SI Flashcards
Epidemiology (small and large bowel)
60+
4th most common
decrease by 11% by 2035
Aetiology
smoking
diet (28% too little fibre)
Crohn disease
Lynch disease
radiation
polyps: benign mass in the bowel which becomes cancerous
coeliac disease
genetics
give info on bowel screening
58-74 years
saves 9/10 people
every 2 years
faecal sample delivered in the post
improves the outcome, gives a better prognosis increasing the survival rate
What are the type of pathology
Adenocarcinoma (40%)
Lymphomas
NETs
Sarcoma (soft tissue in the ileum)
Leiosarcomas
What staging is used?
TNM
Where does met spread come from?
Pancreas and ovaries
Where does local spread go to?
- other regions of the SB
- if in the duodenum, then it can spread to the pancreas
Where does the lymphatic spread travel to?
mesenteric, colorectal patients tend to have mets in the liver
Where does haematological spread go to?
lung, liver, bone
What can’t be formed during a diagnosis?
a biopsy, due to the high risk of perforation, therefore a laparoscopy is performed after a CT/MRI and barium swallow
What are the presentations?
weightloss
malnutrition
fatigue
descended stomach (stomach)
blood in stools, depends on the tumour location could be black or red
what is completed during diagnosis
CT/MRI
laparoscopy: opens the whole abdomen, there are recovery issues
barium swallow
blood test
capsule endoscopy: capsule contains a camera, which follows the digestive pathway
what treatment options are there
surgery, chemotherapy, radiotherapy
describe surgery
dependent on the location
part of the bowel can be removed with the remaining being re-connected
pancreatico-duodectomy
ileostomy: stoma bag
may be followed up by chemo
describe RT
very uncommon, due to constant motion, there is a high risk of ulceration
maybe to the mesenteric nodal group
palliation: ant and post field with 20Gy in 5 or 30Gy in 10
