28. Colorectal Cancer and Diverticular Disease Flashcards
What are the macroscopic types of colorectal cancer?
Fungating polypoid
Annular constricting
Flat ulcerated
Mucinous
What are the specific symptoms of rectal cancer?
PR bleeding with blood on top of stool
Tenesmus
What symptoms are specific to right sided colon cancer?
Iron deficiency anaemia
Can cause obstruction if invading the ileocaecal valve
What symptoms are specific to left sided colon cancer?
PR bleeding within stool
Change in bowel habit
What are the emergency signs of colorectal cancer?
Large bowel obstruction
Perforation and peritonitis
Acute PR bleed
What is the use of CEA in colorectal cancer?
Useful for monitoring disease but not screening because it is not specific
What other diseases can increase CEA?
Alcoholic cirrhosis
IBD
Pancreatitis
What imaging can be utilised in colorectal cancer?
Xray: chest for perforation and abdomen for obstruction
CT abdomen
Barium enema
CT colonoscopy in failed previous colonoscopy
What is the curative treatment of colorectal cancer?
Right/left hemicolectomy
Chemo and radio in rectal
Chemo if node positive
What is the palliative treatment of colorectal cancer?
Chemo
Stent through tumour
Transanal ablation if obstructing rectum
What resection margin is needed for colon tumours?
5cm
What surgery can be used for a rectal cancer in the upper 1/3?
High anterior resection
What surgery can be used for a rectal cancer in the lower 2/3?
Abdominal-perineal resection
Low anterior resection
Where is diverticulitis most commonly found?
Left colon
Right colon in asian patients
What are the complications of diverticular disease?
Diverticulitis Bleeding Perforation and peritonitis Obstruction and strictures Fistula Abscesses
