Pathological Conditions of the Small Bowel: Colon

Question 1

Diverticular Disease (diverticulosis, diverticulitis):
S/SX & DX

Answer 1

Symptoms/Signs:
. Subacute onset of left lower quadrant pain
. Alterations in bowel habits
. Palpable mass
. Fever

Diagnostics:
. History
. Physical examination
. Abdominal X-rays
. Barium studies
. Fiberoptic endoscopy

Question 2

Diverticular Disease (diverticulosis, diverticulitis): TX

Answer 2

Medical:
. Treat complications

Surgical:
. Resection when necessary for ruptures or severe disease

Question 3

Neoplasm (polyps & carcinoma): S/SX & DX

Answer 3

Symptoms/Signs:
. Determined by anatomical locations
. Could range from asymptomatic to change in bowel habits and blood in stool

Diagnostics:
. History
. Physical Exam
. Abdominal X-rays
. CT or Ultrasound
. Barium enema studies
. Colonoscopy
. Fiberoptic endoscopy

Question 4

Neoplasm (polyps & carcinoma): TX

Answer 4

Surgical:
. Adequate local incision for polyps can frequently be done with colonoscopy
. Hemicolectomy or colectomy

Question 5

Ulcerative Colitis & Crohns Disease: S/SX & DX

Answer 5

Symptoms/Signs:
. See small bowel pathology
. Watery diarrhea
. Cramping
. Abdominal pain

Diagnostic:
. History
. Physical examination
. Abdominal X-rays
. Barium studies
. Endoscopy
. Fiberoptic endoscopy

Question 6

Ulcerative Colitis & Crohns Disease: TX

Answer 6

Medical:
. Treat symptoms
. Manage complications

Surgical:
. Colectomy with ileostomy
. Continent ileostomy

Question 7

Obstruction, Volvulus, Intussusception, Impaction: S/SX & DX

Answer 7

Symptoms/Signs:
. Abdominal distention
. Cramping abdominal pain
. Nausea
. Vomiting

Diagnostics:
. History
. Physical examination
. Abdominal X-ray
. Barium studies
. Endoscopy
. Fiberoptic endoscopy

Question 8

Obstruction, Volvulus, Intussusception, Impaction: TX

Answer 8

Surgical:
. Relieve condition if it does not resolve with medical treatment
. Resection if necessary

Question 9

Appendicitis: S/SX & DX

Answer 9

Symptoms/Signs:
. Elevated white blood cell count
. Fever
. Nausea & Vomiting
- Rebound tenderness (pain upon release of palpating RLQ)
- Severe RLQ pain with rupture

Diagnostics:
. Physical exam
. Laboratory results
. CT or Ultrasound

Question 10

Appendicitis: TX

Answer 10

. Open or laparoscopic appendectomy
. Ruptured appendix may require additional procedures to wash out abdominal cavity