Term
| what are the different kinds of small bowel studies? |
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Definition
| small bowel follow through (SBFT), endoscopy, enteroclysis, angiography, double balloon endoscopy, and capsule endoscopy |
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Term
| what is a small bowel follow through (SBFT)? |
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Definition
| a radiological study, low sensitivity, low specificity - mostly obsolete for the small intestine, but inexpensive. it can still be useful for upper GI studies (esophagus, stomach, proximal duodenum) esp when looking for ulcers, lesions, or masses. |
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Term
| what does endoscopy allow? |
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Definition
| direct visualization of the GI tract |
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Term
| what is the gold standard for visualization of the upper GI? |
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Definition
| esophagogastroduodenoscopy (EGD), which reaches the first and second part of the duodenum |
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Term
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Definition
| a kind of endoscopy allowing the dr to visualize up until ~2 ft beyond the ligament of treitz. this is important b/c any bleeding proximal to this point and pts are likely to have hematemesis. |
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Term
| what is retrograde ileoscopy? |
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Definition
| intubation of the ileo-cecal valve during a colonoscopy to view the distal portion of the ileum |
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Term
| what is the sonde methoid of endoscopy? |
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Definition
| an attempt to view the entire GI with a weighted scope that would be propelled by peristalsis |
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Term
| what is an intraoperative endoscopy? |
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Definition
| manually moving the small intestine up over the scope to visualize the mucosa of the small intestine. not the most efficient form of dx, b/c it requires sx |
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Term
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Definition
| entercolysis is a small bowel enema w/double contrast barium which allows a better visualization of the SI than a SBFT. 1L of barium is infused into the duodenum to reach the ileum, then the SI is inflated - allowing the barium to coat the surface before the x-ray is taken. this is performed by a invasive radiologist and is *less sensitive in the distal ileum (which is problematic w/crohns pts). |
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Term
| what is double balloon endoscopy? |
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Definition
| this allows visualization of the entire small intestine with a 200 cm scope and 145 cm overtube. it is called double balloon b/c there is a balloon on the tip of the scope and one at the distal end of the overtube. it was developed to dx *obscure GI bleeds* |
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Term
| what is angiography used for? |
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Definition
| angiography looks at vasculature and is useful in detecting lower GI bleeds, angiodysplasia (such as arterial valve malformations), and small intestine bleeds. accumulation in the arterial phase (as opposed to the venous) phase is diagnostic. |
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Term
| what is capsule endoscopy? |
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Definition
| a capsule with a camera which allows visualization of the entire GI from mouth to anus. the number one application of it is *obscure GI bleed, presence of which is often detected with either positive occult blood or melanotic stools. |
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Term
| how is capsule endoscopy performed? |
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Definition
| sometimes a colonoscopy-like prep is given, then the process through the GI takes about 8 hrs as the images (50,000) are transmitted to abdominal leads |
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Term
| what is the number 1 risk with capsule endoscopy? |
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Definition
| retention, which is more likely in pts with crohns disease or strictures/adhesions. there is no risk for infection. |
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Term
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Definition
| indirect radiologic visualization which uses spatial resolution and negatively charged/neutral contrast (mannitol or methylcellulose). it is used to evaluate *mural thickening, *hyperenhancement of mural stratification, *engorged vasa recta (comb sign), fistulas, abscesses, sacroilitis, and choleithiasis. it has a similar sensitivity to capsule endoscopy, but has *greater specificity. it is performed by radiologists. |
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Term
| what is magnetic resonance (MR) enterography? |
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Definition
| this allows *active inflammation to be distinguished from fibrosis (which leads to strictures - esp in crohns). it is beneficial b/c it *doesn't use ionizing radiation (safe in pregnanct/renal failure). |
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