Comprehensive Radiographic Pathology: Chapter 5: Gastrointestinal System Flashcards

trachea

espohagus

an abnormal connection between two hollow spaces

inflammation

diverticulum, or blind pouch, extending from a hollow organ

veins that are enlarged or swollen

opening

referring to a protrusion of a tissue through the wall of the cavity in which it is normally contained

above

stomach

pylorus (opening between the stomach and duodenum)

narrow; contracted; constriction

digestion, digestive

Abnormal twisting of a portion of the gastrointestinal tract, usually the intestine, which can impair blood flow

Stone

bile, gall

enlargement

the serous membrane lining the cavity of the abdomen and covering the abdominal organs.

liver

urinary bladder, cyst, sac of fluid.

absence or abnormal narrowing of an opening or passage in the body.

inflammation of stomach lining caused by alcohol

inflammation of the stomach lining caused by bacterial infection

(nonerosive) refers to severe mucosal atrophy(wasting) that causes thinning and a relative absence of mucosal folds, with the fundus or entire stomach having a bald appearance.

gastric contents that have become mixed with hydrochloric acid and the proteolytic enzyme pepsin, resulting in a milky white product

selective or disproportionate gaseous distention of the large bowel without an obstruction

extra water is absorbed from the fecal Mass to produce a hardened stool

inflammation of the stomach caused by corrosive agents

swallowing

results from increased motility of the small bowel, which floods the colon with an excessive amount of water that cannot be completely absorbed

reduce the wdha syndrome

a substance that acts like soap by dispersing the fat into very small droplets that permit it to mix with water

outpouching found in the distal 10 cm of the esophagus

a tumor usually in the pancreas or duodenum (the first segment of the small intestine) that produces excessive levels of the hormone gastrin, which stimulates the stomach to secrete acid and enzymes, causing peptic ulcers.

excess glucose absorbed is stored as

inflammatory disease of the liver

inflammation of the stomach lining caused by microorganism

spreading into surrounding tissues

hormone secreting neoplasm most frequently in the tail of the pancreas, usually benign

isolated distended loop of small or large bowel

subsequent inflammation of the distal esophagus due to laceration associated with bleeding and mediastinal penetration caused by severe retching and vomiting

chewing

an inflammatory process in which protein and lipid digesting enzymes become activated within the pancreas and begin to digest the organ itself

worm-like movement by which the alimentary canal or other tubular organ propels its contents

resembling a polyp

also known as infantile hypertrophic pyloric stenosis, occurs when two muscular layers of the pylorus become hyperplastic and hypertrophic

process of placing tension between two structures

destruction of tissue creating an opening within a structure

tumor found in pancreas and duodenum that is associated with peptic ulcers

finger-like projections of the small bowel to increase the inner surface area

outpouching that arises from the posterior wall of the upper esophagus

• Secretions of the endocrine and exocrine glands
• Controlled movement of ingested food through the
  tract so absorption can occur

Basic function of the gastrointestinal system is to alter the chemical and physical composition of food so it can be absorbed and used by body cells.

duodenum

emulsifier; it is essential for the digestion and absorption of dietary fat and fat-soluble vitamins

liver

• Bile production and excretion
• Excretion of bilirubin, cholesterol, hormones, and drugs
• Metabolism of fats, proteins, and carbohydrates
• Enzyme activation
• Storage of glycogen, vitamins, and minerals
• Synthesis of plasma proteins, such as albumin, and clotting factors
• Blood detoxification and purification

pear-shaped sac that lies on the undersurface of the liver

to store bile that enters by way of the hepatic and cystic ducks in to concentrate the Bayou by absorbing water. in response to the presence of dietary fat in the small bowel, the gallbladder contracts and ejects the concentrated bile into the duodenum.

the pancreas controls the level of circulating blood glucose by secreting insulin and glucagon in the islets of langerhans... necessary for the breakdown of proteins, carbohydrates, and fats.

result from the failure of the esophageal lumen to develop completely separate from the trachea

Type III

caused by cancer (50%), infection, trauma, instrumentation perforation

Aspiration Pneumonia

The lack of the development of the esophageal lumen resulting in a blind pouch

Acute form of esophagitis is most commonly the result of reflux of stomach contents into distal esophagus.

