Other GI stuff

Question 1

What is a meckel diverticulum?

Answer 1

Ileal remnant of vitello-intestinal duct.

Contains ectopic gastric mucosa or pancreatic tissue.

Question 2

How can a meckel diverticulum present?

Answer 2

• Most are asymptomatic
• May present with severe rectal bleeding (classically neither bright red nor malaena)
• Other presentations: - Intussusception
  - Volvulus around bowel
  - Diverticulitis (appendix mimic)

Question 3

What scan is used to diagnose a Meckel’s diverticulum and what does it show?

Answer 3

• A technetium scan

- Demonstrates increased uptake by ectopic gastric mucosa in 70%

Question 4

How does malrotation come about?

Answer 4

If mesentery not fixed in fetal life at duodenojejunal flexure or in ileocaecal region - base shorter and predisposed to volvulus.

Question 5

What can cause bowel obstruction in malrotation?

Answer 5

Ladd bands crossing the duodenum

Question 6

What forms of presentation are most common in malrotation?

Answer 6

• Obstruction
• Obstruction with compromised blood supply
• Obstruction with bilious vomiting (usually in 1st few days of life)

Question 7

What is irritable bowel syndrome?

Answer 7

Altered GI motility and abnormal sensation of intrabdominal events.

Question 8

What is the common symptom set in IBS?

Answer 8

• Abdo pain, often worse before/relieved by defaecation
• Explosive, loose or mucousy stools
• Bloating
• Feeling of incomplete defaecation
• Constipation (often alternating with normal or loose stools)