Lower Gastrointestinal Problems

Question 1

Typical location of pain for appendicitis

Answer 1

Right iliac fossa

Question 2

Typical location of pain for acute diverticulitis

Answer 2

Left lower quadrant

Question 3

Typical location of pain for intestinal obstruction

Answer 3

Central

Question 4

Pain initial in the central abdomen before localising to the right iliac fossa (RIF).

Anorexia is common. Tachycardia, low-grade pyrexia, tenderness in RIF

Rovsing’s sign: more pain in RIF than LIF when palpating LIF

Answer 4

Appendicitis

Question 5

Colicky pain typically in the LLQ

Diarrhoea, sometimes bloody.

Fever, raised inflammatory markers and white cells

Answer 5

Acute diverticulitis

Question 6

History of malignancy (intraluminal obstruction)/previous operations (adhesions)

Vomiting. Not opened bowels recently

‘Tinkling’ bowel sounds

Answer 6

Intestinal obstruction