Alimentary tract

CHAPTER 14 Alimentary tract




Oesophagus








Inflammatory stricture






Hiatus hernia


There are two types: sliding (90%) and rolling or paraoesophageal (10%). In the rolling type, the cardio-oesophageal mechanism is intact and therefore reflux does not occur. The stomach rolls up alongside the lower oesophagus pressing on it and causing dysphagia (→ Fig. 14.1).




Sliding hiatus hernia


The stomach slides through the hiatus and therefore the position of the cardio-oesophageal junction changes and reflux occurs (→ Fig. 14.1).








Carcinoma of the oesophagus














Stomach and duodenum



Peptic ulceration









Treatment




Complications of peptic ulceration






Carcinoma of the stomach






Gastric surgery and its complications





Operations








Complications









Upper gastrointestinal tract bleeding














Conditions of the small bowel








Tumours of the small intestine









Small bowel obstruction










Investigations






AXR: distended loops of small bowel in central abdomen (→ Fig. 14.7). Erect films show air/fluid levels. Absent or diminished colonic gas. Dilated proximal small bowel shows lines close together (valvulae conniventes) crossing completely the lumen of the bowel. These get progressively fewer the more distal the distended loop and are absent in the terminal ileum. Look for gas in the biliary tree (gallstone ileus with cholecystoduodenal fistula).





Appendicitis









Jun 14, 2017 | Posted by in GENERAL SURGERY | Comments Off on Alimentary tract

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