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Pathology
Biliary atresia
Crigler-Najjar syndrome
Dubin-Johnson syndrome
Gilbert's syndrome
Rotor syndrome
Acute cholecystitis
Ascending cholangitis
Biliary colic
Cholangiocarcinoma
Chronic cholecystitis
Gallbladder cancer
Gallstone ileus
Gallstones
Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Autoimmune hepatitis
Benign liver tumors
Budd-Chiari syndrome
Cholestatic liver disease
Cirrhosis
Hemochromatosis
Hepatic encephalopathy
Hepatitis
Hepatocellular adenoma
Hepatocellular carcinoma
Jaundice
Neonatal hepatitis
Non-alcoholic fatty liver disease
Portal hypertension
Primary biliary cirrhosis
Primary sclerosing cholangitis
Reye syndrome
Wilson disease
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Acute pancreatitis
Chronic pancreatitis
Pancreatic cancer
Pancreatic pseudocyst
Bowel obstruction
Gallstone ileus
Intestinal adhesions
Volvulus
Colorectal cancer
Colorectal polyps
Familial adenomatous polyposis
Gardner syndrome
Juvenile polyposis syndrome
Peutz-Jeghers syndrome
Gastroschisis
Hirschsprung disease
Imperforate anus
Intestinal atresia
Intestinal malrotation
Intussusception
Meckel diverticulum
Necrotizing enterocolitis
Omphalocele
Abdominal hernias
Femoral hernia
Inguinal hernia
Crohn disease
Microscopic colitis
Ulcerative colitis
Ischemic colitis
Small bowel ischemia and infarction
Celiac disease
Lactose intolerance
Protein losing enteropathy
Short bowel syndrome (NORD)
Small bowel bacterial overgrowth syndrome
Tropical sprue
Whipple's disease
Carcinoid syndrome
Appendicitis
Diverticulosis and diverticulitis
Gastroenteritis
Irritable bowel syndrome
Anal fissure
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Cleft lip and palate
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Tracheoesophageal fistula
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Barrett esophagus
Boerhaave syndrome
Diffuse esophageal spasm
Eosinophilic esophagitis (NORD)
Esophageal cancer
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Mallory-Weiss syndrome
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Ludwig angina
Oral cancer
Oral candidiasis
Parotitis
Sialadenitis
Temporomandibular joint dysfunction
Warthin tumor
Appendicitis: Pathology review
Cirrhosis: Pathology review
Colorectal polyps and cancer: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diverticular disease: Pathology review
Esophageal disorders: Pathology review
Gallbladder disorders: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Malabsorption syndromes: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Viral hepatitis: Pathology review
Small bowel ischemia and infarction
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Small bowel refers to the small intestine and infarction is when ischemia, which is an inadequate blood supply, causes necrosis, or tissue death.
So, a small bowel infarction happens when there’s a reduced blood supply to the small intestine causing parts of the intestinal wall to necrose or die which can be life threatening.
Now, the small intestine is made of several layers.
The innermost layer is the mucosal layer and it’s composed of a few of its own layers.
The first layer is the epithelial lining and it faces the lumen; next is the lamina propria, which is rich with blood and lymph vessels; and finally the muscularis mucosae, which has smooth muscle.
Deep to this mucosal layer is the submucosal layer, which has connective tissue with proteins like collagen and elastin, as well as glands, and additional blood vessels.
The submucosal layer also contains the Meissner plexus which is a part of the enteric nervous system.
Below the submucosal layer is the muscularis propria which is basically two layers of smooth muscle with the myenteric plexus, another part of the enteric nervous system, sandwiched between them.
These muscles are particularly important in helping to move food through the bowel.
Finally, there’s the serosal layer which is the outermost layer of the small intestines that faces the abdominal cavity.
The superior mesenteric artery is the main supplier of blood to the small intestine.
Branches of the artery spread through the mesentery - called mesenteric arteries - and penetrate the serosa layer and travel to the submucosa where they branch further into arterioles.
Because the small intestine has a high demand for oxygen and nutrients to sustain digestion, it is highly susceptible to tissue injury from ischemia.
Small bowel ischemia and infarction refer to a medical condition characterized by reduced blood flow and tissue death in the small intestine. It often results from something like a blood clot or a nearby tumor, a hernia, a volvulus, or intussusception, which blocks blood vessels supplying the small intestine. It may also be due to low blood pressure, or a decrease in the overall amount of blood flowing into the area.
Small bowel ischemia and infarction can complicate into an ileus in which food lingers and doesn't get pushed along, or even peritonitis and sepsis. Symptoms include severe abdominal pain( out of proportion to the physical examination), nausea, vomiting, diarrhea, and fever. Treatment typically involves addressing the underlying cause and restoring blood flow to the affected area, using medications or surgery. Treatment involves IV fluids, pain management, antibiotics, and surgery if needed.
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