Surgery - Diverticula disease Flashcards
> 40 yrs patient with pain over the lower abdomen, gradual onset sharp pain patient also has bleeding from the back passage , tender left iliac fossa ,what likely
a.bowel cancer
b.diverticulitis
c.haemorrhoids
d.coeliac
b.diverticulitis
diverticulosis
common and normal prescence of diverticula (thin outpouchings with no muscularis layer)
diverticulitis
inflamed/infected diverticula
where are most diverticula found
a.sigmoid colon
b.transverse colon
c.small bowel
d.large bowel
a.sigmoid colon
(LHS of tummy pain)
diverticula that are inflammed can perforate and form fistula to ..
bladder
small bowel
causes of diverticulitis
low fibre diet
low collagen and motility of bowel
persistent left iliac fossa pain, patient reports bright red blood in stools , examination shows distention and tenderness on DRE
diverticulitis
if patient has all signs of diverticulitis but on exam shows generalised peritonitis what should be done
a.bloods
b.CT pelvis abdo with contrast
c.colonoscopy
d.IV antibiotics
e.emergency surgery
e.emergency surgery
classification of diverticula
hinchey classification
patient with diverticulitis with mild inflammation and a contained abcess what hinchey classification is this
a.1a
b.1b
c.2
d.3
e.4
a.1a
no operation
patient with diverticulitis with an abcess <4cm what hinchey classification is this
a.1a
b.1b
c.2
d.3
e.4
b.1b
no operation
patient with diverticulitis with an abcess >4cm localised what hinchey classification is this
a.1a
b.1b
c.2
d.3
e.4
d.3
patient with diverticulitis with peritonitis what hinchey classification is this
a.1a
b.1b
c.2
d.3
e.4
d.3 - liquid discharge
e.4- faecal discharge
surgical intervention needed
at what hinchey classification is the threshold for surgery
greater than 2
investigation first for suspected diverticulitis
a.WCC
b.CT pelvis and abdo with contrast
c.colonoscopy
d.aXR
e.biopsy
a.WCC
raised