Disease
Nutcracker Syndrome
SMA syndrome
Mesenteric ischemia
Sphincter of Oddi
dysfunction
Sphincter of Oddi spasm
Pancreatic ductal
adenocarcinomas
Acute pancreatitis
Gilbert syndrome
Cigler Najjar I
Achalasia
Turcot syndrome
Bechet syndrome
Menetrier dz
Microscopic colitis
Acute mesenteric ischemia
Chronic mesenteric ischemia
Cause Sx Tx Others
Compression of L Hematuria
renal vein between Flank pain
SMA and aorta
Compression of 3rd Post-prandial pain RF= rapid weight loss (low
(transverse) part of Intermittent Sx of mesenteric fat)
duodenum between intestinal obstruction -Normally, mesenteric fat keeps
SMA and aorta SMA away from duodenum
Embolism mostly -No rebound tenderness Usually affects jejunum.
from LA, LV to -Occult blood Labs- increased WBC, lactate and
SMAjejunum -Mild tenderness acidosis
affected usually
After gallstones or 1)biliary sx (increased 1)smooth muscle relaxants
pancreatitis LFTs, bilirubin, RUQ pain) (CCB)
resulting in 2)recurrent pancreatitis 2)sphincterotomy
constricted
sphincter of Oddi
Opioid RF= pt with pancreatitis. For pts
(morphine)SM with pancreatitis use meperidine
contraction instead of opioid.
Tumor that arises in Courvoisier sign-painless Cholangiography-filling defect in
pancreatic jaundice with enlarged GB GB and cystic duct
headobstruction
of common bile duct
Increased synthesis Increased serum
of pancreatic pancreatic lipase and
enzymes but amylaseautodigestion
decreased secretion Lipase more specific!
Decreased UDP Increased unconjugated
glucorynyl bilirubin (but less than
transferase (UGT) 3mg/dL)no jaundice .
activity due to -Jaundice in stress
defective UGT gene (fasting, illness)
promoter
Severely reduced Jaundice, kernicterus b/c
UGT activity UB crosses BBB
Degeneration of Dysphagia to solids and Surgery or botulinum Secondary achalasia may come
inhibitory neurons liquids injection from Chagas dz or paraneoplastic
(with NO and VIP) in dz.
myenteric plexus of -RF for esophageal SCCA
esophagus
FAP or Lynch with CNS
tumors (medulloblastoma
and glial tumors
HLA B51 Recurrent aphthous
Due to immune ulcers, genital ulcer and
complex vasculitis of uveitis and erythema
small BV nodosum
Can be seen after
viral (HSV or B19)
infection
Due to increased WAVEE= weight loss, Hyperplasia of gastric mucosa and
EGFR anorexia, vomiting, foveolar cells
epigastric pain, edema Hypoplasia of parietal and chief
cells and decreased acid production
Hypertrophied rigae like brain gyri
Excess mucus production with
protein loss
Inflammatory dz of -chronic watery diarrhea Older female
colon -Histo: - inflammatory
infiltrate in lamina
propria with thick
subepithelial collagen band
OR intraepithelial
lymphocytes.
Embolic occlusion of Abd pain out of proportion
SMA to physical findings
Red currant jelly stools
Atherosclerosis of Post-prandial epigastric Intestinal angina
 celiac, SM orIMA painfood aversion and
weight loss
Colonic ischemia Crampy abdominal pain Watershed area
then hematochesia
Thumb print sign
Peutz-Jeghers syndrome AD Multiple hamartomas Increased risk for breast and GI
throughout GI+ CA
hyperpigmented macules
on mouth, lips, hands and
genitalia
Spontaneous bacterial -E.coli OR Klebsiella Fever, chills, vomiting, abd 3rd gen Composition= fibrin exudate, LDH,
peritonitis -commonly in pain, painful ascites. cephalosporin(cefotaxime) neutrophils
cirrhosis or Peritoneal fluid and Path: pt with cirrhosis or nephrotic
nephrotic syndrome ascites- cloudy, high syndromedecreased
protein, high PMN proteinE.coli more activecovers
PE: guarding and rebound peritoneum increased exudate
tenderness Dx: neutrophil>250
Reye Syndrome VZV and Influenza 1)Mitochondrial ASA reversibly inhibits
(viral infection) abnormalities mitochondrial enz decreased
treated with ASA 2)encephalopathy beta oxidation
3)microvesicular fatty
changes
4)Hypoglycemia
5)coma
6)hepatomegaly