Lecture 16- Lower GI cancer Flashcards
1
Q
Symptoms of lower GI cancers:
A
- Obstruction
- PR bleeding
- Change in bowel habit
2
Q
Obstructions
A
Anything that causing a blockage in the bowl
3
Q
red flags associated with obstruction
A
- Weight loss
- Unexplained abdominal pain
4
Q
General symptoms of obstruction
A
- Abdominal distension – how much air on x-ray
- Abdominal pain
5
Q
benign causes of obstructions
A
- Volvulus- twisting of the bowel
- Diverticular disease
- Hernias
- Strictures
- Pyloric stenosis
- Intussusception – intestine slides inside another part
6
Q
malignant causes of obstruction vary
A
based on location
7
Q
small intestine malignancy and obstruction
A
- If obstructions higher up pressure builds up backwards vomiting first
8
Q
small intestine malignancy and obstruction
A
- Would have to have very significant build up to cause vomiting
- Causes absolute constipation- no wind or faeces
9
Q
PR bleeding Red flags
*
A
- Anyone 40 with unexplained weight loss /abdo pain should be considered
- > 50 with iron deficiency, anaemia and change in bowel habit
- Tenesmus- feeling the need to defaecate and defecating but still feel like there is something still there after finished
10
Q
benign causes of PR bleeding
A
- Haemorrhoids
- Anal fissures
- IBD
- Diverticular disease
- Infective gastroenteritis
11
Q
PR bleeding with S.intestine origin
A
melaena- more time to oxidise
12
Q
PR bleeding with L.intestine origin
A
- Fresher bright red?
13
Q
Change in bowel habits- Red flags
A
- Age dependent
- Weight loss
- Iron deficiency anaemia
14
Q
change in bowel habits
- ‘What is normal for the patient?’*
- x
A
‘What is normal for the patient?’
- Change in frequency
- Change in consistency
- Associated symptoms
15
Q
benign causes of change in bowel habits
A
- IBD
- Thyroid
- Coeliac
- IBS
- medication
23
Q
-
Right sided (ascending colon) – poor prognosis but treatable and manageable surgically
*
A
- Weight loss
- Anaemia
- Less likely to have bowel obstruction- lumen of ascending larger
- Liquid content (site of water reabsorption)
- Change in bowel habit is less likely
- More advanced disease at presentation
- Fungating –> grow out of the wall in one place (not concentrically)
24
Q
- Left sided (descending colon)- better prognosis
A
- Weight loss
- Anaemia
- Bowel obstruction
- Narrower lumen
- Contents more solid
- Tenesmus
- Early change in bowel habit
- PR bleedings
- Less advanced disease t presentation
- Stenosing – concentrically make the lumen get smaller
- Apple core abnormality(barium enema)
32
Q
- Staging
A
-
Staging
- TNM staging
- Dukes staging (for malignancy of large bowel)
