Colonic Disease Flashcards
Predisposing factors for colorectal cancer
Neoplastic polyps
Smoking
IBD
Alcohol
What drug is though to reduce the occurrence of colorectal cancer?
Aspirin
thought to inhibit polyp growth
Clinical presentation of colorectal cancer
PR blood Altered bowel habit or obstruction Tenesmus Weight loss Abdominal pain
Investigations for colorectal cancer
FBC
Colono/sigmoidoscopy
Where can colorectal cancer spread?
Lymphatic By blood (liver, lung, bone)
What is dukes classification used to stage?
Colorectal cancer
Describe dukes classification
A - limited to muscularis mucosa
B - extension through muscularis mucosa
C - involvement of regional lymph nodes
D - distant metastases
What surgical procedure is most commonly used in emergency bowel obstruction?
Hartmann’s procedure
Adjuvant chemotherapy reduces mortality in which dukes classification?
C
What treatment is most commonly used in the palliation of colorectal cancer?
Radiotherapy
What is the most common type of colorectal carcinoma?
Adenocarcinoma
What are diverticulum?
Outpouching of the gut wall usually at sites of entry of perforating arteries
What is diverticulosis?
Means that diverticula are present
What is Diverticular disease?
Means that diverticula are symptomatic
What is diverticulitis?
Inflammation of a diverticulum
Why do diverticula form?
Lack of fibre in diet
Increased intraluminal pressure
Force mucosa to herniate through muscle layers of the gut at weak points
Symptoms of diverticulitis
Abdominal pain (left sided colic relieved by defaecation) Altered bowed habit Pyrexia Tender colon Generalise peritonism
Investigations for diverticulitis
Blood test
CT scan
Treatment of diverticulitis
IV fluids
Antibiotics (Cirpofloxacin, metronidazole)
Complications of diverticular disease
Perforation (abscess formation -> surgery)
Fistula (into bladder)
Intestinal obstruction (usually after repeated acute episodes)
Haemorrhage
What are haemorrhoids?
Disrupted and dilated anal cushions
Causes of haemorrhoids
Constipation ip with prolonged straining
Congestion from a pelvic tumour
Pregnancy
Portal hypertension
Symptoms of haemorrhoids
Bright red blood coating stools
Mucous discharge
Anaemia
For all rectal bleeding what exam do you do?
Abdominal exam
PR exam
Proctoscopy
Sigmoidoscopy
