GIT Disorders || Zag Doctors

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نحدد لنفسنا احنا ؟🙈

دعواتكم لزميلنا بالشفاء🙏

معلش مش عيب هي الدنيا كدا

(…وَمَن يَتَوَكَّلْ عَلَى اللَّهِ فَهُوَ حَسْبُهُ ۚ إِنَّ اللَّهَ بَالِغُ أَمْرِهِ ۚ قَدْ جَعَلَ اللَّهُ لِكُلِّ شَيْءٍ قَدْرًا)

كَريْمٌ يُلَبيْ عَبْدَهُ كُلَّمَا دَعَا … نَهَارًا ولَيْلاً فَي الدُجَى وَالغَياهِبِ سَأسْألُهُ مَا شِئْتُ إنَّ يَمِيْنَهُ ... تَسِحُّ دِفَاقًا بالّلُهَى والرَّغَائِبِ فَحَسْبِيَ رَبِيْ في الهَزَاهِزِ مَلْجَاًّ ...وحِرْزًا إذَا خِيْفَتْ سِهِامُ النَّوائِبِ

Oral Surgery ✅The most common site of salivary calculi

Submandibular salivary gland

✅The most common site of acute Sialoadenitis

Parotid

✅The most common site of adamantinoma

Angle of mandible

✅The most common site of dental cyst

Upper jaw

✅Carcinoma of tongue

Lateral edge of Anterior 2/3 of tongue

✅Ranula

One side of the midline

✅Sublingual dermoid

In the midline

.................................................. ✅80% of parotid tumors

Benign

✅The most common cause of acute Sialoadenitis

Staph aureus

✅Antibiotic with highest salivary concentration

Clindamycin

✅The best ttt for ranula Marsupialization ✅Warthin's tumor only affects

Parotid

🔥Salivary calculi The gland cannot be rolled over the mandible Better felt from inside mouth 🔥While drainage of parotid abscess deep fascia is incised transversely

Amiloblastoma

▪️Basal cell carcinoma ▪️Affect adult female ▪️Painless ▪️Egg shell cracking ▪️Honey comb appearance ▪️Excision +wide safety margin

Stages of chronic superficial glossitis

1️⃣Red hyperemic patches 2️⃣Plaques 3️⃣Carcinoma in situ Red glazed tongue 4️⃣Malignancy Persistent fissures

Pleomorphic adenoma

🔥5-10y after appearance of tumor 🔥Painless 🔥Firm 🔥LN not enlarged 🔥Facial nerve not affected

Malignant salivary gland tumours

🔥5-10 months after appearance 🔥Painful 🔥Hard 🔥Enlarged LN 🔥Early Facial nerve affection #cocci_notes_GIT

The most important investigation for 🔥Esophageal cancer Esophageoscopy & biopsy 🔥Gastric cancer Gastroscopy 🔥Colon cancer Colonoscopy & biopsy 🔥Diverticulitis CT scan with oral contrast 🔥Familial Adenomatous polyposis Sigmoidoscopy & biopsy 🔥Loco-regional assessment of rectal cancer MRI 🔥Anastomostic leak CT with contrast enema 🔥Loco-regional assessment Degree of wall infilteration in esophageal cancer T & local N Staging Endoscopic US 🔥LN & distant metastasis in esophageal cancer PET-CT #cocci_notes_GIT

The most common site of 🍓Carcinoid tumor Appendix 🍓Diverticulum Meckel's diverticulum (jejunum & ileum) 🍓Diverticulosis coli Sigmoid colon 🍓Diverticulosis in duodenum 2nd part at site of enterance of CBD 🍓Cancer colon Sigmoid & rectosigmoid 🍓Gastric Cancer Pylorus 🍓Esophageal cancer Lower 1/3 🍓Anal fissures Midline posteriorly (6) 🍓Anal fissures during labor Midline anteriorly (12) 🍓Amoebic liver abscess Posterior part of dome of right lobe of liver #cocci_notes_GIT

Barium enema ☄Saw tooth appearance Diverticulosis coli ☄Honey comb appearance Familial Adenomatous polyposis ☄Apple core appearance Colon carcinoma ☄Rat Tail appearance Esophageal carcinoma ☄Hen's peak appearance Achalasia ☄Large ulcer niche +Carman's meniscus sign Ulcerative gastric cancer ☄Irregular narrowing of pyloric canal +minimal proximal Dilatation *Linitis plastica in diffuse gastric cancer ☄Leather bottle appearance Diffuse gastric cancer #cocci_notes_GIT

Contraindications || Cocci 🍓Morphine is contraindicated in Chronic pancreatitis 🍓Barium enema is contraindicated in Diverticulitis 🍓Cholangiography is contraindicated in Obstructive jaundice 🍓Irradiation is not recommended in Chronic superficial glossitis 🍓After liver transplant Avoid grape fruit 🍓Fistulectomy is contraindicated in Extra-sphincteric fistula 🍓Enucleation alone in Pleomorphic adenoma is not effective As it May lead to recurrence #cocci_notes_GIT

Triads || Cocci

Tillaux triad

In mesenteric cyst 1️⃣Soft flactuant swelling in umbilical region 2️⃣Swelling move prependicular to mesentry 3️⃣Zone of resonance all around swelling

Whipple's triad

In Insulinoma 1️⃣Attacks of Fainting during fasting or exercise 2️⃣BL glucose <45mg% during attacks 3️⃣Symptoms relieved by ingestion or injection of glucose

Wilkie's triad:

Chronic cholecystitis +chronic peptic ulcer +chronic appendicitis.

Saint's triad:

Rarely gallstones +hiatus hernia +diverticulosis coli.

Charcot's triad

In calcular obstructive jaundice ✅Colicky Pain ✅Jaundice ✅Fever +rigors

☄Murphy sign

pain with Abrupt halt in inspiration during palpation In chronic cholecystitis

☄Boas sign

Hyperasthesia between 9th & 11th rib on right side posteriorly In chronic cholecystitis ☄Pain in tongue carcinoma is referred by Lingual N to auriculo-temporal N ☄Congenital fissures 👉transverse ☄Syphilitic fissures 👉longitudinal ☄Amebiasis cutis Spreading cellulitis of Anterior abdominal wall May complicate open drainage of amoebic liver abscess

☄Therapeutic test of Amoebic liver abscess

Dramatic response to emetine or Metronidazole

Aspiration of liver abscess

Through 9 or 10th ICS Rt mid-axillary line Abscess of left lobe 👉surgical drainage

☄Paramalignant $ with liver carcinoma

Hypercalcemia Hypoglycemia #cocci_notes_GIT

Signs

Rat Tail appearance

Cancer esophagus

Hen's peak deformity

Achalasia

Cork screw deformity

Diffuse esophageal spasm

Worm like filling defect

Esophageal varices

Carman's meniscus sign

Ulcerative gastric cancer

Hourglass or "Teapot" appearance

Hourglass stomach Chronic complication of PU

Soup Plate appearance

Chronic pyloric obstruction

Multiple globular shadows Saw tooth appearance

Diverticulosis coli

Multiple smooth globular shadows Honey comb appearance

Familial Adenomatous polyposis

Apple core appearance

Colon cancer

Chain of lakes appearance

Chronic pancreatitis on ERCP

Attenuation of dye in lesser curve

Pseudocyst

Strawberry gall bladder

Cholecystosis

Cobweb appearance of GB bed

Non-calcular chronic cholecystitis

Gall stone w signet ring appearance

Mixed stones

Multiple umbilicated nodules in liver

Secondary liver tumors #cocci_notes_GIT