GERD – gastroesophageal reflux disease

Chronic esophagitis may result in strictures or Barrett’s esophagus.

patients with sliding Hiatal hernias

a condition related to severe reflux esophagitis in which the normal squamous lining of the lower esophagus is destroyed and replaced by columnar epithelium similar to that of the stomach

• Herpes virus
• Candida

Produces acute inflammatory changes in the esophagus

results in only minimal ulceration

Deeper penetration of the submucosa and muscular layers causes sloughing of destroyed tissue and deep ulceration

Most are squamous cell type

Most common site is esophagogastric junction

Associated with excessive alcohol intake and smoking

Dysphagia(difficulty swallowing) occurs late in the disease

double-contrast barium swallow

CT

Outpouchings of the esophageal wall

Involve all layers of the wall

Composed of only mucosa and submucosa herniating through the muscular layer

Arises from the posterior wall of the cervical esophagus

arises in the distal 10 cm of the esophagus

Dilated veins in the distal esophagus

Caused by portal hypertension

cirrhosis

may hemorrhage

Best shown on a double contrast barium
swallow

Protrusion of a portion of the stomach into the thoracic cavity through the esophageal hiatus in the diaphragm

Commonly causes GERD

Most common abnormality found on UGI

Functional obstruction of the distal esophagus with proximal dilation

Caused by incomplete relaxation of the lower
esophageal sphincter

radiopaque or radiolucent.

Radiopaque is often seen without the aid of contrast.

Radiolucent is best seen with the aid of barium swallow.

Two projections 90 degrees from each other required to truly determine where the object is lodged in esophagus.

• Esophagitis
• Peptic ulcer
• Neoplasm
• External trauma
• Instrumentation

Some perforations may result from severe vomiting (the most common cause) or coughing, often from dietary or alcoholic indiscretion.

is defined as inflammation of the stomach mucosa.

• Alcohol
• Corrosive agents
• Infection

Helicobacter pylori can cause chronic gastritis that may lead to peptic ulcer disease.

It changes the normal surface pattern of the gastric mucosa.

infantile hypertrophic pyloric stenosis (IHPS).

Causes are thought to be a combination of environmental and hereditary factors.

• Lengthening of the gastric antrum and pyloric
  canal
• Edematous and thickened mucosa

hyperplastic and hypertrophic

obstruction (incomplete or complete), preventing food from entering into the duodenum.

ultrasound

is often described as a mobile hard "olive."

is a group of inflammatory processes involving the stomach and duodenum

by the action of acid and the enzyme pepsin secreted by the stomach.

Most common location is the lesser curvature.

Disease spectrum varies from small and shallow superficial erosions to huge ulcers that may perforate.

• Hemorrhage
• Gastric outlet obstruction
• Perforation

most common cause of acute upper gastrointestinal bleeding

Duodenal ulcer is the most common manifestation

majority occur in the duodenal bulb

the United States.

It is prevalent in Japan, Chile, and parts of Eastern Europe.

Pain is not an early symptom, so diagnosis usually occurs late stage.

Most occur in the distal stomach.

Prognosis is poor – staged by CT.

-Atrophic gastric mucosa, as in pernicious anemia
-10 to 20 years after a partial gastrectomy for
peptic ulcer disease.

Lymphoma is a malignancy of the of the lymphoreticular system

often is seen as a large, bulky polypoid mass, usually irregular and ulcerated.

It may be indistinguishable from a carcinoma.

is an idiopathic, chronic, inflammatory disorder.

It most often involves the terminal area of the ileum. It can affect any part of the GI tract.

Cause is unknown, but stress or emotional upsets are frequently related to the onset or relapse of the disease.

Most often caused by fibrous adhesions from
previous surgery
Second most common cause is hernias

also termed paralytic ileus, It is a common disorder of intestinal motor activity. Fluid and gas do not progress normally through a nonobstructed small and large bowel.

Neural, hormonal, and metabolic factors can trigger reflexes that impede intestinal motility.

It occurs in almost every patient who undergoes abdominal surgery.

• Peritonitis
• Medications that decrease intestinal peristalsis
  (those with an atropine-like effect),
• Electrolyte and metabolic disorders
• Trauma

Intussusception is the telescoping of one part of the intestinal tract into another because of peristalsis. It forces the proximal segment of bowel to move distally within the outer portion.

This is a major cause of obstruction in children.

refers to a multitude of conditions in which there is defective absorption of carbohydrates, proteins, and fats from the small bowel.

steatorrhea—the passage of bulky, foul-smelling, high-fat-content stools that float.

is the inflammation of the appendix.

Obstruction of fluid flow by fecalith or scarring

• Gangrene
• Abscess
• Perforation

Appendicitis is more common in children.

CT

is outpouchings that are acquired herniations of mucosa and submucosa through the muscular layers at points of weakness in the bowel wall.

Incidence increases with age

It occurs most commonly in the sigmoid portion.

defined as necrosing inflammation in the diverticula.

Diverticulitis is a complication of diverticulosis.

• Perforation
• Abscess
• Fistulas to adjacent organs

Ulcerative colitis is an idiopathic inflammatory disease of the bowel.
It may have an autoimmune or psychogenic factor (stress exacerbates condition). A characteristic feature is alternating periods of remission and relapse.

is the second major cause of inflammatory bowel disease. It is identical to Crohn’s disease in the small bowel.

