💡Coffee bean sign= Omega sign= inverted U sign.

🔴 بإختصار

🔺اي حاجه في foregut بدير
Epigastric pain

🔺اي حاجه في الـ midgut بدير periumbilical pain

ما عدا الـ appendix في الاول ادير في وجع حولين الـ umbilical زيها زي midgut structure وبعدين دير
Shift to the Rt iliac fossa

🔺اي حاجه hind-gut رح تسمع في suprapubic

ملخص IBD

#GIT💡 :
✨
All GIT cancer common in ♂️ except : Gall bladder cancer common in ♀️
✨
Zinker , meckles , imporforated anus , pinoidal common in ♂️
✨
Acalasia , plummer , crons common in ♀️
✨
Ulcerative colitis  ♀️ = ♂️

#GIT 💡
✨Key words of lower git bleeding:

⭕Ischemic colitis ➡️sever acute pain & sever bleeding
⭕Colon cancer ➡️ old /weight loss /loss of appetite /Alternative bowel  habits/usually mild bleeding
⭕ Divertecular ➡️ Alternative bowel  habits
⭕IBD ➡️diarrhea
⭕ Angiodysplasia ➡️ old Age
Upnormal BV /bleeding painless Perfuse/ asymptomic/ difficulty Dx
⭕ Anal fissure ➡️ painful during defecation
⭕ Homorrhoids ➡️ painless

⭕️ Key points of epigastric pain :

EPIGASTRIC PAIN + pain worse with food = gastric ulcer

epigastric pain + pain better with food = duodenal ulcer.

epigastric pain + weight loss = gastric ulcer or cancer

epigastric pain +tenderness = pancretitis

epigastric pain + bad taste ,cough ,hoarse= GERD

epigastric pain + nothing = non ulcer dyspepsia [ 90% of cases]

epigastric pain + diabetic and bloating = diabetic gastroparesis

Epigastric pain+diabetic = think about MI until proven otherwise

نم مطمئنًا بأن مُدبّر الأمور رحيمٌ لطيف، حاشاه أن يرى عبده في بقعة مظلمة دون لطف يُجريه، يأتيك بالنور ويعطيك خيرًا مما فقدت، ويجبرك جبرًا يُنسيك مُرّ حزنك ويرزقك من حيث لا تحتسب❤

كُل الملاجئ دون اللهِ كاذبةٌ
بالله لا بالناسِ تُقضى الحوائجُ ❤

⭕️ Crohn's :

¹ Non-Specific Granuloma

² Regional ilietis (ileum) From mouth To anus

³ Unknown (heriditary- focal) Familial ischemia

⁴ Transmural (all Layers)

⁵ Skip Lesion/ Cabble stone.

⁶ 15-30 yrs, female  +Extra-intestinal manifestation + Bloody diarrhoea + mucous

⁷ Dx  CT/u/s/endoscopy Barium meals Follow string sign of Kantor

⁸ Fissuring ,sticture, Cobble stone.

⁹ ttt medical (steroid, Pentosa)  Surgery: resection/stricturoplasty

⭕️ ulcerative colitis :

¹ Non-Specific ulceration.

² Practo colitis (⏏️ Rectum).

³ unknown (immunoglogic, genitic)

⁴ mucosa & submucosa

⁵ No Skip/ No stone

⁶ 20 - 35 yrs  + Extra-intestina manfestion+ Bloody diarrhea + mucous.

⁷ DX+CT/us / endoscopy Barium(enema) pipe stem and minute ulceration.

⁸ ttt Medical = same

Panprocto colestomy + ileostomy.

● Diverticular disease of colon is the most commonest cause of massive lower git bleeding.
Most important d/d is Angiodysplasia b/c Perfuse painless old Age.

🛑 Endoscopy & barium are C/I in
Acute Diverteculitis
Use ct scan with contrast.

Indication of surgery in Divertecular disease :
1.complicated diverticulitis
2. Recurrent  non-complicated diverticulitis
3 bleeding that dosn't stop by colonscopy
4. Perforation
5. IO

🛑 Perforated duodenal ulcer :MOST common in duodenal ulcer
Sing & symptoms :
Sudden sever Abdominal pain ass with nausea & vomiting
Abdominal rigidity shock
DX:by xray chest show air under diaphragm.

🚑 Intussception:
Common in ilieocecal valve
Children in Age 6  months to 18 months.
Symptoms :
Pain vomiting constipation Abdominal Distension.
Late Per rectum bleeding (Currant jelly stool).

Muconium illious:
ass ' cystic fibrosis & microcolon
X ray no air fluid level
Ground glass appearance.