Intestinal Problems 5 and 6 - Benign conditions of large intestines, colorectal pathology Flashcards
What is GI diverticulum?
Mucosal herniation through muscle coat
What is the difference between diverticulum, diverticular disease, and diverticulitis?
Diverticulum means they are presentDivertiular disease means they are symptomaticDiverticulitis means they are inflamed
Where do diverticulum most often occur?
Sigmoid colon
Do patients who develop diverticular disease tend to have a low or high fibre diet?
Low fibre intake
How are diverticulum diagnosed?
Barium enemaSigmoidoscopy
Symptoms of diverticular disease?
Altered bowel habitLeft sided colic relieved by deificationFlatulenceNausea
Symptoms of diverticulitis?
LIF pain/ tendernessSepticAltered bowel habit
Complications of diverticular disease? (5)
Pericolic abscessPerforationHaemorrhage (if it ruptures through a blood vessel)FistulaStricture
Treatment of uncomplicated (bacterial infection with possible sepsis) diverticulitis?
Pain reliefManagement in the communityOral antibiotics
Treatment of complicated diverticulitis?
Hartmann’s procedure (proctosigmoidectomy)Primary resection/ anastomosisPrecutaneous drainage - access around the bowelLaparoscopic lavage and drainage - peritonitis
Causes of acute and chronic colitis?
Infective colitisUlcerative colitisCrohns colitisIschaemic colitis
Causes of acute and chronic colitis?
Infective colitisUCCrohns colitisIschaemic colitis
Symptoms of acute and chronic colitis?
Diarrhoea with/ without bloodAbdominal crampsDehydrationSepsisWeight lossAnaemia
Diagnosis of acute and chronic colitis?
Plain x-rayStool cultureSigmoidoscopy + biopsyBarium enema (Not usually in acute colitis in order to prevent irritating the bowel)
What sign on an AXR is suggestive of colitis?
Thumb-printing - mucosal oedema
Treatment for UC/ Crohns colitis?
IV fluidsIV steroids (once infective/ ischaemic colitis ruled out)GI rest
3 main types of bowel ischaemia?
Acute mesenteric ischaemia (almost always small bowel)Chronic mesenteric ischaemiaIschaemic colitis
Cause of ischaemic colitis?
Low flow in the inferior mesenteric artery
presentation of ischaemic colitis?
Lower left sided abdominal pin+/- bloody diarrhoea