Colorectal Flashcards
What are the most commonest types of colorectal cancer?
rectal: 40%
sigmoid: 30%
descending colon: 5%
transverse colon: 10%
ascending colon and caecum: 15%
What is diverticular disease?
Consists of herniation of colonic mucosa through the muscular wall of the colon. The usual site is between the taenia coli where vessels pierce the muscle to supply the mucosa
Altered bowel habit, bleeding, abdo pain
What are the complications of diverticular disease?
Diverticulitis Haemorrhage Development of fistula Perforation and faecal peritonitis Perforation and development of abscess Development of diverticular phlegmon
What is the severity scale- Hinchey for diverticular disease?-
I. Para-colonic abscess
II Pelvic abscess
III Purulent peritonitis
IV Faecal peritonitis
Why does diverticular disease cause a colovesicle fistula?
Recurrent attacks of diverticulitis may cause the development of local abscesses which may erode into the bladder resulting in urinary sepsis and pneumaturia
What are the 3 types of colorectal cancer?
sporadic (95%)
hereditary non-polyposis colorectal carcinoma (HNPCC, 5%)
familial adenomatous polyposis (FAP, <1%)
Patients with HNPCC are at risk of getting which cancers?
Colon
Endometrial
Pancreatic
What is the Amsterdam criteria for HNPCC diagnosis?
at least 3 family members with colon cancer
the cases span at least two generations
at least one case diagnosed before the age of 50 years
What are the types of resection used for colonic cancer sites?
Right hemicolectomy- Caecal, ascending or proximal transverse colon
Left hemicolectomy- Distal transverse, descending colon
High anterior resection- sigmoid colon
Anterior resection- upper rectum
Anal verge- abdomino-perineal excision of rectum
What are sigmoid volvulus associations?
older patients
chronic constipation
Chagas disease
neurological conditions e.g. Parkinson’s disease, Duchenne muscular dystrophy
psychiatric conditions e.g. schizophrenia
What’s the best marker to use in bowel cancer?
CEA
