Small & Large Intestine - Benign Conditions

Question 1

What is short bowel syndrome? Types, causes, C/F, management

Answer 1

Less than 200 cm of short bowel

Types:
1. Net secretors
<100 cm of small intestine

2. Net absorbers
   >100 cm of small intestine

Causes
1) AMAE (Superior Mesenteric Artery embolism)
2) Crohn’s disease
3) Trauma

C/F
1) Malabsorption (lack of ileum) - Vitamin B12 deficiency & Bile salt loss causing diarrhea
2) Diarrhea
3) Weight loss
4) Bacterial overgrowth : Vit B12 deficiency

Management:
1) Long term TPN
2) Small intestinal transplantation
3) Medical management
- Tuduglutide
- Loperamide
- Cholestyramine
4) Surgery - Bianchi surgery & STEP (Serial Transverse Enteroplasty)

Question 2

M/c site of diverticula of colon

Answer 2

Sigmoid colon

Question 3

Investigation for diverticulosis

Answer 3

IOC : barium enema or colonoscopy

Barium enema shows Saw-tooth appearance

Question 4

M/c cause of massiv lower GI Haemorrhage

Answer 4

Diverticulosis

Question 5

M/c cause of PR Bleeding

Answer 5

Haemorrhoids

Question 6

2nd most common cause of massive lower GI Haemorrhage?

Answer 6

Angiodysplasia

Question 7

Heyde syndrome

Answer 7

Angiodysplasia + Aortic stenosis
Associated with Von Willebrand Disease - ADAMTS 13 gene

Question 8

Criteria for Severe UC

Answer 8

Given by Truelove & Witt’s Classification

Severe UC characterised by:
1) >6 stools / day with blood
2) Fever >37.5
3) HR>90
5) Anemia with Hb <75% of normal
6) ESR> 30 mm of Hg