24 Intestinal Disorders

Appendicitis

• rebound tenderness: pressing and letting go

• perforation of abdomen viscus: peritonitis and then rigid abdomen and death

Diverticulum

• weakness in layer

• rebound tenderness like appendicitis

• occult blood: can't see with eyes but present

• inflammed diverticulum on CT

• inflammation narrow lumen

Adhesion

• C sections, appendectomy

• most commonly cause SBO

• intestines contract, resisted by adhesions: abdominal/pelvic pain

Intussusception

Volvulus

Bowel Obstruction

• can't pass stool or gas

Hirschsprung

• absent Meissner

• transition zone: dilated to small

• dilated: normal

• narrow: missing ganglion. No peristalsis

Ileus

Ogilvie

• so sedentary life style that bowel become sedentary

IBS

Necrotizing Enterocolitis

• preterm

• prematurity: immature mucosal defense

• necrosis of mucosa

Angiodysplasia

• older people

• lower GI bleeding, aberant blood vessel (right) on colonoscopy

Osler-Weber-Rendu

• multiple dilated blood vessels that resemble angiodysplasia