Benign conditions of Large bowel Flashcards
What is diverticular disease? Which part of the colon is affected?
Mucosal herniation through muscles coat. Sigmoid colon
Two clinical investigations used to diagnose diverticular disease?
- Contrast study (barium) 2. Sigmoidoscopy
What is diverticulitis?
Inflammation of the diverticular. May present with- LIF pain, tenderness, septic, altered bowel disease
What are the complications Diverticular disease?
- Pericolic abscess 2. Perforation 3. Haemorrhage 4. Fistula 5. Stricture
What are the Hinchey classification for acute Diverticulitis? (Stage 0,Ia b , II, III, IV)
0 - Clinically mild diverticulitis Ia-
Treatment for a simple Diverticulitis?
Antibiotics and can be sent home
Treatment for Complex diverticulitis? (4)
- Percutaneous drainage
- Hartmann’s syndrome
- Laproscsopic lavage & drainage
- Primary resection/anastomosis
What are the 4 types Colitis (acute & chronic)?
- Infective colitis
- Ulcerative colitis
- Croh’s colitis
- Ischaemic colitis
What are the symptoms of acute colitis?
- Diarrhoea
- Bleeding
- Dehydration
- Sepsis
What are the investigations needed to confirm Colitis?
- Stool sample
- Sigmoidoscopy + biopsy
- Plain X ray
What X ray changes are classical of colitis?
- One side of the colon is a lot smoother than the other- looks like a leadpipe
What treatment is needed for ulcerative/Crohn’s colitis? (2)
IV fluids
IV steroids
If medical interventions dont work for ulcerative/ Crohn/s disease, what is the next option?
Surgery, rescue medical therapy
Ischaemic colitis is caused by an acute or chronic vessel _
Occlusion- can affect celiac trunk, superior or inferior mesenteric artery.
What is colonic angiodysplasia?
Submucosal lakes of blood- obscure cause of rectal bleeding, usually right side of colon
Needs a CT Angiogram to confirm diagnosis
What are the treatment options for Colonic angiodysplasia?
- Embolisation
- Endoscopic ablation
- Surgical resection
What are the causes of large bowel obstruction?
- Colorectal cancer
- Benign stricture
- Volvulus
- Hernias
What will be the symptoms of Large bowel obstruction?
- Vomiting
- Constipation
- Pain
- Distension
Treatment of large bowel obstruction?
- Resuscitate
- Operate
- Stenting
What happens in sigmoid volvulus?
Bowel twists on mesentery- most commonly affects the sigmoid as it has the longest mesentery of any part of the colon
Investigations used to confirm a sigmoid volvulus?
- Plain X ray
- Rectal contrast
Treatment for sigmoid volvulus?
- Flatus tube
- Surgical resection
What is pseudo-obstruction?
No real obstruction, however the coordinated contraction of the GI tract (peristalsis) becomes altered and inefficient
What is functional GI disorder?
number of separate idiopathic disorders which affect different parts of the gastrointestinal tract and involve visceral hypersensitivity and impaired gastrointestinal motility.
