Colorectal Surgery Flashcards
Important factors of continence
- rectal compliance
- stool composition
- pelvic floor muscles
- external anal sphincter
- internal anal sphincter
- anorectal sensation
what happens to pressure in rectum when volume increases
shouldn’t increase immediately , but eventually should to make you aware of contents
what happens to the ability of rectum to react to volume increase in some disease states?
rectum cannot regulate its pressure, and therefore as soon as volume increases there becomes an urgent need to release contents (happens in diarrhoea sometimes)
describe the transition zone of the rectum
simple columnar -> stratified squamous
5 main surgical problems in colon and rectum
- tumour
- inflammation
- degeneration
- abnormal function
- congenital
common causes of inflammation in colon/ rectum
- ulcerative colitis
- crohns disease
common cause of degeneration of colon/ rectum
diverticular disease (wasting that comes with old age)
examples of abnormal colon/ rectum function
constipation
incontinence
inflammatory bowl disease
congenital issues arising in colon and rectum
atresia
hirschsprungs disease
what do patients with colorectal problems complain of?
change in bowl habit/ continence
bleeding
pain
non-intestinal manifestations (spread systemically)
explain visceral pain in the gut
- pain receptors in smooth muscles of gut
- poor localisation
with regards to visceral pain, , how and where will the pain be found
pain is poorly localised, but in region of the arterial blood supply to the organ it is originating from, because pain transmits along the artery wall
what is colorectal surgery guided by
pathology
arterial supply
what do bowl anastomosis need in order to be successful
- tension free
- well perfused
- well oxygenated
- clean surgical site
- acceptable systemic state
complications of surgery
- anaesthetic related
- bleeding
- sepsis
- DVT
- anastomotic breakdown
- small bowl obstruction
- wound hernia
