General Surgery - Colorectal

Question 1

Where does the ampulla of Vater enter the bowel?

Answer 1

Descending part of the duodenum.

Question 2

What is the ampulla of Vater?

Answer 2

Where the common bile duct and the pancreatic duct enter the second part of the duodenum.

Question 3

Normal diameter of caecum?

Answer 3

ULN is 10-12cm.

Question 4

Normal diameter of ascending colon?

Answer 4

ULN is 8cm.

Question 5

Normal diameter of recto-sigmoid colon?

Answer 5

ULN is 6.5cm.

Question 6

What abdominal x-ray finding suggests a diagnosis of volvulus?

Answer 6

“Kidney-bean” shape.

Question 7

Describe the abdominal x-ray appearance of sigmoid volvulus?

Answer 7

“Kidney-bean” shape i.e. a dilated, inverted U-shaped loop projecting towards the R side of abdo.

Question 8

Describe the abdominal x-ray appearance of caecal volvulus?

Answer 8

Kidney bean - dilated right colon rotates to L side.

Question 9

Intramural bowel gas on abdominal x-ray is suggestive of?

Answer 9

Intestinal ischaemia.

In neonates it is diagnostic of necrotising enterocolitis.

Question 10

Intramural bowel gas on abdominal x-ray in a neonate is diagnostic of?

Answer 10

Necrotising enterocolitis.

Question 11

A “bird’s beak” appearance on investigation with contrast enema is seen in which condition?

Answer 11

Volvulus.