-
GI Emergency Statistics
- 500,000 emergency room visits/year
- 5% of all ER visits
- 300,000 are GI bleeds
-
GI Disease Risk Factors
- Excessive Alcohol Consumption
- Excessive Smoking
- Increased Stress
- Ingestion of Caustic Substances
- Poor Bowel Habits
-
Visceral Pain
Dull, poorly localized pain originating in the walls of hollow organs.
-
Somatic Pain
Sharp, localized pain originating in the walls of body such as skeletal muscles.
-
Referred Pain
Pain originating in a region other than where it is felt.
-
Referred Pain Patterns
- Liver: Right shoulder
- Gallbladder: Right at diaphragm, Right mid back
- Pancreas, Duodenum: Right, at diaphragm.
- Small Intestine: Umbilicus
- Appendicitis: McBurney's Point, Right pelvis.
- Colon: Pubis
-
Peritonitis
Inflammation of peritoneum which lines abdominal cavity.
-
Cullen's Sign
Ecchymosis in the periumbilical area
-
Grey Turner's Sign
Ecchymosis in flanks
-
GI System
- GI Tract
- Liver
- Gallbladder
- Pancreas
- Appendix
-
Upper GI Tract
- Mouth
- Esophagus
- Stomach
- Duodenum
-
Upper GI Bleeding
Bleeding within GI tract superior to the ligament of Treitz
-
Ligament of Treitz
Ligament that supports the Duodenojejunal junction
-
Major Causes of Upper GI Bleed
- Peptic ulcer disease
- Gastritis
- Esophageal varix rupture
- Mallory-Weiss tear
- Esophagitis
- Duodenitis
-
Mallory-Weiss Tear
Esophageal laceration, usually secondary to vomitting
-
Hematemisis
Bloody vomitus
-
Melena
Dark, tarry, foul-smelling stool indicating presence of partially digested blood
-
Sengstaken-Blakemore Tube
Three-lumen tube used in treating esophageal bleeding
-
Upper GI Diseases
- Esophageal varices
- Acute gastroenteritis
- Chronic gastroenteritis
- Peptic ulcers
-
Esophageal Varix
Swollen vein of esophagus
-
Portal
Pertaining the the flow of blood in liver
-
Cirrhosis
Degenerative disease of liver
-
Acute Gastroenteritis
Sudden onset of inflammation of the stomach and intestines
-
Hematochezia
Bright red blood in stool
-
Chronic Gastroenteritis
Nonacute inflammation of GI mucosa
-
Peptic Ulcer
Erosion caused by gastric acid
-
Zollinger-Ellison Syndrome
Condition that causes the stomach the excrete excessive amounts of hydrochloric acid and pepsin
-
Lower GI Tract
- Jejunum
- Ileum
- Large intestine
- Rectum
- Anus
-
Lower GI Bleeding
Bleeding inferior to the ligament of Treitz
-
Major Causes of Lower GI Bleeding
- Diverticulosis
- Colon lesions
- Rectal lesions
- Inflammatory bowel disorder
-
Lower GI Diseases
- Ulcerative colitis
- Crohn's disease
- Diverticulitis
- Hemorrhoids
- Bowel obstruction
-
Pancolitis
Ulcerative colitis spread throughout the whole color
-
Proctitis
Ulcerative colitis limited to the rectum
-
Colic
Acute pain associated with cramping or spasms in the abdominal organs
-
Crohn's Disease
Idipathic inflammatory bowel disorder associated with small intestine
-
Diverticulitis
Inflammation of diverticula
-
Diverticulosis
Prescence of diverticula with or without associated bleeding
-
Diverticula
Small outpouchings in the mucosal lining of the intestinal tract
-
Hemmorhoid
Small mass of swollen veins in the anus or rectum
-
Bowel Obstruction
Blockage of the hollow space within intestines
-
Hernia
Protrusion of an organ through its protective lining
-
Intussusception
Condition that occurs when part of an intestine slips into the part just distal to itself
-
Volvulus
Twisting of the intestine
-
Adhesion
Union of normally separate tissue surfaces by a fibrous band of new tissue
-
Infarction
Area of dead tissue caused by lack of blood
-
Accessory Organ Diseases
- Appendicitis
- Cholecystitis
- Pancreatitis
- Hepatitis
-
Appendicitis
Inflammation of the vermiform appendix at the juncture of the large and small intestines
-
McBurney Point
Common site of pain for appendicitis. 1-2 inches above the anterior iliac crest in a direct line with umbilicus
-
Murphy's Sign
Pain caused when an inflamed gallbladder is palpated by pressing under the right costal margin
-
Causes of Acute Pancreatitis
- Alcohol Abuse
- Gallstones
- Elevated serum lipids
- Drug induced
-
Mild Pancreatitis S/S
- Epigastric pain
- Abdominal distention
- N/V
- Elevated amylase/lipase
-
Severe Pancreatitis S/S
- Refractory hypotensive shock
- Blood loss
- Respiratory failure
|
|