Anatomy clinical correlates: Viscera of the gastrointestinal tract

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Anatomy clinical correlates: Viscera of the gastrointestinal tract

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A 48-year-old man comes to the office because he noticed rectal bleeding. He has occasionally noticed a few streaks of bright-red blood on the toilet paper after wiping, but today he saw blood dripping in the toilet at the end of defecation. The patient also reports mild itching around the perianal opening but no pain. The rest of the review of systems is unremarkable. Past medical history is significant for chronic constipation and type II diabetes mellitus. Current medications include atorvastatin and metformin. Family history is noncontributory. Vitals are within normal limits. On physical examination the abdomen is nontender and nondistended. The digital rectal examination does not demonstrate an abnormal mass or tenderness. Anoscopy is significant for bulging purplish-blue veins above the dentate line. Which of the following best describes the cutaneous innervation of this region above the dentate line?  


The gastrointestinal tract runs from the mouth all the way to the anus and contains the esophagus, the stomach, the small and large intestine and the anus. All these structures, like any other part of our body, are prone to injury or disease.

This video will give you a better understanding of the anatomy of the GI tract and how it relates to the clinical conditions that affect them!

Let’s start by looking at gastric and duodenal ulcers, which are open lesions in the lining of the stomach or duodenum that lead to inflammation in the gastric or duodenal wall.

These are often associated with a specific stomach bacteria called H. Pylori, H.Pylori....Helicobacter Pylori.

Duodenal ulcers are more frequent than gastric ulcers and can be located anywhere along the duodenal wall, classically affecting either the anterior or posterior duodenal wall. If severe enough, ulcers can erode through the duodenal wall, which can cause perforation or gastrointestinal bleeding.

Anterior wall duodenal ulcers are more prone to perforation into the anterior abdominal cavity, and this can result in a pneumoperitoneum, because air from the gastrointestinal tract enters the abdominal cavity.

A classic finding on x-ray is free air under the diaphragm indicating a pneumoperitoneum. This can also result in peritonitis, because as duodenal contents leak into the abdominal cavity, they irritate the peritoneum.


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  4. "What every gastroenterologist needs to know about common anorectal disorders" World Journal of Gastroenterology (2009)
  5. "Haemorrhoids: modern diagnosis and treatment" Postgraduate Medical Journal (2015)
  6. "Clinical Manual of Surgery - e-book" Elsevier Health Sciences (2014)
  7. "The ASCRS Textbook of Colon and Rectal Surgery" Springer Science & Business Media (2011)
  8. "Review of hemorrhoid disease: presentation and management" Clin Colon Rectal Surg (2016)
  9. "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death" Lancet (2015)

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