Colon/Rectum/Anus Flashcards
What often causes Appendicitis?
Lumen occluded by fecalith or lymphoid proliferation
Symptoms of Appendicitis?
RLQ abdominal pain
N/V
Fever with High WBC
If the appendix ruptures, what other signs will be present?
Rebound tenderness, guarding and hypotension
What is the imaging choice for Appendicitis? In children or pregnant mothers?
CT with IV contrast
– OR US/MRI for children/pregnant mothers
What is Ogilvie Syndrome?
Colonic Pseudo-obstruction
How will Ogilvie Syndrome present?
Just like a bowel obstruction – but there is NOT one
What will be seen on imaging with Ogilvie Syndrome?
Colonic dilation with small bowel unaffected
– NO obstruction
Colonic dilation with no obstruction seen and the small bowel is normal?
Ogilvie Syndrome
How will a Sigmoid Volvulus present?
Just like a bowel obstruction
= Abdominal pain/distention/constipation
What will be seen on X-ray with a Sigmoid Volvulus?
“Coffee bean” sign
What will be seen on CT with a Sigmoid Volvulus?
“Whorl sign”
What is the treatment for a Sigmoid Volvulus?
Sigmoidoscopy or Sigmoid colectomy
In what patients is Rectal Prolapse more common?
Older women with chronic constipation or who have vaginally delivered many kids
What will be seen on exam with Rectal Prolapse?
Patient bears down
–> Mass protrudes from the anus
How will the mass protruding from the anus look with Rectal Prolapse?
Mass with concentric rings
An Anal Fissure is a laceration that involves what layers? Is the sphincter involved?
Mucosa and submucosa but NOT the sphincter
Where does an Anal Fissure usually occur?
MIDLINE and posterior in the anal canal
An Anal Fissure will present how?
Constipation –> pain with pooping
Treatment for an Anal Fissure involves a high fiber diet and medications to do what?
Relax the anal sphincter because it is too tight
Where are Internal Hemorrhoids located? What innervates them?
ABOVE the pectinate line
– Autonomic innervation
With what type of Hemorrhoid will there be pain?
External Hemorrhoid
Where are External Hemorrhoids located? What innervates them?
BELOW the pectinate line
– Somatic innervation = PAIN