Patient will present as → a 45-year-old male from Ireland with complaints of diarrhea, steatorrhea, flatulence, weight loss, weakness, and abdominal distension. He reports having 3-5 loose stools per day for the last six months. The condition improves when he fasts.
Small bowel inflammation from an allergy to gluten
Symptoms usually occur following the ingestion of gluten-containing food. Also, has extraintestinal manifestations.
Diarrhea, steatorrhea, flatulence, weight loss, weakness, and abdominal distention
Associated with dermatitis herpetiformis (chronic, itchy skin rash on elbow, knees, butt, scalp)
Associated conditions: T1DM, autoimmune hepatitis, autoimmune thyroid DZ, down, turner, Williams syndrome, increased incidence of small bowel lymphoma
IgA anti-endomysial (EMA) and anti-tissue transglutaminase (anti-TTG) antibodies
Small bowel biopsy (duodenum) is the gold standard
You are called to see a 61 y/o with acute onset severe abdominal pain and vomiting
Heart Rate: 67
Respiratory Rate: 16
Pulse Oximetry: 99% on RA
Blood Pressure: 130/79
Signs and Symptoms
Acute onset severe abdominal pain and vomiting
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Patient will present as → a 65-year-old female with diffuse abdominal pain and vomiting. She has not had a bowel movement in three days. PE reveals high-pitched, hyperactive bowel sounds, tympany to percussion, no rebound tenderness, and a temperature of 100.4 F. Abdominal radiograph reveals distended loops of bowel with a step ladder pattern of differential air-fluid levels.
What are the 4 cardinal signs of strangulated bowel?
The 4 cardinal signs of strangulated bowel: fever, tachycardia, leukocytosis, and localized abdominal tenderness.
Patient will present as → a 61-year-old healthy man who undergoes a screening colonoscopy. He exercises daily, does not use tobacco, bloody or dark stools, changes in stool, abdominal pain, or fatigue. His prior colonoscopy 10 years ago was normal. During today’s colonoscopy, his gastroenterologist notes a small pedunculated growth in the descending colon.
Colonic polyps are common; the incidence ranges from 7% to 50% (depending on the diagnostic method used)
The main concern is malignant transformation, which occurs at different rates depending on the size and type of polyp
Distal colon are commonly benign if seen in the proximal colon they are more likely to be cancerous
The larger the colonic polyp, the greater the risk of malignant transformation
Villous adenomas have a 30-70% risk of malignant transformation
The greater the number of concomitant colonic polyps, the greater the risk of malignant transformation
Most common cause of painless rectal bleeding in the pediatric population
Once identified follow-up colonoscopy in 3-5 years
Familial adenomatous polyposis (FAP) - is characterized by the development of hundreds to thousands of colonic adenomatous polyps
Colorectal polyps develop by a mean age of 15 years and cancer at 40 years
First-degree relatives of patients with FAP should undergo genetic screening after age 10 years
The family should undergo yearly sigmoidoscopy beginning at 12 years of age