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Abdomen (Subject) / Abdomen (Lesson)

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• Unresectable pancreatic cancer factors? Vascular encasement (SMA). Direct invasion of adjacent organs. Liver metastasis. Adenopathy. Ascites (peritoneal spread).
• Paraneoplastic condition in pancreatic adenocarcinoma? Trousseaus sign (spontaneous venous thrombosis).
• Normal size of duodenal papilla? Less than 1.5 cm.
• Perivaterian neoplasms? Carcinoma. Polyps. Leiomyoma. (Familial polyposis syndrome and associated Gardners syndrome)
• Two types of gastric volvulus? Organoaxial. Mesenteroaxial.
• Small bowel folds in Celiac disease and Scleroderma? Celiac: Jejunum decreased folds, ileum increased folds. Scleroderma: Increased folds throughout. 5 folds per inch is normal.
• Ileocecal valve upper limits of normal size? 3 cm, certainly abnormal if > 4 cm.
• Most common cause of enlarged ileocecal valve? Lipomatous infiltration.
• Diseases that can enlarged the ileocecal valve? Lipoma. Crohns disease. Lymphoma. Prolapsing ileal neoplasms.
• 2 conditions that can cause eccentric sacculations of the small bowel? Crohns disease. Scleroderma.
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• What vitamin deficiency may occur with small bowel diverticula? Vitamin B12 from bacterial overgrowth.
• Causes of toxic megacolon? Ulcerative colitis. Crohn disease. Infectious colitis (especially in AIDS). Ischemia. Pseudomembranous colitis.
• Which colon segment is most commonly involved in toxic megacolon?. Transverse colon (most non-dependent).
• What causes the colonic dilation in toxic megacolon? Transmural inflamation with destruction of ganglion cells (myenteric plexus).
• 3 causes of intramural tracking? Diverticulitis. Crohns disease. Malignancy.
• What disorders cause wide-mouth diverticula (pseudosacculations) in the colon? Scleroderma. Crohns disease. Ischemia.
• In what patient population does right-sided diverticulitis occur? Young adults. Asians.
• Main differential feature of diffuse esophageal spasms and presbyesophagus? Diffuse esophageal spasm presents with chest pain. Presbyesophagus is asymptomatic.
• Does emphysematous cholecystitis result in air in the biliary system outside of the gallbladder? No, because the cystic duct is obstructed.
• What tumors of the appendix can product pseudomyxoma peritonei? Mucocele. Mucinous cystadenoma. Myoglobulosis.
• What are the two categories of cecal volvulus? Axial torsion. Bascule (folding of cecum on right colon without significant twisting).
• What underlying condition do patients with emphysematous cholecystitis most likely have? Diabetes.
• What conditions can lead to superior mesenteric artery syndrome? Rapid weight loss. Immobilization. Wearing a body cast. Decreased peristalsis. Drugs.
• Whats the Bourne test? In suspected enterovesical fistula, urine is collected, spun, and radiographed for dectection of barium.
• Whats the difference between a fistula and a sinus tract? Fistula tract connects two mucosal lined structures. Sinus tract ends blindly or in a cavity without normal mucosa.
• What drug is associated with pneumatosis of the bowel? Steroids.
• What pulmonary and collagen vascular diseases can cause pneumatosis of the bowel? Scleroderma. SLE. Dermatomyositis. Asthma. COPD. CF.
• Factors that distinguish a pancreatic abscess from pseudocyst? Abscess (forms earlier after pancreatitis, days to weeks, high HU 20-50, may contain air).
• Gallstone ileus triad? Air in biliary system. Radiopaque stone. Bowel obstruction. All 3 present probably only 30% of the time.
• Causes of nodular filling defects in duodenal bulb and proximal duodenum? Heterotopic gastric mucosa. Benign lymphoid hyperplasia. Brunners gland hyperplasia (large nodules).
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• What conditions may result in loss of haustral folds? Most types of colitis. Laxative abuse. Scleroderma.
• Most common location in stomach for a malignant ulcer? Antrum (most common area for benign ulcers, too). Fundus ulcers, though uncommon, are more likely to be malignant.
• What liver lesion exhibitis cetripetal opacification? Hemangioma, peripheral to central enhancement over time.
• Spigelian, Richters, and Littres hernias? Spigelian: lower quadrant through semilunar line. Richters: only one wall of bowel involved. Littres: Meckels diverticulum hernia.
• Disorder that causes thyroid and breast abnormalities, hyperkeratosis, and harmartomas of the small bowel? Cowden disease. (ein pleomorphes, autosomal-dominant vererbtes Syndrom, das klinisch durch Hamartome aller drei Keimblätter in Erscheinung tritt. Ursache ist eine Mutation im PTEN-Gen)
• Features of Cronkhite-Canada syndrome? Weight loss. Anorexia. Alopecia. Multiple intestinal hamartomas.
• Cutaneous masses and small bowel tumors? Neurofibromatosis.
• What conditions may cause focal strictures of the small bowel? Crohns disease. Certain infections. Radiation therapy. Ischemia.
• What neoplasms of the stomach grow exophytically? Spindle cell tumors (GISTs, leiomyoma, leiomyosarcoma, leiomyoblastoma). Neurofibromas. Lymphomas.
• Bony abnormalities in patients with adenomatous polyposis syndrome? Osteomas. Cortical hyperostosis.
• Possible extraintestinal neoplasms of FAPS? Osteomas. Glioblastomas. Medulloblastomas. Thyroid carcinoma.
• Congenital condition that may cause diffuse bowel edema? Lymphangiectasia.
• Complications of Carolis disease (Type V Choledochal Cyst or communicating cavernous ectasia of the bile ducts)? Cholangitis. Fibrosis. Portal hypertension. Cholangiocarcinoma.
• Most common cause of portal hypertension and varices worldwide (parasite)? Shistosomiasis.
• Unusual variant of esophageal carcinoma that spreads submucosally producing thickened folds? Varicoid carcinoma of the esophagus.
• Most common internal hernia? Paraduodenal hernia.
• A left paraduodenal hernia extends through the fossa of? Landzert.
• A right paraduodenal hernia etends through the fossa of? Waldeyer.
• Paraduodenal hernia is due to a congenital defect in the? Transverse mesocolon.
• Causes of rectal varices (not internal hemorrhoids)? Portal hypertension. IVC obstruction. Severe abdominal adhesions.

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