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 Jan 18, 2020, 2:29 AM 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 Mar 11, 2020, 10:59 PM HirotoShishido
risk fators for diverticular disease☆diet in red meat & fat & low in fiber
obesity, physical inactivity, smoking gastrointestinalUWorld Feb 24, 2020, 3:11 AM HirotoShishido
action of vasoactive intestinal polypeptide(VIP)increase secretion of water and electrolytes into the intestinal lumen
Picture
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 Jan 1, 2020, 1:42 AM HirotoShishido
psoas abscess
etiology, symptomsprimary origin or a secondary origin from a contiguous infection such as osteomyelitis, ☆IBD (eg, Crohn disease), or pyelonephritis
diverticulosis and diverticulitis
symptoms, on imagingdiverticulosis→ painless hematochezia
many facse diverticula of the colon
diverticulitis→ several days of worsening LLQ pain(Japanese→RLQ pain is more common)
☆pericolic fat stranding gastrointestinal Nov 5, 2019, 3:01 AM HirotoShishido
treatment for Wilson disease, hemochromatosisWilson→ chelation with ☆penicillamine
metoclopramide clinical use☆diabetic and postsurgery gastroparesis(promote gastric emptying), antiemetic, persistent GERD(increase LES tone) pharmacologygastrointestinal Nov 5, 2019, 1:47 AM HirotoShishido
inguinal canal structureICE TIE
Internal spermatic fascia
Cremasteric muscle and fascia
External spermatic fascia
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 Oct 8, 2019, 6:40 PM HirotoShishido
blood supply of esophagusthe proximal 1/3 is supplied by inferior thyroid artery
