GASTROINTESTINAL PATHOLOGY RT 124 2011 1 Be Kind

GASTROINTESTINAL PATHOLOGY RT 124 2011 1 Be Kind to your patientsoffer them a wet towel for the Ba mustache !

2 GI DISORDERS Abdominal pain Gallbladder disease RUQ Acid reflux (GERD) Gastritis Appendicitis Gastroenteritis and food poisoning Bleeding ulcer (hematemesis) Hiatal hernia (=Hiatus hernia) H. pylori gastritis Colon cancer Irritable bowel syndrome(IBD) Crohns disease Diverticulitis Diverticulosis Traveler's diarrhea Esophageal cancer Ulcerative colitis Ulcers (stomach and duodenal) PYLORIC STENOSIS INGUINAL HERNIA INTUSSUSCEPTION VOLVULUS

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Normal Esophagus which position? 4

Normal Stomach which position? 5

Esophageal Strictures Gastric contents/ acid contents reflux into the esophagus Causing inflammation, scarring stricture formation. 6

Esophageal Varices 7

8 Esophogeal varices

9 cancer

Esophageal Diverticula 10

GERD 11

12 What do you see Free air NG tube Type of contrast to use?

INTRODUCTION OF GASTRO VIA NG TUBE 13

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Pneumoperitoneum (air under the diaphram) possible perforated bowel 16

Pyloric Stenosis “String Sign” 17

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Large HIATAL HERNIA Hiatal Hernia seen on lat CXR (GI) 19

Hiatal Hernia 20

Intrathoracic stomach malrotation 21

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24 H Pylori Helicobacter Pylori Half of the world's population is infected the incidence is decreasing in highincome countries. H. pylori colonizes the stomach and has been associated with gastric ulcer and cancer.

Gastric neoplasm (cancer) w/ perforation 25

Increased folds = inflammation Path? 26

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Bezoars are tightly packed collections of partially digested or undigested material stuck in the stomach or other parts of the digestive tract. Foreign bodies are small ingested objects that can also get stuck in the digestive tract and sometimes perforate it. Gastroparesis is a stomach disorder in which the stomach takes too long in emptying its contents 28

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Bezoar from eating hair 30

31 What Causes This?

32 Problem With This? Positioning? What exam is this

Small bowel obstruction 33

End of Path for UGI SMB 34

Path for colon 35

Ca of colon “apple core lesion” 36

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Diverticulosis (chronic diverticulitis) 38

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Ulcerative Colitis is inflammation of the outer lining of the colon only, hence the term colitis. Crohn's disease, can affect any part of the gut from the mouth to the anus, but most commonly affects the colon or ileum (small bowel) and can involve the full thickness of the bowel wall. Symptoms Both types of inflammatory bowel disease may have similar symptoms depending on the site and severity of the inflammation. 40

Crohn’s Disease 41

Crohn's disease (IBS) Cobblestone appearance 42

Colitis “stove pipe” Crohns Disease / Laxative Use 43

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Ulcerative colitis 45

CHRONIC Ulcerative colitis NOTE: LOSS OF HAUSTRAL MARKINGS 46

Intussuception Volvulus 47

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Volvulus 50

Volvulus in cecum 51

Sigmoid volvulus note: beak sign 52

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Intussusception with reduction by BE 54

Not well prepped 55

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PERFORATED RECTUM 57

RECTAL CA 58

Inguinal Hernia 59

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APPENDCOLITH 62

What is the most common abdominal emergency surgery in the U. S? Appendicitis 63

64 APPENDICITS PAIN ANOREXIA NAUSEA VOMITING FEVER Navel or RLQ pain may have one or more of the following signs and symptoms: Nausea and sometimes vomiting Loss of appetite A low-grade fever that starts after other signs and symptoms appear Constipation An inability to pass gas Diarrhea Abdominal swelling

APPENDICITIS is the most common surgical emergency seen in hospitals. Six of every hundred persons will get it at some point in their life. 65

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GB STONES Calculi in gallbladder and bile ducts 67

68 “Stratificaton” (layering) of GB stones (cholelithaisis) seen in upright OCG

Female Anatomy Review 69

70 VAGINOGRAM Or what your image will look like if you put the tip in the wrong place!

VAGOGRAM Be careful with the insertion of the tip! FISTULA 71

EEL inserted into rectum – OUCH perforating bowel 72