20. Large Bowel Disease Flashcards
Where is the plexus of meissner located?
Submucosa
Where is the plexus of auerback located?
Muscle
What is Hirschsprung’s disease?
Congenital megacolon due to arrested migration of neural crest cells: no meissner or auerbach plexuses so no peristalsis, causing a functional obstruction
What patient group is more likely to have Hirschsprung’s disease?
Male
Downes syndrome
What parts of the bowel are susceptible to Hirschsprung’s disease?
Rectum and sigmoid
What gene is associated with Hirschsprung’s disease?
RET gene
What are the clinical features of Hirschsprung’s disease?
Failure to pass meconium
Constipation, vomiting and abdominal distension
What are the complications of Hirschsprung’s disease?
Massive dilatation and perforation
Infection
What is the treatment for Hirschsprung’s disease?
Resect the part without ganglion cells
What part of the enteric tract is supplied by the superior mesenteric artery?
Caecum to splenic flexure
What part of the GIT is supplied by the inferior mesenteric artery?
Colon to rectum
What arteries supply the lower rectum?
Internal iliac and internal pudendal
What is a transmural infarction caused by?
Sudden occlusion of a major vessel causing infarction of all layers
What are the other types of infarction of the bowel?
Mural: mucosa and submucosa
Mucosal
What are the clinical features of transmural bowel infarction?
Severe abdominal pain
Bloody diarrhoea
Reduced peristaltic sounds
Rigidity
What are the clinical features of mucosal and mural infarcts?
Intermittent bloody diarrhoea
Non-specific abdominal complaints
What is angiodysplasia?
Dilatation of blood vessels in caecum and right colon
Seen in elderly as a result of wear and tear
What is hereditary haemorrhagic telangiectasia?
AD
Thin walled blood vessels in mouth and GIT which can rupture