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Difference between revisions of "Small intestine"
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= | =The segments= | ||
==Duodenum== | |||
{{main|Duodenum}} | |||
The duodenum is often biopsied by gastroenterologists. | |||
Common reasons for biopsy: | |||
*Suspected giardia. | |||
*Suspected [[celiac sprue]]. | |||
*Is this [[cancer]]? | |||
*Looks normal... want to dot the i's and cross the t's. | |||
==Jejunum== | |||
*Uncommonly seen by pathologists. | |||
*May be seen in the context of a resection done for a bowel obstruction. | |||
==Ileum== | |||
*This is seen occasionally -- often in the context of IBD and more specifically [[Crohn's disease]]. | |||
*Crohn's disease (and [[ulcerative colitis]]) is discussed in the ''[[colon]]'' article. | |||
=Specific conditions= | |||
==Small bowel obstruction== | ==Small bowel obstruction== | ||
*Abbreviated ''SBO''. | *Abbreviated ''SBO''. | ||
===General=== | ===General=== | ||
*Radiologic/clinical diagnosis | *Radiologic/[[clinical diagnosis]]. | ||
The usual causes of bowel obstruction (large & small) are (mnemonic) ''SHAVING'': | The usual causes of bowel obstruction (large & small) are (mnemonic) ''SHAVING'': | ||
| Line 49: | Line 68: | ||
In the context of bowel obstructions and IBD, pathologists often see resected [[stoma]]s (that were put in place emergently). These specimens are usually fairly straight forward. | In the context of bowel obstructions and IBD, pathologists often see resected [[stoma]]s (that were put in place emergently). These specimens are usually fairly straight forward. | ||
===Gross=== | |||
*+/-Adhesions. | |||
*+/-Bowel contorted. | |||
*+/-Luminal narrowing +/-proximal dilation. | |||
*+/-Serosal exudate. | |||
**Suggestive of perforation. | |||
= | ==Microscopic== | ||
Features: | |||
*+/-Adhesions (serosal). | |||
**Dense fibrous tissue replaces the adipose tissue. | |||
**+/-Increased vascularity. | |||
*+/-Submucosal fibrosis. | |||
* | |||
* | |||
* | |||
* | |||
DDx: | |||
* | *Small bowel [[adenocarcinoma]] - most important differential diagnosis. | ||
*Metastatic adenocarcinoma - classically on the serosal aspect. | |||
*[[Signet ring cell carcinoma]]. | |||
* | |||
* | |||
==Small bowel neoplasms== | ==Small bowel neoplasms== | ||
*Adenocarcinoma - like colonic. | *Adenocarcinoma - like colonic. | ||