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37 Cards in this Set

  • Front
  • Back
DDx GB Wall Thickening
Cholecystitis/Hepatitis
Cirrhosis/Portal HTN
CHF/Edema
Hypoprotinemia
Esophageal Ulcers DDx
Small
Big
Small
HSV
Candida
Glycogen Acanthosis (small plaques)
Viral in patients with immunocompromise

Big
HIV
CMV
Benign Ulcer signs
Hampton's Line - Thin lucent collar of normal mucosa resistant to edema

Projects beyond expected lumen

Folds (regular, smooth) radiate to ulcer edge

Location (suggestive not diagnostic)
Lesser curve - often B9
Malignant are most often antral
Pharyngeal tumors
Most common squamous cell (anterior - vallecula, pyriform sinuses, epiglottis)

Second lymphoma (posterior where the lymphoid tissue is)
Normal duodenal papilla size
1.5 cm
What causes...
Collar button ulcers?
Aphthi?
Long, fissuring ulcers?
Fistulae?
Collar button - Any colitis/inflammatory condition

Aphthi - Crohn's and infection

Long, fissuring ulcers - Crohn's

Fistulae - Crohn's dz, TB
Sprue associations
Decrease in jejunal folds (5/inch normal)

Jejunization of ileum (increase in folds)

Barium flocculation (more secretions in SB breaks up older barium suspensions)

Malapsorption (esp B12 def)

LAD - can be B9 or lymphoma

Intussusception
Gastric volvulus
Both occur with hiatal hernias

Organoaxial - Along LONG axis (greater curve above lesser curve)

Mesoaxial - Along Short axis
Ileocecal valve normal size
< 3 cm

Lipamtous infiltration
Cancer (lymphoma, ACA)
Lymphadenopathy and SB Dz
Whipples, Sprue, Crohn, Lymphoma, Mycobacterial Dz
SB Sacculations

Colon Sacculations
Antimesenteric
Broad
SB

Crohn
Sceroderma

Colon add Laxative abuse, ischemia
Small bowel diverticuli
Mesentric side (at vessel insertion)

Asymptomatic except for bacterial overgrowth (B12 deficiency)
Which gastric malignancies can cross the pylorus
Lymphoma > adenocarcinoma
Normal small bowel fold thickness

Diffuse thickening suggestive of what?
> 3mm

Edema/Hemorrhage
Stomach varilliform erosions
Linear aphthi

Gastritis (ASA, ETOH)
Crohn
Stress/burns/trauma
Toxic Megacolon
Transmural inflammation destruying ganglion cells in myenteric plexus -> Dilation of bowel and peritonitis

Trv colon often dilates since it is nondependent. > 8 cm worrisome.
SB Lymphoma location
Distal

Many forms (nodules, solitary mass, infiltrating, mesenteric mass), but most common is endoexenteric (aneurysmal dilation) due to infiltration and destruction of nerve plexus leading to dilation and mucosal irregularity.
Intramural tracking of barium
What is it?
DDx?
Barium tracking parallel to lumen intramurally.

DDx of 3:
Diverticulitis
Crohn
Malignancy
GI fistula etiologies
Malignancy
Crohn
Radiation
Surgery
Appendiceal tumors
MC is Carcinoid
Mucocele
Mucinous cystadenoma
Signs of free air on plain film
Rigler's sign - THIN bowel wall from air on both sides

Air outlines falciform

Free air under diaphragm

Football sign
Mucosal irregularity anterior rectum
Serosal mets (esp ovarian, gasric, pancreatic)

Inflammatory (TOA, appy, diverticulitis, endometriosis)
Splenic cysts
Calcified - Secondary (infection, hematoma, abscess) or parasitic

Non-calcified - Primary (rare - epithelial lined)
Ileal disease
Progressive narrowing - TB, Crohn

Backwash ileitis UC - terminal ileum dilates and is granular in setting of pancolitis

Yersinia - Normal caliber ileum

Amebiasis - does not affect terminal ileum
Bowel pneumatosis
Ischemia

Inflammatory (NEC, PMC, Crohn, infection)

CVDz - Sceroderma

Steroids

Obstruction, trauma, malignancy, chemo, idiopathic
Duodenal rounded filling defects
Small -
Heterotopic gastric mucosa (angulated/plaquelike margins, focal)
B9 lymphoid hyperplasia (1-2 mm, diffuse)

Larger -
Brunner's gland hyperplasia (up to 1 cm, cobblestone appearance)
Diffuse ahaustral colon
Colitis (esp UC - often granular appearance to mucosa, returns to normal after Tx, as opposed to Crohn which stays ahaustral from fibrosis)

Laxative abuse

Scleroderma
Colonic urticaria
Polygonal superficial lesions of colonic mucosa

Allergic conditions producing urticaria
Zoster
Yersinia
Diffuse gastric fold thickening
Infections/inflammatory - Gastritis (H pylori - look for ulcers)
Neoplasm - lymphoma > adenocaricnoma/mets
Infiltrative dz - Eosinophilic gastritis, sarcoid/amyloid
Varicies
Menetrie's Dz (dec gastric acid, protein losing enteropathy)
Zollinger-Ellison
Focal strictures
Crohn
Infection
Ischemia (cocaine, amphetamines)
Radiation
Neoplasm
Gastric polyps
Inflammatory/hyperplastic
Mets
Polyposis syndrome
Long segment esophageal stricture
Caustic ingestion (esp lye)
Esophageal pseudodiverticulosis
Dilated mucus glands
Associated with candida
Associated with strictures/inflammation
Barrett's
Proximal strictures
Distal plaques

Adenocarcinoma tends to cross GEJ but SCC often does not
Infectious cholangitis
HIV cholangitis (bacterial, CMV, cryptosporidiosis)

Parasites (ascariasis and clonorchis)
Varicies
Isolated gastric
Downhill
Isolated gastric - spelenic vein thromosis

Downhill - SVC obstruction (lung cancer, mediastinal fibrosis from radiation/histo, mets)
Coned cecum
Crohn, TB
Neoplasm (adenocarcinoma, lymphoma)
Yersinia
Amebiasis (spares terminal ileum)