Benign conditions of Large bowel

Question 1

What is diverticular disease? Which part of the colon is affected?

Answer 1

Mucosal herniation through muscles coat. Sigmoid colon

Question 2

Two clinical investigations used to diagnose diverticular disease?

Answer 2

1. Contrast study (barium) 2. Sigmoidoscopy

Question 3

What is diverticulitis?

Answer 3

Inflammation of the diverticular. May present with- LIF pain, tenderness, septic, altered bowel disease

Question 4

What are the complications Diverticular disease?

Answer 4

1. Pericolic abscess 2. Perforation 3. Haemorrhage 4. Fistula 5. Stricture

Question 5

What are the Hinchey classification for acute Diverticulitis? (Stage 0,Ia b , II, III, IV)

Answer 5

0 - Clinically mild diverticulitis Ia-

Question 6

Treatment for a simple Diverticulitis?

Answer 6

Antibiotics and can be sent home

Question 7

Treatment for Complex diverticulitis? (4)

Answer 7

1. Percutaneous drainage
2. Hartmann’s syndrome
3. Laproscsopic lavage & drainage
4. Primary resection/anastomosis

Question 8

What are the 4 types Colitis (acute & chronic)?

Answer 8

1. Infective colitis
2. Ulcerative colitis
3. Croh’s colitis
4. Ischaemic colitis

Question 9

What are the symptoms of acute colitis?

Answer 9

1. Diarrhoea
2. Bleeding
3. Dehydration
4. Sepsis

Question 10

What are the investigations needed to confirm Colitis?

Answer 10

1. Stool sample
2. Sigmoidoscopy + biopsy
3. Plain X ray

Question 11

What X ray changes are classical of colitis?

Answer 11

• One side of the colon is a lot smoother than the other- looks like a leadpipe

Question 12

What treatment is needed for ulcerative/Crohn’s colitis? (2)

Answer 12

IV fluids

IV steroids

Question 13

If medical interventions dont work for ulcerative/ Crohn/s disease, what is the next option?

Answer 13

Surgery, rescue medical therapy

Question 14

Ischaemic colitis is caused by an acute or chronic vessel _

Answer 14

Occlusion- can affect celiac trunk, superior or inferior mesenteric artery.

Question 15

What is colonic angiodysplasia?

Answer 15

Submucosal lakes of blood- obscure cause of rectal bleeding, usually right side of colon

Needs a CT Angiogram to confirm diagnosis

Question 16

What are the treatment options for Colonic angiodysplasia?

Answer 16

1. Embolisation
2. Endoscopic ablation
3. Surgical resection

Question 17

What are the causes of large bowel obstruction?

Answer 17

1. Colorectal cancer
2. Benign stricture
3. Volvulus
4. Hernias

Question 18

What will be the symptoms of Large bowel obstruction?

Answer 18

1. Vomiting
2. Constipation
3. Pain
4. Distension

Question 19

Treatment of large bowel obstruction?

Answer 19

1. Resuscitate
2. Operate
3. Stenting

Question 20

What happens in sigmoid volvulus?

Answer 20

Bowel twists on mesentery- most commonly affects the sigmoid as it has the longest mesentery of any part of the colon

Question 21

Investigations used to confirm a sigmoid volvulus?

Answer 21

1. Plain X ray
2. Rectal contrast

Question 22

Treatment for sigmoid volvulus?

Answer 22

1. Flatus tube
2. Surgical resection

Question 23

What is pseudo-obstruction?

Answer 23

No real obstruction, however the coordinated contraction of the GI tract (peristalsis) becomes altered and inefficient

Question 24

What is functional GI disorder?

Answer 24

number of separate idiopathic disorders which affect different parts of the gastrointestinal tract and involve visceral hypersensitivity and impaired gastrointestinal motility.