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84 Cards in this Set
- Front
- Back
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Where are zenkers diverticulum locateed
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90% are left sided at killians triangle
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What is the clinical features of zenkers diverticulum
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dysphagia
regurgitation halitosis |
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What is a pt complication of zenkers diverticulum
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may lead to aspiration
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What is feline esophagus look like
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multiple thin horizontal folds in esophagus
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What are 3 causes of feline esophagus
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normal variant (MC)
reflux scleroderma |
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What is the cause of a pulmonary sling
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aberrant left pulmonary artery
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What part of the esophagus is indented with a pulmonary sling
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anterior esophagus (posterior to the trachea)
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What are the clinical features of pulmonary artery sling
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respiratory difficulty
dysphagia (rare) |
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What is the treatment for a pulmonary sling
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surgical
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What is the MCC of a posterior indetation of the esophagus
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abberant left subclavian (usually asymptomatic)
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Where does the aberrant right sublavian artery travel
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posterior to the esophagus
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What is called when a aberrant right subclavian has a dilated insertion into the aorta
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diverticulum of kommerell
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If there is an clinical findings in a pt with an abberant right sublvaian what will it be
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dysphagia
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What are 3 common causes of esophageal stricture
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esophageal cancer
peptic stricture corrosive ingestion |
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What are the diverticulum at the bottom of the esophagus called
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epiphrenic diverticulum
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What are 2 causes of epiphrenic diverticulum
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pulsion (mc)
traction (rare) |
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What is the cause of a pulsion diverticulum
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motility problem of the esophagus
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What is cause of a traction diverticulum
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Acquired condition due to subcarinal or perihilar granulomatous lymph node pathology and adherence to the esophagus and pulling out
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What is the tx of a pulsion diverticulum
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excision and myotomy to address the motility problem
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What are the classic cxr findings of achalasia
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esophagus dilated
absent stomach bubble |
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What is the name of the narrowing of the distal esophagus in achalasia
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birds beak
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What happens to the motility in a patient with achalasia
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disordered
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What does the large size of the esophagus tell if you suspect achalasia
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it is highly unlkely to be malignant bc it is so dilated
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What is in the ddx for achalasia
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colonic interposition which is a procedure used to tx esophageal cancer (not used often)
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What is the appearance of scleroderma
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dilated esophagus
wide open GEJ with free relux poorly motile or amotile (as opposed to dysmotile of achalasia) |
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What are the common causes of esophagitis
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reflux
corrosive ingestion candida herpes |
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What is the appearance of in esophagitis
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ragged
discrete ulcers |
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What should be considered in a pt with acute dysphagia with obstructing filling defect
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food bolus impaction
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What is the treatment of a food bolus impaction
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effervescent agents and or muscle relaxants
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What is diffuse esophageal spasm
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motility problem caused by spastic contractions
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What are the clinical findings in DES
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dysphagia
regurgitation CP |
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What is the gold standard of dx and treatment for DES
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manometry and tx is medical
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What does DES look like
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a corkscrew
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What is the ddx of linitis plastica
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infiltrative gastric cancer
mets corrosive ingestion lymphoma sarcoid |
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What are the radiographic features of linitus plastica
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diffuse narrowing of the stomach
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What is the measurement for thickened gastric folds
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1cm
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What is the ddx for thickened gastric folds
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inflammation
infiltration menetriers varices |
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Where do varices tend to occur in the stomach
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fundus
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What is menetriers disease
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hypoproteinemia
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What is the ddx of filling defects in the stomach
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mets
polyps varices pancreatic rest |
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Describe the findings of varices
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single umbilicated and located at the inferior antrum
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What are common cancers that metastasis to the stomach
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lung
breast melanoma renal cell |
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What are the findings of a duodenal ulcer
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round pools
edematous ring radiating folds scarred and spastic duodenu |
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Do duodenal ulcers perforate
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yes
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What is chilaiditis syndrome
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interpostion of the colon between the liver and the right diaphragm that may mimic free air
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What is riglers sign (seen in supine abdomen)
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air on both sides of the bowel wall
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What is a cause of a false riglers sign
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two opposed bowel loops
fat adjacent to bowel |
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What is the left lateral decubitus commmonly used for
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suspected perforation
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What is the best test to look for free air
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CT
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If a patient is given contrast and has a perforation does it always lead out
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only 73% of the time
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What is the 1st sign of crohns disease
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transmural inflammation which causes aphthous ulcers and may eventually lead to cobblestoning
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What are the radiographic findings of crohns disease
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uclers
cobblestones string sign fisulae |
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Does small bowel diverticulosis exist
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yes
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What does small bowel diverticulosis look like
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multiple outpouchings on the mesenteric border of the small bowel
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What is the percentage of involvement of scleroderma in the esophagus, anorectum, small bowel, and colon
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esophagus-75-90
anorectum-50-70 SB-40 colon-10-50 |
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What r findings of scleroderma of the sb
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dilated atonic bowel
sacculations |
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What are the clinical associations of nodular lymphoid hyperplasia
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idiopathic
hypogammaglobulinemia lymphoma giardiasis |
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What is the classic appearance of nodular lymphoid hyperplasia
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diffuse tiny nodules in the TI
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What is the ddx of small bowel filling defects
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nodular lymphoid hyperplasia
crohns whipples mastocytosis waldenstroms lymphoma polyposis syndromes |
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Name 4 general causes of small bowel wall thickening
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edema
hematoma crohns radiation |
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What is the saw-tooth or stack of coins indicative of
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small bowel wall thickening
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What are the radiographic sb findings of graft versus host disease
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thickened small bowel that is featureless "ribbon" like
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What disease is ileal jejunal reversal associated with
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celiacs
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Does celiacs cause sb dilation
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yes
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What is the chance that a 10mm polyp is malignant
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5%
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What percent of applecore lesions occur in the rectosigmoid
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70%
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Is a cecal volvulus a surgical emergency
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yes (closed loop)
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What is the classic findings of cecal volvulus
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LUQ bean shaped loop
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What is better for determing if a pt has a cecal volvulus; ct or water contrast enema
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enema (look for beak)
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What is the typical age group of a cecal volvulus
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30s
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What age group gets sigmoid volvulus
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elderly person who is typically on laxatives
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What is the cause of a sigmoid volvulus
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long redundant volvulus
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What are the findings of a sigmoid volvulus
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dilated inverted U shape loop with apex in LUQ
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Where is the inferior convergence of a sigmoid volvulus
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to the left of s1
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do both cecal and sigmoid volvulus have the apex in the LUQ
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yes
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Is the ahaustral margin inside or outside in a sigmoid volvulus
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outer margin
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What is more common a sigmoid or a cecal volvulus
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sigmoid
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Orgin on the left side of the pelvis
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sigmoid volvulus
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What is the tx of sigmoid volvulus
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non-strangulated-tube deflation and elective resection
strangulated-emergency resection |
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What are the clinical associations of cystic pneuamatosis coli
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asymptomatic
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Describe the associations of cystic pneumatosis coli
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copd
peptic ulcers pyloric stenosis intestinal bypass transplant sxr |
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What are the radiographics of cystic pneumatosis coli
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grape like clusters in the colon
small intramural gas filled cyst multiple polyp like defects on BE |
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What are the radiographic findings of ischemic pneumotosis
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linear non cystic air
PV gas |
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What are the findings of UC
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pseudopolyps
filiform polyps (from erosion of diseased mucosa) thumbprinting leadpipe colon toxic megacolon lead pipe colon |
