Investigations + Treatments Flashcards
FBC?
anaemia or low platelets
Clotting?
do they have a bleeding tendancy
Urea?
a rise in Urea is consistent with a recent upper GI bleed (urea is a breakdown product of digested RBCs).
Proctoscopy/rigid sigmoidoscopy?
enable identification of bleeding haemorrhoids or a rectal cancer.
Colonoscopy?
diagnostic and has therapeutic options of controlling local haemorrhages.
Mesenteric angiography?
useful if haemorrhage obscures endoscopy view, and can detect angiodysplasia, embolization can be performed during the procedure
CT angiography?
Involves venous access and so is safer than mesenteric, provides rapid imaging
Rectal bleeding investigation pathway?
Dieulafoy lesion?
a ruptured submucosal artery, most commonly at the oesophagagastric junction, but also common in the small bowel
Colonic angiodysplasia?
a submucosal arteriovenous malformation, can present as frank bleed or occult blood loss with anaemic presentation. Treatment is embolization, surgical resection or endoscopic laser electrocoagulation.
Internal haemorrhoids lifestyle treatment?
increase fibre, hydrate, avoid straining
Internal haemorrhoids medical treatment?
local anaesthetic creams, steroidal creams, laxative therapy
Internal haemorrhoids surgical treatment?
rubber band ligation, injection sclerotherapy, infrared coagulation, haemorroidectomy
Anal fissure medical management?
high fibre diet with laxatives prevents further damage and relieves pain, topical analgesics (lidocaine gel), GTN can increase blood flow and relax the internal anal sphincter.
Diverticulosis, diverticular disease, diverticulitis?
Diverticulosis; presence of diverticula in the intestine. Diverticular disease; symptomatic diverticulosis. Diverticulitis; diverticular inflammation.
Colorectal carcinoma risk factors?
age, male, obesity, colorectal disease (IBD, previous cancer, colorectal polyps), family conditions, sedentary lifestyle.
