pathology of large bowel + colorectal cancer Flashcards
what is diverticular disease
divertoculosis, the presence of diverticulum which is an outpouching/ herniation of epithelial lining in bowel
which area is most likely to be affected by diverticular disease
sigmoid colon
what factors can contribute to DD
low fibre, high fatty duet
what is true DD compared to false
all layers of bowel affected, false only serosa and mucosal
what is diverticulitis
inflammation of diverticulum
what are the symptoms of diverticulitis
common in elderly, left illiac fossa pain/ tenderness, altered bowel habits
what are the symptoms of diverticular disease
asymptomatic until complications
how is diverticular disease discovered
often accidentally by colonoscopy or barium, gold is USS or sigmoidoscopy
what are some complications of diverticular disease
perforation, fistula, intestinal obstruction, bleeding, mucosal inflammation
for uncomplicated diverticular disease what would the treatment be
IV fluids and antibiotics
for complicated diverticular disease what would the treatment be
hartmann’s procedure, percutaneous drain
name some symptoms of colitis
diarrhoea and blood, abdominal cramps, dehydration, weight loss/ anaemia
what are investigations for colitis
AXR, sigmoidoscopy, stool
what is the treatment for colitis
IV fluids, IV steroids (if not ischaemic or infective), GI rest. Surgery last resort
what arteries are normally occluded for ischaemic colitis
superior or inferior mesenteric arteries. left sided disease
what is the aiteology for ischaemic bowel disease
AF, CVD, old, atherosclerosis, withering of crypts and smudged lamina propria
what bacteria can cause antibiotic induced pseudomembranous colitis
C diff
how does C diff cause colitis
produce toxins A and B which attack epithelium
what is the treatment for C diff colitis
flagyl and vancomycin
what is the main symptom for collagenous colitis and what causes it
watery diarrhoea, increases thickness of basement membrane
what causes lymphocytic colitis and what are the symptoms
intraepithelial lymphocytes are raised, watery diarrhoea
what is radiation colitis
telangiectasia, from cancer causes vessel damage
what is the main cause of acute colitis
infection
what is colonic angiodysplasia
submucosal lakes of blood, is an obscure cause of rectal bleeding and is normally right sided
what is the investigations and treatment for colonic angiodysplasia
CT angiography, colonoscopy, injection or surgery
what can cause large bowel obstruction
cancer, faecal impaction, pseudo-obstruction, volvulus (twist)
how do you diagnose large bowel obstruction and treat it
X ray, resuscitate and operate
