Large Bowel Flashcards

1
Q

colitis types

A

bowel wall thickening

infectious, ischemic, pseudomembranous, ulcerative, typhilitis

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2
Q

colonic ischemia

A

acute arterial thrombus, chronic arterial stenosis, low flow states (CHF), venous thrombosis

splenic flexure most susceptible

rectum has dual blood supply; hardly ever ischemic (superior rectal artery, and inferior/middle rectal rectal arteries)

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3
Q

ischemic colitis findings

A

segmental, continuous thickening of colon in vascular distribution; sparing of rectum

evaluate for atherosclerotic disease, left atrial thrombus

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4
Q

cause of infectious colitis

A

bacterial, TB, viral, amoebic

right colon: yersinia, salmonella, colonic TB (and ileocecal valve)

pancolitis: e. coli, CMV, C diff

pericolonic fat stranding, ascites, colonic wall thickening

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5
Q

pseudomembranous colitis

A

infectious coliits; overgrowth of C diff due to alteration of gut flora

pancolitis; accordion sign and thumbprinting

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6
Q

ulcerative colitis

A

inflammatory bowel disease; begins in rectum and spreads proximally (NO skip lesions); does not extend more proximally than cecum (backwash ileitis)

associated with PSC, colon cancer, cholangiocarcinoma

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7
Q

extra abdominal manifestations of UC

A

sacroilitis, iritis, erythema nodosum (tender red subcutaneous nodules), pyoderma gangrenosum (cutaneous ulcers)

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8
Q

imaging findings of UC

A

circumferential wall thickening with granular mucosal pattern; pseudopolyps

collar butten ulcer

lead pipe colon

toxic megacolon

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9
Q

typhilitis/neutropenic enterocoiltis

A

right sided colitis in immunocompromised patients

treat with abx and antifungals

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10
Q

polyposis syndromes affecting the bowel

A

FAP, hereditary nonpolyposis colon cancer syndrome (Lynch), peutz jeghers, cowden syndrome, cronkhite canada

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11
Q

FAP

A

AD syndrome with innumerable premalignant adenomatous polyps

treatment: prophylactic colectomy

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12
Q

gardner syndrome

A

variant of FAP

polyps + desmoid tumors + osteomas + papillary thyroid cancer + epidermoid cysts

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13
Q

turcot syndrome

A

variant of FAP

polyps + CNS tumors (glioma/medulloblastomas)

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14
Q

hereditary nonpolyposis colon cancer/Lynch syndrome

A

AD polyposis caused by DNA mismatch repair and microsatellite instability on molecular level

adenomatous colon polyps

associated with endometrial, stomach, small bowel, liver, biliary malignancies

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15
Q

cowden syndrome

A

AD of multiple hamartomatous polyps in skin and external mucous membranes

increased risk of thryoid cancer (follicular), skin, oral, breast, uterine malignancies

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16
Q

cronkhite canada

A

non inherited polyposis with hamartous polyps through GI tract

associated with abnormal skin pigmentation, alopecia, onychodystropy (malformation of nails)

17
Q

appendicitis

A

obstruction of appendix leading to venous congestion, mural ischemia, bacterial translocation;

tip appendicitis to gangrenous appendicitis with abscess

18
Q

imaging findings of appendicitis

A

distended fluid filled appendix > 6mm, appendiceal wall thickening, appendicolith

indirect: periappendiceal at stranding, cecal wall thickening, hydroureter, small bowel ileus

noncompressibility of appendix on US

19
Q

diverticulitis

A

microperforation/inflammation of colonic diverticulum

usually affects left colon > right

20
Q

uncomplicated vs complicated diverticulitis

A

uncomplicated: bowel wall thickening, pericolonic fat stranding around diverticulum
complicated: periconolic/hepatic abscess, extraluminal air, bowel obstruction, bowel fistula, mesenteric venous thrombis

21
Q

indications for diverticulitis surgery

A

fistula, recurrent diverticulitis with 2 prior episodes of diverticulitis treated conservatively

22
Q

epiploic appendagitis

A

benign mimic of diverticulitis caused by torsion of fatty tag/appendage from colon

oval fat attenuating lesion abutting normal colon wall with mild fat stranding