colorectal x ray Flashcards
what to look for to assess penetration and coverage
12th rib, pubis, transverse processes - good penetration and coverage
how to tell between large and small bowel
large = haustra HALF
small bowel = valvulae conniventes
black in bowel means
gas
terminology simple needed to pass
dilated loops of bowel
ground glass appearance means
stool
likely cause of dilated transverse colon
obstruction around splenic flexure
what is more urgent to sort- small or large bowel obstruction
large
3 cardinal features of bowel obstruction
absolute constipation (no flatus or solids), abdominal distention, pain
why don’t you get vomiting in large bowel obstruction
one way ileo caecal valve (urgent to sort otherwise valve will pop and faecal peritonitis which is deadly)
commonest causes of small bowel obstruction
adhesions, hernia and colon cancer
name for an accumulation of foreign body material such as hair
bezoar from pica
tumours of bowel wall
lymphoma in bowel wall, can get adenocarcinoma but very rare
things that can press externally to cause obstruction
ascetics, gynaecological tumours, lymphoma
majority of large bowel obstruction
colon cancer
less common = diverticular disease
coffee bean shape
sigmoid volvulus
pain is lower than what you would imagine as these people have had chronic slow bowel for years meaning that bowels are already stretched
treatment of volvulus
rigid sigmoidoscope until you get to twist, and explosion of gas and stool out of scope
or
flexible scope but that is slower
most common type of volvulus
sigmoid
classic patient with sigmoid volvulus
psychiatric patients or elderly patients
why would you ask for an erect cxr having patient sat up for a few minutes
free gas underneath diaphragm can be visualised - means probable perforation
what causes straight lines on xray
fluid
what is apple core sign
bowel cancer causing narrowed lumen
what to do with polyps
colonoscopy to remove as can turn into cancer
mortality and morbidity for faecal peritonitis
80% mortality 100% morbidity
what is Hartmans
removal of the sigmoid colon, end colostomy, staple off rectal stump
features of a screening test
common problem, low risk, something you can do about it, acceptable to patients, cost effective
what does heel prick test check for
PKU
common imaging for biliary tree
MRCP
management of small bowel obstruction caused by adhesions
drip and suck - NG tube to aspirate and give IV fluids
oral gastrograffin - osmotic laxative and used to visualise
