Colon And Rectum Flashcards
Diverticulosis, IBD(chrons, uc), Benign tumors of colon, malignant tumors of colon, rectal polyps, rectal prolapse
What are the types of diverticular disease
Congenital and Acquired
What is Meckel’s diverticulum
It is a congenital type of Diverticular disease. A reminant of vitellointestinal duct
What are some important features of Meckel’s diverticulum
Occurs in 2% of patients
Should be looked for when finding normal appendix intra OP for suspected appendicitis
If found incidentally can be left provided it’s not thickened and has a wide mouth
How does Meckel’s diverticulum present
Hemorrhage
Diverticulitis - present as appendicitis
Intussusception– lead point for ileoileal or ileocolic
Chronic ulceration
Intestinal obstruction - band bn apex and umblicus
Perforation
What risk factor increases the chance of acquired Diverticulosis? How?
Dietry(low fiber diet)
Low stool bulk– segmentation n hypertrophy– increased luminal pressure – mucosal hernation through muscular
What is the difference between Diverticulosis and diverticular disease?
Diverticulosis may be asymptomatic
Diverticular disease is a condition where the diverticula is causing the symptom
How does it appear on barium enema image
Saw tooth appearance/ concertina
What are the clinical presentation Diverticulosis in mild forms
Distension, flatulence and sensation of heaviness in lower abdomen
How does a Diverticulitis present in emergency condition
Persistent left lower abdominal pain, tenderness
Sigmoid colon palpable tender and thickened
Fever malaise leukocytosis…painful Diverticulosis ruled out
Generalised peritonitis
If Hemorrhage– profuse and painless bright red if sigmoid, darker if right colon
How do you diagnosis diverticulitis
CT with contrast, x ray (free air in peritonium)
Non acute setting, barium enema and colonoscopy
How do you manage an uncomplicated Diverticulosis
Diet modification
Bulk formers to soften stool– isobel, bran, celevac
Bed rest
Iv antibiotics – in acute(cefuroxime and metronidazole)
Antispasmodics
What are the surgical modalities for treating diverticulitis
Elective– bowel prep, resection, primary anastomosis
Minimal perforation- lavage and suture of small perforation
Obstruction, oedema, adhesions or perforation– sigmoid resection with left iliac fossa colostomy and closure of rectal stump
