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Y2 - GI > Appendicitis And Diverticulitis > Flashcards

Appendicitis And Diverticulitis Flashcards

1
Q

What is appendicitis?

A

Inflammation of the appendix

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2
Q

What must be done once appendicitis is discovered?

A

Surgical removal

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3
Q

What is the function of the appendix?

A

Has no function its a vestigial structure

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4
Q

What are the potential causes of the inflammation of the appendix (appendicitis)?

A

Obstruction:
Fecalith (hardened piece of stool stuck in appendix)
Lymphoid hyperplasia near appendix
Foreign bodies (rare)

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5
Q

What it’s the danger of apppendicitis?

A

Pressure in appendix increases due to blockage + inflammation

Venous congestion occurs causing oedema and impaired blood flow to the appendix causing necrosis of apppendix

Necrotic appendix can rupture/perforate releasing contents into peritoneum leading to infection of peritoneum called PERITONITIS

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6
Q

What are the symptoms of appendicitis?

A

Initially rough pain around umbilicus
Pain then localises to right lower quadrant in the RIGHT ILIAC FOSSA

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7
Q

At what point does the pain in appendicitis shift from diffuse pain around the umbilicus too specific pain in the right iliac fossa and why?

A

When the inflamed appendix comes into contact with the parietal peritoneum
Parietal peritoneum has a very well defined nerve supply so the pain is more intense and localised to that area

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8
Q

How is appendicitis diagnosed?

A

Rebound tenderness in RLQ (inc pain when pressure released from area)
Slightly ill
Slight fever/tachycardia
Imaging like Ultrasound or CT

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9
Q

How is appendicitis treated?

A

Appendectomy

Removal of appendix through either open surgery or laparoscopy

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10
Q

Why must appendicitis be treated quickly?

A

Prevent it perforating and causing peritonitis

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11
Q

What is Diverticulosis?

A

Presence of small, pouch like outpouchings called diverticula in the colon especially in the sigmoid colon

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12
Q

What leads to the formation of diverticula (outpouchings of large colon) in diverticulosis?

A

Inc pressure in colon:
-low fibre diet
-age related weakening of colon wall

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13
Q

How does diverticulosis present?

A

Asymptomatic
Usually discovered during diagnostic procedures like colonoscopy or imaging scans

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14
Q

What is diverticular disease?

A

Abdominal pain and discomfort of individuals with diverticulosis

Pain is normally mild and happens without signs of inflammation or infection

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15
Q

What is acute diverticulitis?

A

When one or ore diverticula become inflamed or infected

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16
Q

What are the symptoms of acute diverticulitis?

A

LLQ pain
Fever
Bloating
Constipation
Rectal bleeding

17
Q

What is the term for rectal bleeding??

A

Haematochezia

18
Q

What are some complications of the inflammation of the diverticula in acute diverticulitis?

A

Abscesses
Fistulas (abnormal connections between organs)
Perforation of diverticula

19
Q

How is acute diverticulitis diagnosed?

A

Clinical evaluation
Blood tests (inc white cells)
Ultrasound, CT

20
Q

How is acute diverticulitis treated?

A

Antibiotics
Analgesia
Diet modification t clear source of infection and prevent recurrence

21
Q

What is the potential treatment for complicated diverticulitis?

A

If large abscesses or perforation surgical removal may be needed

Partial colectomy

22
Q

Why do diverticula typically form in the sigmoid colon?

A

Has the highest pressure here due to peristalsis and firm stool consistency

23
Q

Why can acute appendicitis present differently?

A

Location of appendix can vary

24
Q

What locations cant eh appendix be in?

(Look at slide 3 of the appendicitis lecture)

A

Retro-caecal
Pelvic
Sub-caecal
Para-ileal

25
Q

What are the 3 categories of appendicitis?

A

Acute (mucosal oedema)
Gangrenous (transmural inflammation and necrosis)
Perforated

26
Q

Why can appendicitis present different in pregnant women?

A

Anatomy is different

27
Q

What is McBurneys Point?

A

Point 2/3s from umbilicus to ASIS where pain is experienced in the right iliac fossa with appendicitis

28
Q

What actually are the outpouchings in diverticulosis?

A

Mucous and submucosa herniating through the Muscularis layers of teh large intestine

Happens where nutrient vessels (vasa recta) penetrate bowel wall

Y2 - GI (35 decks)

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