Gastrointestinal System

Visceral peritoneum

Serous lining attached to the abdominal organs (inner layer)

Peritoneal peritoneum

Serous lining attached to the abdominal wall (outer layer)

Peritoneal cavity

Potential

space between

parietal & visceral

peritoneum

Mesentery

Double fold of parietal peritoneum, Attaches the

stomach, small

intestine, pancreas,

spleen, and other

organs to the

posterior wall of

the abdomen.

Lesser omentum

Fold of peritoneum,

attaches the liver to

the lesser curvature.

Greater omentum

Double fold of

peritoneum, attaches

to duodenum,

stomach, and

transverse colon.

Esophagus

1st part of the GI system

Esophagus

10 to 12 inches long and

extends from the posterior

pharynx to the stomach

LUQ

Stomach occupies which quadrant?

T10 to T11

Cardiac orifice is level of ...

Right of L1 to L2

Pyloric canal level

21 ft

How long is the small intestine?

Duodenum

Located between the stomach and the

middle part of the small intestine

(jejunum)

10-15 inches

How long is the duodenum?

Jejunum

The part of the small intestine

between the duodenum and

ileum

8 ft long

How long is the jejunum?

Ileum

Third portion of the

small intestine,

between the

jejunum and the

cecum

11.5 ft long

How long is the ileum?

6 ft

How long is the large bowel?

Ascites

Abnormal accumulation of fluid

in the peritoneal cavity of the

abdomen

Ascites

Abdominal dropsy

Baglike

ASKITES (Greek) meaning ...

General abdominal haziness

Radiographic appearance of Ascites

Transudate

Thin, low protein count and

low specific gravity (diluted)

Exudate

High protein count and

specific gravity (concentrated)

1. Hepatic Cirrhosis

2. Alcoholic Hepatitis

3. Heart Failure

4. Hypoproteinemia

5. Portal Vein Thrombosis

6. Peritoneal Dialysis

Causes of Transudative Ascites:

1. Peritoneal

Carcinomatosis

2. Pancreatitis

3. Abscess

4. Nephrotic Syndrome

5. Peritonitis

6. Bowel Obstruction

Causes of Exudative Ascites:

Pneumoperitoneum

Refers to the free air or gas

in the peritoneal cavity

Pneumoperitoneum

RA: Thin "crest-shaped"

radiolucency under dome of

the right hemidiaphragm on

erect

1. Double wall sign (Rigler's sign/bas-

relief sign)

2. Telltale triangle sign (Triangle

Sign)

Pneumoperitoneum, Bowel related signs:

1. Football sign

2. Falciform ligament sign

3. Lateral umbilical ligament sign

(Inverted "V" sign)

4. Urachus sign

Pneumoperitoneum, Peritoneal ligament related signs:

1. Lucent liver sign

2. Hepatic edge sign

3. Morison's pouch sign

4. Cupola sign

Pneumoperitoneum, Right upper quadrant signs:

Dynamic or mechanical bowel obstruction

A physical blockage of the

bowel that may be caused by

tumors, adhesions or hernia

Dynamic or mechanical bowel obstruction

RA: Circular staircase/Herringbone pattern

1. Fibrous disease

2. Crohn's disease

3. Intussusception

4. Volvulus

Types of dynamic obstruction:

Fibrous adhesions

Fibrous band of tissue

interrelates with the intestine

creating a blockage

Crohn's disease

Inflammation of the SI

Crohn's disease

RA: Distended loops of air-filled

small intestine

Intussusception

Telescoping of a section of a bowel into

another loop.

Terminal ileum

Intussusception is common in the ...

Intussusception

RA: coiled spring appearance

Volvulus

Twisting of a loop of intestine

Volvulus

RA: Large amount of air in sigmoid

with tapered narrowing at the

site

Volvulus

RA: coffee bean sign

Adynamic or nonmechanical bowel obstruction

cessation of peristalsis

Adynamic or paralytic Ileus

paralysis of intestinal motility

RA: Large amount of air in entire

dilated small and large intestine

with air-fluid levels.

Ulcerative colitis

- Chronic disease

- Inflammation of the

colon

Ulcerative colitis

RA:

Deep air-filled mucosal

protrusion of colon wall

Enteritis

• Inflammation of the

small intestine

• Caused by

contaminated food and

drinks

Enteritis

RA:

Thickening of the

mucosal folds and poor

definition of circular folds

Crohn's disease

RA:

Cobblestone

String sign (small bowel series)

Burill Bernard Crohn

Crohn's disease was discovered by ...

Giardiasis

✓ Caused by giardia lamblia

✓ "Beaver fever"

✓ Contaminated food and

water

Giardiasis

RA:

Dilation of intestine, with

thickening of circular folds

Neoplasm

New and abnormal growth

Sprue

✓ Malabsorption Syndrome

✓ Unable to process and absorb

certain nutrients

Sprue

RA:

Segmentation of the barium column,

flocculation (resembling tufts of

cotton), and edematous mucosal

changes