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Transcript of Common GI Pathologies
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Common GI PathologiesKhalid Alkhamis
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Content
Common GI Pathologies 2016 1
Stomach & duodenum
Small intestine
Large intestine
Esophagus
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Common GI Pathologies 2016 2
Esophageal abnormalities
Strictures of Esophagus
Dilatation of Esophagus
• Esophageal cancer• Peptic strictures• Achalasia• Corrosive strictures
• Benign tumours (leiomyomas)• Other mediastinal masses• Anomalous right subclavian artery
• Obstructive• with a visible stricture e.g. achalasia or carcinoma
• Non-obstructive• E.g. scleroderma or disease involves the esophageal muscle
Other abnormalities• E.g. Zenker’s diverticulum or esophageal web
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Zenker's Diverticulum
LocationOutpouching of pharyngeal mucosa above the cricopharyngeus (upper esophageal sphincter)
ImagingDiagnosis can be made by barium esophagogram or endoscopy. Barium esophagogram reveals a barium filled outpouching in the region of the esophageal inlet.
Common GI Pathologies 2016 3
Esophageal abnormalities
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Common GI Pathologies 2016 4
Achalasia
Location & CauseNeuronal degeneration within the Auerbach'splexus in the esophagus.
ImagingBarium swallow reveals dilated esophagus with distal tapering and narrowing.
dilated esophagus with a sharply tapered “bird beak" narrowing
Esophageal abnormalities
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Common GI Pathologies 2016 5
Esophageal abnormalities
Esophageal Carcinoma Peptic stricture
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Common GI Pathologies 2016 6
Stomach & Duodenum
Peptic Ulcer
The ulcer (arrow) projects from the lesser curve of
the stomach
En face the ulcer (arrow) is seen as a rounded collection of barium.
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Common GI Pathologies 2016 7
Stomach & Duodenum
Hiatus hernia
Sliding Rolling
gastro-esophageal junction (arrow)
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Imaging Signs
Common GI Pathologies 2016 8
Small Intestine
Dilatation
Mucosal abnormality
Narrowing
UlcerationNormal barium follow-through
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Common GI Pathologies 2016 9
Small Intestine
Dilatation Mucosal abnormality
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Common GI Pathologies 2016 10
Small Intestine
Narrowing Ulceration
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Small bowel loops are centrally located as compared to the large bowel
Extrinsic: Hernias, adhesions, masses, volvulusIntrinsic: Gallstones, foreign bodies
Common GI Pathologies 2016 11
Causes
Location
Small intestine Obstruction
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Common GI Pathologies 2016 12
Small Intestine Obstruction
multiple distended centrally located small bowel loops with air-fluid levels
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Imaging Signs
Common GI Pathologies 2016 13
Large Intestine
Narrowing or dilatation of the lumen
Filling defects
Diverticula and muscle hypertrophy
UlcerationNormal double-contrast
barium enema
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Common GI Pathologies 2016 14
Large Intestine
Narrowing of the lumen Filling defects
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Common GI Pathologies 2016 15
Large Intestine
muscle hypertrophy Ulceration
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Common GI Pathologies 2016 16
AXR shows a grossly distended coffee bean shaped loop of bowel in the right upper
quadrant
Sigmoid Volvulus
A smooth narrowing is seen in the sigmoid colon where the colon has
twisted (arrow)
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Common GI Pathologies 2016 17
References