It most commonly affects the proximal colon. Most also have disease of the terminal ileum. Rarely affects the rectum.

Ischemic colitis is characterized by the abrupt onset of lower abdominal pain and rectal bleeding.

Diarrhea is common. It is often accompanied by abdominal tenderness.

It is most common in those over 50 years old.

Most have a history of cardiovascular disease.

refers to several conditions that have an alteration in intestinal motility as the underlying pathophysiologic abnormality.

are alternating periods of constipation and diarrhea.

cancer of the colon

Most typical primary colon cancer is annular.

Peak age incidence is 50 to 70 years old.

It is twice as common in men

• Long-term ulcerative colitis
• Familial polyposis

About 70% of large bowel obstructions result from primary colonic carcinoma.

Diverticulitis and volvulus account for most other cases.

It is usually less acute than small bowel obstructions.
Symptoms develop more slowly.
Fewer fluid and electrolyte disturbances are produced.

Volvulus of the colon refers to a twisting of the bowel on itself. May cause obstruction.

Cecum
Sigmoid

Hemorrhoids are varicose veins of the distal
rectum. Symptoms include pain, itching, and bleeding.

Caused by increased venous pressure, such as with:

• Constipation
• Pelvic tumor
• Pregnancy

• Cholesterol – predominant type in the United States.
• Pigment

• Family history
• Over age 40
• Overweight
• Female

ultrasound

is acute inflammation of the gallbladder.

It is usually caused by cystic duct obstruction by a gallstone.

Emphysematous cholecystitis is a rare condition that occurs when stasis, ischemia, and cystic duct obstruction (stones) allow the growth of gas-forming organisms in the gallbladder.

It occurs most commonly in elderly men and in patients with poorly controlled diabetes mellitus.

refers to calcification of the gallbladder walls. It is caused by chronic cholecystitis. Walls become fibrous, then calcified.

hepatitis

• Viral infection
• Reaction to drugs and toxins

• Hepatitis A virus (HAV)
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
• Hepatitis E virus (HEV)

It is transmitted through contaminated blood and blood products and sexual contact.
Vaccine is available and often required for employment.

Cirrhosis refers to the chronic destruction of liver cells and structure, with nodular regeneration of liver parenchyma and fibrosis. It is an end-stage liver disease.

The major cause is chronic alcoholism (i.e., 10 to 20 years of alcohol abuse).

• Postnecrotic viral hepatitis
• Hepatotoxic drugs and chemicals
• Biliary cirrhosis
• Hemochromatosis

Most characteristic symptom or complication– ascites
Fluid accumulation in the abdomen Incurable and irreversible

in normal individuals, the liver always appears brighter than the spleen, whereas in patients with cirrhosis of the liver is much darker because of the amount of fat. The portal veins appear as high-density structures surrounded by a background of low-density caused by hepatic fat; this is the opposite of a normal pattern of the portal veins, which are low-density channels on non-contrast scans.

is primary liver cell cancer. It is most common in those with cirrhosis.

CT

is the most common malignancy of the liver. Prognosis is very poor

• CT
• US
• MRI
• NM

is an inflammatory process in which protein- and lipid-digesting enzymes become activated within the pancreas and begin to digest the organ itself.

Excessive alcohol consumption

Gallstones obstructing bile flow

results when frequent injury to the pancreas causes scar tissue.

Recurring episodes usually result from chronic alcohol abuse. It causes the gland to lose its ability to produce digestive enzymes, insulin, and glucagon.

• Pain
• Malabsorption causing weight loss
• Diabetes

is defined as walled-off fluid collections.

occur due to inflammation, necrosis, or hemorrhage.

• Acute pancreatitis
• Trauma

Most common type of cancer of the pancreas is adenocarcinoma.

• Usually advanced at time of diagnosis.
• Prognosis is poor.

Most common site is the head of the pancreas.

CT

is defined as free air in the peritoneal cavity.

• Perforation of a gas-containing viscus (surgical
  emergency)
• Abdominal, gynecologic, intrathoracic, or
  iatrogenic causes (does not require operative
  intervention)

is enlargement of the spleen.

• Infections (subacute bacterial endocarditis,
  tuberculosis, infectious mononucleosis, malaria)
• Connective tissue disorders
• Neoplastic hematologic disorders (lymphoma,
  leukemia)
• Hemolytic anemia
• Hemoglobinopathies
• Portal hypertension (cirrhosis)

Most common cause of splenic rupture is trauma. Rapid blood loss usually requires immediate surgery.

may be a complication of the palpation of a spleen enlarged by infection (especially infectious mononucleosis) or leukemia.