Benign Conditions of the Large Bowel Flashcards
What is diverticular disease?
Mucosal herniation (diverticula) through the muscle coat of the gut
Where does diverticular disease most commony affect?
Sigmoid colon
What does diverticular disease encompass?
- Diverticulosis
- Diverticulitis
What is diverticulosis?
An asymptomatic condition involving the development of outpouchings (diverticula) from the colon
What is diverticulitis?
Inflammation of diverticula
What are the clincical symptoms of diverticulitis?
- Tenderness
- Pain
- Septic
- Altered bowel habit
- LIF pain
Which classification system is used to classify the severity of acute diverticulitis
Hinchey classification
What complications may develop from diverticular disease?
- Pericolic abscess
- Perforation
- Haemorrhage
- Fistula
- Stricture
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What is a fistula?
An epithelialised communication between two hollow organs
Which two variants of diverticulitis exist?
- Uncomplicated
- Complicated
What is uncomplicated diverticultis?
Patients do not need to stay in hospital
They only need antibiotics at most
What does complex diverticulitis require?
- Hartman’s procedure - removes diseased area and creates stoma
- Primary resection and anastomosis is another option
- Percutaneous drainage
- Laparoscopic lavage and drainage
What is the first investigation for potential colitis?
Stool culture
(eliminates concerns of obtainign from holiday/exotic conditions)
Which other investigations can be done for suspected colitis?
- X-ray
- Sigmoidoscopy
- Barium enema (rarely, if ever)
How can ulcerative colitis be treated?
IV fluids
IV steroids
GI rest
Which type of patients are likely to suffer from ischaemic colitis?
Elderly patients
Those with diabetes (problems with arteries)
In ulcerative colitis, there is increased regeneration of colonic mucosa, what does this lead to, and what sign confirms this on X-ray?
Hypertrophy of the muscularis mucosae
Lead-piping sign seen on X-ray due to the contraction of this muscle
What is colonic angiodysplasia?
An uncomon cause of bleeding due to the development of submucosal lakes of blood
Why is the sigmpid colon prone to twisting to form a volvulus?
It has the longest mesentery
What is pseudo-obstruction?
No true obstruction
This occurs in the elderly with other chronic medical problems
Most functional bowel disorders have what causes?
- Dietary
- Laxative use
- Motility disorders
