|
|
(7 intermediate revisions by the same user not shown) |
Line 44: |
Line 44: |
| ====Roux-en-Y gastric bypass==== | | ====Roux-en-Y gastric bypass==== |
| {{Main|Obese}} | | {{Main|Obese}} |
| <pre>
| | {{Main|Roux-en-Y gastric bypass}} |
| Small Bowel, Excision during Roux-en-Y Gastric Bypass:
| |
| - Small bowel wall within normal limits.
| |
| </pre>
| |
|
| |
|
| ====Block letters==== | | ====Block letters==== |
Line 100: |
Line 97: |
| **[[Tuberculosis]]. | | **[[Tuberculosis]]. |
| *Benign ileum - may have focal intra-epithelial lymphocytes associated with lamina propria lymphoid nodules. | | *Benign ileum - may have focal intra-epithelial lymphocytes associated with lamina propria lymphoid nodules. |
| | *[[NSAID enteropathy]].<ref name=pmid20532706>{{Cite journal | last1 = Dilauro | first1 = S. | last2 = Crum-Cianflone | first2 = NF. | title = Ileitis: when it is not Crohn's disease. | journal = Curr Gastroenterol Rep | volume = 12 | issue = 4 | pages = 249-58 | month = Aug | year = 2010 | doi = 10.1007/s11894-010-0112-5 | PMID = 20532706 }}</ref> |
|
| |
|
| ====Images==== | | ====Images==== |
Line 108: |
Line 106: |
| Image: Mild ileitis -- high mag.jpg | Ileitis - high mag. (WC) | | Image: Mild ileitis -- high mag.jpg | Ileitis - high mag. (WC) |
| </gallery> | | </gallery> |
| | |
| | ===Sign out=== |
| | <pre> |
| | Terminal Ileum, Biopsy: |
| | - Small bowel with moderate active inflammation, marked villous blunting, basal plasmacytosis |
| | and prominent eosinophils, see comment. |
| | - NEGATIVE for granulomas. |
| | - NEGATIVE for dysplasia. |
| | |
| | Comment: |
| | The inflammation is nonspecific; it could be due to infection, inflammatory bowel disease (especially Crohn's disease), ischemia, or therapy/drugs. Clinical correlation is required. |
| | </pre> |
|
| |
|
| ==Small bowel obstruction== | | ==Small bowel obstruction== |
Line 146: |
Line 156: |
|
| |
|
| ===IHC=== | | ===IHC=== |
| *CD20 and CD3 - mixed population of lymphocytes. | | *[[CD20]] and CD3 - mixed population of lymphocytes. |
| *[[CD23]] - follicular dendritic cells. | | *[[CD23]] - follicular dendritic cells. |
| *Cyclin D1 -ve. | | *Cyclin D1 -ve. |
Line 210: |
Line 220: |
|
| |
|
| ==Meckel diverticulum== | | ==Meckel diverticulum== |
| ===General===
| | {{Main|Meckel diverticulum}} |
| *Most common congenital anomaly of the gastrointestinal tract.<ref name=pmid15026601>{{Cite journal | last1 = Levy | first1 = AD. | last2 = Hobbs | first2 = CM. | title = From the archives of the AFIP. Meckel diverticulum: radiologic features with pathologic Correlation. | journal = Radiographics | volume = 24 | issue = 2 | pages = 565-87 | month = | year = | doi = 10.1148/rg.242035187 | PMID = 15026601 }}</ref>
| |
| **Remnant of the ''omphalomesenteric duct'' - a connection of the yolk sac and midgut.
| |
| | |
| The rule of 2s:
| |
| *2 feet from the terminal ileum
| |
| *2% of the population
| |
| *2% symptomatic.
| |
| *2 inches long.
| |
| *2 year old.
| |
| *2 types of epithelium - gastric and pancreatic.
| |
| | |
| Main clinical DDx of a symptomatic Meckel diverticulum:
| |
| *[[Appendicitis]].
| |
| | |
| ===Gross===
| |
| *Antimesenteric attachement, i.e. a ''Meckel's diverticulum'' hangs off the side opposite of the mesentery.
| |
| | |
| Image:
| |
| *[http://commons.wikimedia.org/wiki/File:Meckel%27s_Diverticulum_AFIP.jpg Meckel diverticulum - (AFIP/WC)].
| |
| | |
| ===Microscopic===
| |
| Features:<ref name=pmid15026601/>
| |
| *Small bowel mucosa.
| |
| *+/-Gastric mucosa:
| |
| **Foveolar epithelium: champagne flute-like columnar epithelium.
| |
| **Oxyntic mucosa: parietal cells (pink) and chief cells (purple).
| |
| *+/-Pancreatic epithelium:
| |
| **Pancreatic acini.
| |
| | |
| Images:
| |
| *[http://radiographics.rsna.org/content/24/2/565/F12.expansion.html Gastric foveolar epithelium in a MD (radiographics.rsna.org)].
| |
| *[http://radiographics.rsna.org/content/24/2/565/F15.expansion.html Gastric glands in a MD (radiographics.rsna.org)].
| |
| *[http://radiographics.rsna.org/content/24/2/565.long Pancreatic glands in a MD (radiographics.rsna.org)].
| |
|
| |
|
| ==Ischemic enteritis== | | ==Ischemic enteritis== |
| ===General===
| | {{Main|Ischemic enteritis}} |
| *Typically elderly and due to [[atherosclerosis]].
| |
| *Rare.
| |
| *High mortality.<ref name=pmid18616124>{{Cite journal | last1 = Nakase | first1 = H. | title = [Ischemic enteritis]. | journal = Nihon Rinsho | volume = 66 | issue = 7 | pages = 1330-4 | month = Jul | year = 2008 | doi = | PMID = 18616124 }}</ref>
| |
| *May occur together with ischemia of the colon, i.e. ''[[ischemic colitis]]'', in which case it is known as ''ischemic enterocolitis''.
| |
| | |
| Etiologies:
| |
| *[[Atherosclerosis]].
| |
| *[[Vasculitis]].
| |
| *Embolism.
| |
| *Thrombosis.
| |
| | |
| ===Microscopic===
| |
| Features:
| |
| *See ''[[ischemic colitis]]''.
| |
| | |
| DDx:
| |
| *Infection.
| |
| *[[Crohn's disease]].
| |
| *[[Radiation changes]].
| |
| *Drugs/toxins.
| |
|
| |
|
| =Weird stuff= | | =Weird stuff= |