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37 Cards in this Set
- Front
- Back
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DDx GB Wall Thickening
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Cholecystitis/Hepatitis
Cirrhosis/Portal HTN CHF/Edema Hypoprotinemia |
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Esophageal Ulcers DDx
Small Big |
Small
HSV Candida Glycogen Acanthosis (small plaques) Viral in patients with immunocompromise Big HIV CMV |
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Benign Ulcer signs
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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 |
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Pharyngeal tumors
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Most common squamous cell (anterior - vallecula, pyriform sinuses, epiglottis)
Second lymphoma (posterior where the lymphoid tissue is) |
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Normal duodenal papilla size
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1.5 cm
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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 |
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Sprue associations
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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 |
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Gastric volvulus
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Both occur with hiatal hernias
Organoaxial - Along LONG axis (greater curve above lesser curve) Mesoaxial - Along Short axis |
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Ileocecal valve normal size
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< 3 cm
Lipamtous infiltration Cancer (lymphoma, ACA) |
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Lymphadenopathy and SB Dz
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Whipples, Sprue, Crohn, Lymphoma, Mycobacterial Dz
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SB Sacculations
Colon Sacculations |
Antimesenteric
Broad SB Crohn Sceroderma Colon add Laxative abuse, ischemia |
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Small bowel diverticuli
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Mesentric side (at vessel insertion)
Asymptomatic except for bacterial overgrowth (B12 deficiency) |
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Which gastric malignancies can cross the pylorus
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Lymphoma > adenocarcinoma
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Normal small bowel fold thickness
Diffuse thickening suggestive of what? |
> 3mm
Edema/Hemorrhage |
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Stomach varilliform erosions
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Linear aphthi
Gastritis (ASA, ETOH) Crohn Stress/burns/trauma |
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Toxic Megacolon
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Transmural inflammation destruying ganglion cells in myenteric plexus -> Dilation of bowel and peritonitis
Trv colon often dilates since it is nondependent. > 8 cm worrisome. |
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SB Lymphoma location
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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. |
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Intramural tracking of barium
What is it? DDx? |
Barium tracking parallel to lumen intramurally.
DDx of 3: Diverticulitis Crohn Malignancy |
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GI fistula etiologies
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Malignancy
Crohn Radiation Surgery |
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Appendiceal tumors
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MC is Carcinoid
Mucocele Mucinous cystadenoma |
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Signs of free air on plain film
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Rigler's sign - THIN bowel wall from air on both sides
Air outlines falciform Free air under diaphragm Football sign |
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Mucosal irregularity anterior rectum
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Serosal mets (esp ovarian, gasric, pancreatic)
Inflammatory (TOA, appy, diverticulitis, endometriosis) |
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Splenic cysts
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Calcified - Secondary (infection, hematoma, abscess) or parasitic
Non-calcified - Primary (rare - epithelial lined) |
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Ileal disease
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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 |
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Bowel pneumatosis
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Ischemia
Inflammatory (NEC, PMC, Crohn, infection) CVDz - Sceroderma Steroids Obstruction, trauma, malignancy, chemo, idiopathic |
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Duodenal rounded filling defects
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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) |
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Diffuse ahaustral colon
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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 |
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Colonic urticaria
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Polygonal superficial lesions of colonic mucosa
Allergic conditions producing urticaria Zoster Yersinia |
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Diffuse gastric fold thickening
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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 |
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Focal strictures
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Crohn
Infection Ischemia (cocaine, amphetamines) Radiation Neoplasm |
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Gastric polyps
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Inflammatory/hyperplastic
Mets Polyposis syndrome |
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Long segment esophageal stricture
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Caustic ingestion (esp lye)
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Esophageal pseudodiverticulosis
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Dilated mucus glands
Associated with candida Associated with strictures/inflammation |
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Barrett's
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Proximal strictures
Distal plaques Adenocarcinoma tends to cross GEJ but SCC often does not |
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Infectious cholangitis
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HIV cholangitis (bacterial, CMV, cryptosporidiosis)
Parasites (ascariasis and clonorchis) |
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Varicies
Isolated gastric Downhill |
Isolated gastric - spelenic vein thromosis
Downhill - SVC obstruction (lung cancer, mediastinal fibrosis from radiation/histo, mets) |
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Coned cecum
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Crohn, TB
Neoplasm (adenocarcinoma, lymphoma) Yersinia Amebiasis (spares terminal ileum) |
