GASTROINTESTINAL SYSTEM

• Gastrointestinal System Menu


  • Zenker's Diverticulum
  • Traction Diverticulum
  • Epiphrenic Diverticulum
  • Hiatal Hernia
  • Gastroesophageal Reflux Disease
  • Achalasia
  • Esophageal Varices
  • Esophagus Cancer
  • Candida
  • Peptic Ulcers
  • Gastric Carcinoma
  • Bezoar
  • Bowel Obstruction
  • Hernia
  • Bowel Adhesion
• Zenker's Diverticulum


  An outpouching that occurs due to a weakening in the lining of the digestive system, not to be confused with a neoplasm, often diagnosed with barium studies, arise from the posterior wall of the upper esophagus in the area of the pharynx, often asymptomatic but can cause dysphagia and halitosis
• Zenker's Diverticulum


  • Barium swallow study clearly depicts an outpouching of the posterior aspect of the upper esophagus
• Traction Diverticulum


  This type of diverticulum forms in the mid esophagus area, may form due to scarring from pulmonary tuberculosis or an inflammatory process within the mediastinum
• Epiphrenic Diverticulum


  Arises in the distal esophagus just superior to the lower esophageal sphincter, may form as a complication to achalasia
• Epiphrenic Diverticulum


  • Diverticula located within the distal 10 cm of the esophagus
• Hiatal Hernia


  Occurs when a portion of the stomach protrudes (herniates) into the thorax through the esophageal opening in the diaphragm, sliding hiatal hernia is the most common type, rolling or paraesophageal hiatal hernia is very rare
• Sliding Hiatal Hernia


  • Portion of the stomach (fundus) has herniated through the esophageal opening in the diaphragm
• Paraesophageal Hiatal Hernia


  • Portion of the stomach has herniated into the thorax while the esophagus and lower esophageal sphincter remain in place
• Gastroesophageal Reflux Disease (GERD)


  Characterized by a backward flow of gastric contents into the esophagus due to an incompetent lower esophageal sphincter, commonly associated with a hiatal hernia, acquired by poor eating habits, obesity, pregnancy, NG tubes, alcohol abuse, tobacco, and as a side effect of morphine
• Gastroesophageal Reflux Disease (GERD)


  • Barium refluxing from the stomach back into the esophagus
• Achalasia


  Esophageal motility disorder caused by the inability of the lower esophageal sphincter to relax, results in the esophagus filling with ingested food and fluids, treated with a bland diet, medication to relax the LES, surgery, and an upright position to reduce regurgitation
• Achalasia


  • Entire length of the esophagus filled with barium due to a nonfunctional lower esophageal sphincter
• Esophageal Varices


  Dilated, tortuous veins of the esophagus which may rupture, commonly a result of portal hypertension and/or liver cirrhosis, often a complication of alcoholism
• Esophageal Varices


  • Tortuous varicose veins of the esophagus
• Esophagus Cancer


  Represents 2% of all cancers, high incidence in smokers and alcoholics, very poor prognosis with a 5 year survival rate of 25%, presents with a "ratty" radiographic appearance on a barium swallow, treated with chemotherapy, radiation therapy, and esophagogastrectomy
• Esophagus Cancer


  • Stenosis of the esophagus with the distal portion having the classic "apple-core" appearance of an adenocarcinoma
• Candida


  A fungus that has affected the esophagus, sometimes referred to as thrush, an opportunistic infection often found in HIV positive and cancer patients due to a suppressed immune system
• Candida


  • Overgrowth of the fungus Candida within the body
• Peptic Ulcer Disease (PUD)


  A general term used to describe ulcers of the stomach and duodenum, usually a chronic disease caused by the use of aspirin, steroids, spicy foods, stress, and bacterial infection, complications include obstruction, perforation, and bleeding, treated with a bland diet, antacids, decreased stress, surgery, antibiotics, and abstinence from smoking, alcohol, and aspirin
• Peptic Ulcer Disease: Duodenal


  • Duodenal ulcer located within the duodenal bulb, more common than gastric ulcers and usually not associated with cancer
• Peptic Ulcer Disease: Gastric


  • Gastric ulcer, it is imperative to determine the etiology to ensure it was not caused by stomach cancer, a biopsy will be performed to rule this out
• Gastric Carcinoma


  Generally asymptomatic in the early stages and has generally metastasized by the time it is diagnosed, resulting in a poor prognosis, UGI studies present thick, irregular, and rigid (linitis plastica) folds, treated with gastrectomy, chemotherapy, and radiation therapy
• Gastric Carcinoma


  • UGI radiograph showing the classic "apple-core" appearance characteristic of an adenocarcinoma
• Bezoar


  A hard mass of entangled material found within the stomach or intestines that cannot be digested, often made of hair and food fibers
• Bezoar


  • Radiograph showing a large mass of entangled materials that cannot be digested
• Bowel Obstruction


  Two broad categories: adynamic or paralytic ileus and mechanical bowel obstruction, results in a partial or complete loss of normal peristaltic action, signs and symptoms include abdominal pain/cramping, distention, vomiting, and constipation
• Adynamic or Paralytic Ileus

  Caused by a reduction in normal peristaltic action, results in the lumen of both small and large intestines filling with air and fluid, common causes include anesthesia, abdominal surgery, and illness
• Adynamic or Paralytic Ileus


  • Dilated loops of small bowel indicating a small bowel obstruction, likely caused by a combination of anesthesia exposure and abdominal surgery
• Mechanical Bowel Obstruction


  Caused by a motility disorder resulting from a structural abnormality, can be caused by hernia, adhesions, volvulus, intussusception, neoplasm, Crohn's disease, or constipation
• Hernia


  • Weakening of the abdominal wall allowing a portion of the small and/or large intestine to protrude through, a reducible hernia can be pushed back in while an incarcerated hernia cannot and can lead to a bowel obstruction, a common hernia in men is an inguinal hernia where the bowel protrudes through the inguinal ring
• Bowel Adhesion


  Bands of fibrous connective tissue that can cause a mechanical bowel obstruction
• Adhesions


  Bands of fibrous connective tissue that connect organs and tissues that are normally separate
• Volvulus


  A loop of intestine that has twisted around itself causing either a partial or complete obstruction
• Intussusception


  When a section of bowel is constricted by peristalsis causing it to prolapse or telescope into itself
• Neoplasm


  • Adenoma/Polyp
  • Adenocarcinoma
• Crohn's Disease


  A chronic inflammation of the bowel with unknown etiology
• Constipation


  A very common digestive complaint where the patient experiences hard stool that can be difficult to defecate
• Hernia


  A weakening of the abdominal wall that allows a portion of the small and/or large intestine to protrude through it
• Hernia


  • A reducible hernia can be pushed back into the abdominal cavity while an incarcerated hernia cannot and could therefore lead to a bowel obstruction
  • A common hernia in men is called an inguinal hernia