Benign Conditions of Large Bowel Flashcards
what is diverticular disease
mucosal herniation through muscle coat (lining of intestine)
where does diverticular disease most common
sigmoid colon
causes of diverticular disease
low fibre intake
incidental finding
what is diverticulitis
mucosal herniation through muscle coat become inflamed or infected
tests for diverticular disease
clinical diagnosis
CT
sigmoidoscopy
hinchey classification
symptoms of diverticulitis
left iliac fossa pain/tenderness sepsis altered bowel habit diarrhoea +/- PR bleeding elevated inflammatory markers
complications of diverticular disease
pericolic asbcess perforation haemorrhage fistula stricture
treatment for uncomplicated diverticulitis
oral antibiotics
treatment for complicated diverticulitis
percutaneous drainage
Hartmann’s procedure
laparoscopic lavage and drainage
primary resection/anastomosis
what is colitis
inflammation of the inner lining of the colon
causes of colitis
infection
ulcers
crohn’s
ischaemia
symptoms of colitis
diarrhoea +/- blood abdominal cramps dehydration sepsis weight loss anaemia
tests for colitis
ACR
sigmoidoscopy and biopsy
stool culture
barium enema
treatment for ulcerative colitis/Crohn’s colitis
IV fluids
IV steroids (only if infection and ischaemia ruled out)
GI rest
surgery - last step
epidemiology of ischaemic colitis
elderly
arteriopaths
where does ischaemic colitis effect in GI tract
can be an acute or chronic occlusion affecting the inferior mesenteric artery
what is colonic angiodysplasia
small vascular malformation of the gut - submucosal lakes of blood
Lesions are multiple
causes of colonic angiodysplasia
unexplained GI bleeding (e.g. rectal bleeding)
anaemia
where does colonic angiodysplasia found in the GI tract
usually right side of colon
caecum
ascending colon
tests for colonic angiodysplasia
angiography
colonoscopy
infection or surgical resection
treatment fo colonic angiodysplasia
embolisation
endoscopic ablation
surgical resection
causes of large bowel obstruction
colorectal cancer
benign stricture
volvulus
treatment for large bowel obstruction
resuscitate
operate
stenting
causes of volvulus
bowel twists on mesentery
may become gangrenous
tests for volvulus
AXR
rectal contrast
treatment for volvulus
flatus tube
surgical resection
describe pseudo-obstruction of large bowel
motility disorder
no real mechanical obstruction
intestine cannot push food through
symptoms of pseudo-obstruction
no lesions in intestinal lumen
hypoxia
epidemiology of pseudo-obstruction
elderly
debilitated
what is chronic constipation
functional bowel disorder
causes of chronic constipation
common - diet
uncommon - motility disorder
what is faecal impaction
functional bowel disorder
constipation
epidemiology of faecal impaction
bed ridden
elderly
treatment for faecal impaction
strong analgesics (painkiller) manual evacuation
tests for faecal impaction
enemas
