colon rectum anus Flashcards
What week does embryonic GI tract begin developing
4th week of gestation
Most common bacteria in the colon
B. Fragilis
Diagnostic test used if perforation or leak is suspected in the colon
Gastrografin - water soluble contrast agent
How can ultrasound differentiate a benign polyp from invasive tumor?
Based on integrity of the submucosal layer
Most common traumatic cause of incontinence
Injury to the anal sphincter during vaginal delivery
Most common site of diverticulosis
sigmoid colon
Most common fistula of diverticulitis
colovesical fistula (5%)
hinchey staging for complicated diverticulitiys
I - pericolic abscess
II - pelvic abscess
III - purulent peritonitis
IV - fecal peritonitis
Diagnostic test for diverticulitis
CT scan
Treatment of uncomplicated diverticulitis
- out patient
- broad spectrum antibiotic 7 to 10 days
- low residue diet
- failure to improve in 48 to 72 hours indicates abscess formation
Treatment of complicated diverticulitis
Elective sigmoid colectomy
What gene is mutated in familial aadenomatous polyposis
APC gene - chromosome 5
Multiple polyps in the intestine associated with melanin spots in the buccal mucosa and lips
Peutz Jegher Syndrome
Characteristic of Cronkite Canada Syndrome
- polyposis
- alopecia
- cutaneous pigmentation
- atrophy of fingernails and toenails
Characteristic of Cowden Syndrome
- GI polyps
- facial trichilemoas
- breast cancer
- thyroid disease
What type of adenoma has the highest cancer risk
Villous adenoma (50%)
Most common form of spread of colorectal carcinoma
lymphatics
Duke’s staging of colorectal cancer
A - mucosa and submucosa
B - muscularis propria
C - lymph node
D - distant metastases
Treatment of colorectal cancer
- LAR - tumor within 5 to 10 cm from anal verge
2. APR - tumor less than 5 cm from anal verge or recurrent cancer
Triad of carcinoid tumor
- flushing - bradykinin
- diarrhea - serotonin
- vascular heart disease (mitral valve) - serotonin
Diagnostic test of caarcinoid tumor
24 hour 5 -HIAA test
This refers to squamous cell carcinoma in situ
Bowen’s disease (anal intraepithelial neoplasia)
This disease is seen as bent inner tube or coffee bean appearance with loop convexity lying in the RUQ
sigmoid volvulus
This diease is seen as kidney shaped, air filled structuree in the LUQ
cecal volvulus
Treatment of sigmoid volvulus
- fluid resuscitation
2. endoscopic detorsion
Treatment of cecal volvulus
- surgical exploration
most common complication of hemorrhoidectomy
urinary retention
most common location of anal fissure
posterior midline
Medical management of anal fissure
- lubricant
- hot sitz bath
- bulk laxatives
surgical management of anal fissure
Lateral subcutaneous partial internal sphincterectomy
most common type of anorectal abscess
perianal abscess
most common type of fistula in ano
intersphincteric
It is a class of fistula in ano where in it tracks through the distal internal sphincter and intersphincteric space to an external opening near the anal verge
intersphincteric
it is a class of fistula in ano where in it results fro an ischiorectal abscess and extends through bot the internal and external sphincter
transsphincteric
it is a class of fistula in ano where in it originates in the intersphincteric plane and tracks up around the entire external sphincter
suprasphincteric
it is a class of fistula in ano where in it originates in the rectal wall
extrasphincteric
Treatment of fistuala in ano
fistulotomy with drainage or seton placement
What is important in maintaining the integrity of colonic mucosa
short chain fatty acids
