of the gastric wall causes narrowing of the stomach that may mimic gastric cancer

Pyloric stenosis

occurs when the two muscular layers of the pylorus become hyperplastic and hypertrophic

IHPS means?

Infantile Hypertrophic Pyloric Stenosis

IHPS radiographic appearance

Doughnut or target sign

Peptic ulcer disease

Group of inflammatory processes involving the stomach and duodenum.

Doudenal ulcer

most common manifestation of peptic ulcer disease.

Duodenal Ulcer radiographic appearance

Cloverleaf deformity

Gastric Ulcer

occur on the lesser curvature of the stomach

Linitis Plastica

Diffuse infiltration of the stomach wall by cancer cells, causing thickening and loss of elasticity.

Polypoid mass

A protruding mass that can develop from the inner lining of the stomach

Linitis plastica

Leather bottle stomach

Polypoid mass

A large, lobulated filling defect within the stomach

Crohn’s disease

a chronic inflammatory disorder of unknown cause that most often involves the terminal area of the ileum but can affect any part of the GI tract.

String sign

Narrowing of the terminal ileum due to chronic inflammation and fibrosis.

Skip lession

Patchy areas of inflammation separated by normal bowel segments, seen on small bowel series.

Cobblestone appearance

Due to ulcerations and submucosal edema.

Fistulas

Abnormal connections between bowel loops or to adjacent structures, visible on contrast studies.

Adynamic ileus

Lack of intestinal peristalsis, resulting in a functional obstruction without a physical blockage.

Adynamic ileus

occurs to some extent in almost every patient who undergoes abdominal surgery.

Localized Ileus

refers to an isolated distended loop of small and large bowel (the sentinel loop), which is often associated with an adjacent acute inflammatory process

Clonic ileus

refers to selective or disproportionate gaseous distention of the large bowel without an obstruction

Mechanical ileus

Blockage caused by a physical obstruction, such as adhesions, hernias, or tumors.

Intussuspection

Is a condition where one segment of the intestine telescopes into an adjacent segment, leading to obstruction and compromised blood flow. In children, intussusception is most common in the region of the ileocecal valve.

Malabsorption Disorder

refers to a large number of conditions in which there is defective absorption of carbohydrates, proteins, and fats from the small bowel.