Small Bowel by Hetal vithalani

congenital failure of a dudenum to canalize associated with Down syndrom clinical features polyhydrammions Distension of stomach and lind loop of duodenum (double bubble) Bilious vomiting Duodenam observes nutrician from food form in 6th week of pregnency just below the stomuch by 10 week of pregnancy - dudenum attresia forms

Meckel Diverticulum Outpouching of all three layers of the bowel wall (true diverticulum) arises due to failure of the vitelline duct to involute Rule of 2nd seen in 2% of the population 2inches long and located in the small bowel with in 2 feet of the ileocecal valve can present during the first 2years of life with bleeding, volvulus, intussusception, or obstruction - mimic appendicitis however most causes are asymptomatic. gastric metaplasia

Celiac sprue Gluten sensitive entrerophathy and nontropical sprue is due to hypersensitivity to gluten resulting in loss of small bowel villi and malabsorption. HLA B8 , DR3, and DQ have been linked to celiac sprue. Microscopically loss of villi with increased inttraepithelial lymphocytes and increased plasma cell in the lamina propria clinically celiac sprue usally presents with childhood with malasorption. Symptoms Abdominal distention blotting dermatitis herpetiformisTreatment no gluten Celiac sprue features CELIAC:Cell-mediated autoimmune diseaseEuropean descentLymphocytes in Lamina propria/ Lymphoma riskIntolerance of gluten (wheat)Atrophy of villi in small intestine/ Abnormal D-xylose testChildhood presentation (Atrophied villi cause less absorption, so diarrhea, weight loss, less energy.)

Tropical Sprue Malabsorptive disease of unknown etiology affecting travelers to tropical regions such as the caribean and south america the microscopic apearance is similar to celiace sprue treatment Antibiotics Vitamin B12 Folate

is a rare infectious disease involving many organs including small intestines joints lung heart liver spleancentral nervous systemCaucasian males aged 30 to 50 infecting organisam is tropheryma whipplei - gram negative rod shaped bacilli clinically present with malbsorption weight loss and diarrhea treatment antibiotics

Decresed function of the lactase enzyme found in the brush border of entrerocytes Lactase normally breaks down lectose in to glucose and galactose presents with abdominal distension and diarrhea upon consumption of milk products undeigested lactose is osmotically active deficiency may be congetial or acquired

malignant proliferation of neuroendocrine cells low grade maligancy Neuroendocrine tumor, most common small bowel tumor (50%)Common sites: appendix, small intestine, rectum, stomach, colonProduce 5HT (serotonin), but asymptomatic unless 5HT gets beyond liver’s first-pass metabolism. Generally, in order for symptoms to occur, the tumor must metastasize to the liver. Uncommonly, primary tumors in the bronchus can cause symptoms without mets.f carcinoid metastasizes to liver or beyond → carcinoid syndrome (symptomatic)Carcinoid syndrome: paroxysmal wheezing, skin flushing, diarrhea, right-heart murmurThey are sometimes quite hard to rember, because they seem unrelated: diarrhea, flushing, diseases of the right heart valves and bronchospasm. So imagine a toilet with this sign on it: When in DIARRHEA: Please FLUSH using the RIGHT VALVE to avoid BRONCHOSPASM

Volvulus twisting of a segment of bowel on its vascular mesentery, resulting in intestinal obstruction and infaction. volvulus is often associated with congential abnormalities such as inestinal malrotation. common location include the signoid colon and small bowel complication infraction and peritonitis

telescoping of proximal segment of bowel forward in to distal segment most common in infants and children. in adults, intussusception may be associated with a mass or tumor it present with intestinal obstruction abdomianl pain current jelly stool it can get infacted

Small bowel infarction smll bowel is highly susceptible to ischemic injury transmural infaction occurs with thrombois embolism of the superior mesentric artery or thrombosis of the mesentric vein mucosal infarction occurs with marked hypotensionclinically fetures include abdominal pain bloody dieariea and decresed bowel sounds.