1 Name three mechanisms of bowel obstruction, and give examples and incidence of each type a. Extrinsic compression: Adhesions (60%), malignancy (20%), hernias (10%), volvulus and others (5%). b. Internal blockage of the lumen by abnormal materials (obturation): Bezoars, gallstones,…
1 What is peptic ulcer disease (PUD)? PUD includes gastric and duodenal mucosal defects (ulcerations) extending to the muscularis mucosa. 2 What is the incidence of PUD? The lifetime risk for PUD is about 8%–14%. It usually occurs between ages…
1 What are the presenting signs and symptoms of esophageal cancer? Presenting symptoms most commonly include progressive dysphagia and weight loss. Notably, a tumor can obstruct over half of the esophageal lumen before dysphagia becomes symptomatic. Symptoms common to gastroesophageal…
1 What is the most common cause of gastroesophageal reflux disease (GERD)? Pregnancy. And, it’s not the bowling ball in the abdomen; it’s the estrogen and progesterone that relax the lower esophageal sphincter (LES). 2 What symptoms suggest GERD? Substernal…
1 Describe the common causes of upper gastrointestinal bleeding (UGIB) in US populations Peptic ulcer disease is the number one cause of UGIB in the United States. The gram-negative bacteria Helicobacter pylori plays a significant role in the pathogenesis for…
1 What is chronic pancreatitis? The classic description is a prodrome of smoldering abdominal pain and eventual pancreatic insufficiency. Histologically, chronic fibroinflammatory processes result in destruction of the functioning endocrine and exocrine pancreatic cells. 2 What is the most common…
1 What are the common causes and incidence of acute pancreatitis? Gallstones (40%–70%), alcohol (25%–35%), idiopathic (10%), and other (<5%). The incidence of acute pancreatitis is estimated 13–45 per 100,000 people, making it the second highest cause of total hospital…
1 What is the magnitude of the problem? For the year 2016, there were an estimated 53,000 new cases of pancreatic cancer in the United States, and more than 41,790 deaths, making this arguably one of the most lethal tumors.…
1 What is the prevalence of gallstones in Western society for women and men 60 years of age? Women, 50%; men, 15%, although there is formidable ethnic predilection with gallstones endemic in American Indians. 2 What is the difference between…
1 What is the classic presentation of acute appendicitis? Periumbilical pain that migrates to the right lower quadrant (RLQ) in a patient who is anorexic. Associated symptoms include nausea, vomiting, and bowel changes. 2 What is the pathophysiology of appendicitis?…