1 What are the mechanical causes of large bowel obstruction (LBO)? The most common mechanical causes are carcinoma (50%), volvulus (15%), adhesions (15%), and diverticular disease (10%). Extrinsic compression from metastatic carcinoma or noncolonic neoplasms is another cause of obstruction.…
1 What is a colonic diverticulum? A protrusion of mucosa and submucosa through the muscular layers of the bowel wall. It has no muscular covering. Because these diverticula do not involve all layers of the bowel wall, they are really…
1 What is the arterial supply to the gut? The foregut (stomach and duodenum) receives its blood supply from the celiac artery, the midgut (jejunum to the proximal descending colon) from the superior mesenteric artery (SMA), and the hindgut (the…
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…