Colo Rectal Surgery Flashcards
disease spreads in a progressive distal to proximal manner in colon only
Ulcerative colitis
Mucosal change in UC
dysplastic transformation
Age of UC
Bimodal
B /w 15-25 & 55-65 years
Ulcerative colitis location
always starts at rectum, does not spread beyond ileocaecal valve
Continuous
most common extra-intestinal feature in both CD and UC
Arthritis
Unrelated to disease activity extraart8cular symptom of crohn
Primary sclerosing cholangitis
Unrelated to disease activity most common extraarticular symptom of UC
Uveitis
Extraarticular manifestation of Crohn vs UC Related to disease activity
Arthritis: pauciarticular, asymmetric
Erythema nodosum
Episcleritis
Osteoporosis
Barium enema finding of UC
Loss of haustrations
Superficial ulceration, ‘pseudopolyps’
Smoking in Crohns
Crohns disease is worse in smokers and smoking is an independent risk factor for disease recurrence following resection.
Crihn vs UC distribution
Crohn is transmural
UC is only mucosal
Macroscopic changes of UC vs Crohn
UC: contact bleeding
Crohn: cobblestone appearance, apthoid ulcr
Operation for rectal prolapse
Altmeir
Delormes
Rectopexy
1st two are perineal approaches
most commonly utilised treatment for fissure in ano
Topical vasodilator therapy
Surgical division of which sphincter for fissure
internal sphincter and not external
Rx of lower GI bleed 2° diverticular disease
Conservative management with close observation
Usual site of diverticular disease
between the taenia coli where vessels pierce the muscle to supply the mucosa
If visit in clinic with diverticular disease
Get Cologram
If visit to ER with diverticular disease then
Get Abd xray to rule out air
CT Abd for infective organ
Which Severity Classification for diverticular disease
Severity Classification- Hinchey
Severity Classification- Hinchey.
I= Para-colonic abscess
II= Pelvic abscess
III= Purulent peritonitis
IV= Faecal peritonitis
epithelial defect proximal to tip of coccyx and others too superiorly in the midline too
Pilonidal Sinus
In natal cleft
Surgery for pilonidal sinus
- Bascom Procedure
- Limberg procedure, Z-plasty or Karydakis procedure( these three to prevent tension free closure )
site in the abdomen for fluid to collect following a perforated appendix
Pelvis