Small Bowel and Appendix Disease

Question 1

How should small bowel obstruction be treated?

Answer 1

no strangulation:
iv fluids + nasogastric suction
operate if no resolution 24-48 hours
strangulation:
resuscitate
antibiotics
early surgery

Question 2

What are signs of strangulation?

Answer 2

Constant pain
Signs of sepsis
Shock

Question 3

What are the commonest sites of Crohn’s?

Answer 3

small bowel, terminal ileum
perianal disease
large bowel, Crohn’s colitis

Question 4

How should Crohn’s exacerbations be treated?

Answer 4

medical therapy:
steroids and immunosuppression

surgery:
for mechanical complications
usually a small bowel resection

Question 5

What happens to amylase in small bowel ischaemia/infarction?

Answer 5

increases

Question 6

How should small bowel ischaemia/infarction be treated?

Answer 6

revascularise intestine

resect gangrenous intestine

Question 7

Who is Meckel’s diverticulum symptomatic in and what are these symptoms?

Answer 7

symptomatic in children
rectal bleeding
obstruction
perforation

Question 8

How is Meckel’s diverticulum diagnosed?

Answer 8

Technicium Tc 99M Scan

detects ectopic gastric mucosa

Question 9

Does carcinoid tumour of appendix have symptoms and what is its appearance?

Answer 9

No

Brown-yellowish nodule