follow up of the patients with liver cirrhosisin any patient with cirrhosis, screening ★abdominal ultrasound is recommended every 6 months to evaluate for new-onset HCC
caused by any abdominal process irritating the phrenic nerve
☆splenic laceration, peritonitis, ☆pneumoperitoneum(commonly caused by
anterior duodenal ulcer), hemoperitoneum, etc. gastrointestinalUWorld HirotoShishido
small intestinal bacterial overgrowth
cause, resultcause→ Roux-en-Y gastric bypass
result→ overproduction of vitamin K and ☆folate, associated with nausea, bloating, abdominal discomfort, and malabsorption gastrointestinalUWorld HirotoShishido
risk fators for diverticular disease☆diet in red meat & fat & low in fiber
obesity, physical inactivity, smoking gastrointestinalUWorld HirotoShishido
action of vasoactive intestinal polypeptide(VIP)increase secretion of water and electrolytes into the intestinal lumen
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symptoms, etiologytoxic megacolon
severe abdominal pain with visibly distended colon→ ☆increased risk of colonic perforation(☆colonoscopy and barium contrast are contraindicated)
Predisposing factors include infection with Clostridium difficile, ☆loperamide use (especially in young children<2yo), and ulcerative colitis. gastrointestinalUWorld HirotoShishido
psoas abscess
etiology, symptomsprimary origin or a secondary origin from a contiguous infection such as osteomyelitis, ☆IBD (eg, Crohn disease), or pyelonephritis
Clostridium difficile
two toxinsToxin A=enterotoxin→alters fluid secretion
Toxin B=cytotoxin(more potent than Toxin A)→cause ☆apoptosis in a variety of cell types via actin depolymerization
(Toxins inactivate Rho-regulatory proteins which is involved in actin cytoskeletal structure maintenance. The result is ☆loss of cytoskeleton integrity, leading to cell rounding/retraction, disruption of intercellular tight junctions, and increased paracellular intestinal fluid secretion (eg, watery diarrhea)) gastrointestinalmicrobiology HirotoShishido
blood supply of esophagusthe proximal 1/3 is supplied by inferior thyroid artery
