benign conditions of the large bowel Flashcards
What are the common large bowel disease?
carcinoma of the colon and rectum
colonic polyps
crohns colitis and UC
Give examples of less common large bowel disease?
colonic volvulus
colonic angiodysplasia
ischaemic colitis
pseudo-obstruction
What is diverticular disease?
mucosal herniation through muscle coat. Occurs in the sigmoid colon leading to low fibre intake
How do you diagnose a diverticulosis?
barium enema and sigmoidoscopy
What are the clinical features of diverticulitis?
LIF (left iliac fossa) pain/tenderness, septic, altered bowel habits
What are the complications with diverticular disease?
pericolic abscess perforation haemmorhage fistula stricture
How do we classify acute diverticulitis?
Hinchey classification
What are stage 0 and 5 of hinchey classification?
0=clinically mild diverticulitis
5=faecal perionitis
What is the treatment for complex diverticulitis ?
percutaneous drainage
hartmanns procedure
primary resection/anastomosis
laparoscopic lavage and drainage
What are symptoms of acute and chronic colitis?
diarrhoea abdominal cramp dehydration sepsis weight loss, anaemia
How do we diagnose acute and chronic colitis?
plain x-ray
sigmoidoscopy+biopsy
stool cultures
barium enema
How to treat crohns and UC?
Failure to settle?
IV fluid IV steroids GI rest unsettled: rescue medical therapy -surgery
What is ischaemic colitis?
inflammation and injury of the large intestine result from inadequate blood supply.
What is colonic angiodysplasia?
vascular malformation in gut causing:
submucosal lakes of blood
rectal bleeding
how to diagnose colonic angiodysplasia?
angiography
colonoscopy
injection or surgical resection
How do you treat colonic angiodysplasia?
embolisation
endoscopic ablation
surgical resection
What is endoscopic ablation?
radiofrequency which destroys harmful tissue in the body
What are the causes of large bowel obstruction?
colorectal cancer
benigh stricture
volvulus
What is the treatment of large bowel obstruction? (emergency)
resuscitate
operate
stenting
What is sigmoid volvulus?
bowel twists on mesentery and may become gangrenous
What is the diagnosis of sigmoid volvulus ?
plain x-ray abdo
rectal contrast
