Benign Colon Conditions Flashcards
What is a divertculum?
Mucosal herniation through muscle coat
What is diverticulosis?
presence of diverticulum
What is Diverticulitis?
presence of inflammation of the diverticulum
What is used to diagnose a diverticulum?
clinical history
barium enema
sigmoidoscopy
What are the clinical features of Diverticulitis? (uncomplicated)
left iliac fossae pain/tenderness
Septic
altered bowel habit
What are the complications of Diverticular disease? (complicated)
pericolic abscess
haemorrhage
Perforated colon – feaces in the abdominal cavity so patient is at high risk of dying
Fistula – abnormal communication between two epithelial surfaces
- passing bubbles when they pee – confirms fistula
Stricture – caused by chronic colitis and cancer
At what stage in the Hinchey classification would surgery be the first line response?
Stage 4
What is the only form of mangement for Uncomplicated Diverticulitis?
oral antibiotics
What are the treatments for Complicated Diverticulitis?
Percutaneous Drainage
Hartmann’s procedure
Laparoscopic Lavage and Drainage
Primary resection/ anastomosis
What are the causes for acute and chronic colitis?
Infective colitis
Ulcerative colitis
Crohn’s colitis
Ischaemic colitis
What are the symptoms for acute and chronic colitis?
Diarrhoea + blood abdominal cramps dehydration sepsis weight loss anaemia
How are acute and chronic colitis diagnosed?
Plain X-ray
Sigmoidoscopy + biopsy - most common
stool cultures
barium enema
What is the first line treatment for ulcerative colitis and Crohn’s?
IV fluids
IV steroids - once infective/ischaemic colitis ruled out
GI rest
What is the second line treatment for ulcerative colitis and Crohn’s?
Rescue medical therapy
Surgery
Describe the causes of ischeamic colitis?
Elderly
Arteriopaths - people with diseased arteries
acute or chronic occlusion of inferior mesenteric artery
What is Colonic angiodysplasia?
Submucosal lakes of blood
obscure cause of rectal bleeding
usually right side of colon
What is the diagnostic procedures for Colonic angiodysplasia?
Angiography
Colonoscopy
Injection or surgical resection
What is the treatment for Colonic angiodysplasia?
embolisation
endoscopic ablation
surgical resection
What can cause a large bowel obstruction?
Colorectal cancer
Benign Stricture
Volvulus
What is the treatment for large bowel obstruction?
resuscitate
Operate
Stenting
How can a sigmoid volvulus be diagnosed?
plain X-ray abdo
rectal contrast
What is the treatment of sigmoid volvulus?
Flatus tube
Surgical resection
What is a pseudo-obstruction?
No real mechanical obstruction
common in elderly/debilitated
signs: abdominal pain and vomiting
hypoxia
biochemistry
What can give you sluggish bowel movements?
hyperthyroidism
