Colorectal Surgery Flashcards

1
Q

How do we screen patients for colorectal cancer?

A

Quantitative faecal immunochemical test (qFIT)

Possible sigmoidoscopy

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2
Q

What are the signs of CRC?

A
Abdominal pain
Rectal bleeding
Change in bowel habits
Weight loss
Tenesmus
Fatigue
Vomiting
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3
Q

What are investigations used for colorectal suspicions?

A
Colonoscopy
Biopsy
CT colongraphy
Plain CT abdo/pelvis with contrast
Staging CT if confirmed CRC
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4
Q

What is removed in rectal cancer during surgery?

A

Rectum and its mesorectum

If mesorectal fascia involved surgery is no use

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5
Q

What is pre-op MRI used for in rectal cancer?

A

Restaging following neoadjuvant treatment

Surgery after treatment

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6
Q

What are the bowel anastomosis principles?

A
Tension free
Well perfused
Well oxygenated
Clean surgical site
Acceptable systemic state
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7
Q

Where is the site of an ileostomy?

A

Usually right iliac fossa

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8
Q

Where is the sit of a colonostomy?

A

Usually left iliac fossa

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9
Q

What are the contents of an ileostomy?

A

Liquid, looser stool

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10
Q

What are the contents of a colonostomy?

A

Solid stools

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11
Q

What is the appearance of an ileostomy?

A

Spouted

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12
Q

What is the appearance of a colonostomy?

A

No spout, flush with skin

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13
Q

What are the complications of a stoma?

A

Bleeding
Infection (superficial + deep)
Anastomotic leak
Stoma problems (ischaemia, retraction, prolapse, hernia, high output
Possible damage to pelvic nerves and impaired fecundity in younger women

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14
Q

What are the cardinal signs and symptoms of bowel obstruction?

A
Abdominal pain
Vomiting
Absolute constipation (flatus and solids)
Abdominal distension
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15
Q

What are the causes of large bowel obstruction?

A

Malignant (60%)

Benign: strictures, volvulus, faecal impaction, intussusception, pseudo-obstruction

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16
Q

What are the causes of small bowel obstruction?

A

Adhesions

Hernias

17
Q

How is bowel obstruction managed?

A
ABC
Fluid resuscitation
NBM - consider nasogastric tube if vomiting
Analgesia + antiemetics
Consider IV antibiotics
Bloods (FBC, U+E, G+S, coagulation screen)
Blood gas (lactate, pH, BE)
CT abdo/pelvis