Benign Diseases of the Colon and Rectum

Question 1

pulsion diverticula

Answer 1

• colonic segmentation during peristalsis increases pressure

Question 2

anatomy of diverticular disease

Answer 2

• can occur from cecum to rectum

- cannot occur in rectum - no tenia coli

Question 3

most common location of diverticular disease

Answer 3

• sigmoid colon

Question 4

bleeding and diverticular disease

Answer 4

• diverticulosis - common

- diverticulitis - rare

Question 5

test of choice for diverticular disease

Answer 5

• CT of abdomen and pelvis

- NO role for colonoscopy - risk of perforation

Question 6

indications for surgery for diverticular disease

Answer 6

• recurrent attacks of 2 or more episodes
• one attack of complicated diverticulitis
• undrainable abscess
• high grade obstruction
• fistula formation

Question 7

treatment of severe diverticulitis

Answer 7

• healthy patient - resection with primary anastomosis

- mildly ill patient - resection with primary anastomosis with proximal diversion

Question 8

treatment of ruptured diverticulitis/peritonitis

Answer 8

• Hartmanns procedure: sigmoid resection, end colostomy with rectal stump
• restoration of intestinal continuity can be performed 8 weeks later to remove stoma

Question 9

most common site of volvulus

Answer 9

• sigmoid colon

Question 10

treatment of sigmoid volvulus

Answer 10

• initial colonoscopic decompression

- operative treatment is decided by ischemia: if iscemia then Hartmanns, if no ischemia then resection with anastomosis

Question 11

procedure of choice for cecal volvulus

Answer 11

• right colectomy with ileal-transverse colon anastomosis

Question 12

treatment of transverse colon volvulus

Answer 12

• resection

Question 13

diagnosis of volvulus

Answer 13

• colonoscopy is gold standard for sigmoid volvulus but NOT cecal volvulus

Question 14

most common cause of LGIB

Answer 14

• UGIB

Question 15

test of choice for colorectal cancer

Answer 15

• colonoscopy