Surgical Therapies for IBD Flashcards
What is an example of a planned emergency operation?
Sub total colectomy for UC
Resectino for crohn’s disease
What is claeed an unexpeted finding “suprise” operation?
Diagnostic laparoscopy
Recta/ anal disease
What are the elective surgeries that can be performed for crohn’s disease?
Resection
Stricturoplasty
Fistulas
Anal disesae
What are the elective operations for UC?
Prorocolectomy with end ileostomy
Protocolectomy with ileorectal anastomosis
What are the indications for elective surgery in ulcerative colitis?
Medically unresponsive disease Intolerability Dysplasia/ metaplasia Growth retardation in children Attemptped resolution of extrea-intestinal disease
What are the 3 different types of pouches?
W pouch
J pouch
S pouch
What are the intermediate complications of a resection?
HAemorrhage
Enterotomy
Anaphylaxis
What are the early complications of resection?
Urinary dysfunction Wound infection Pelvic abscess Anastomotic leak Atelectasis Ileus Portal vein thrombosis
What are the late complications of a resection?
Imptence Infertility Puchitis DVT/ PE Small bowel obstruction
What is the truelove and Witt critea for a severe attack of UC?
ESR/ CRP Haemoglobin Bloody stools Temperature Heart rate
What is a subtolal colectomy?
Lap or open
Rectal stump can be brought out as a mucous fistula
Stapled and left in (riskier)
What is toxic megacolon?
Sepsis Distension Pain Requires decromression May perforate Can be fatal
What are the indications of surgery in CD?
Stenosis causing obstruction Enterocutaneous fistulas Inta-abdominal fistulas Abscesses Bleeding (acute or chronic) Free perforation
What can be perormed for a duodenal or pyloric stenosis?
Gastrojejunostomy
What can be performed for a multisite disease?
Stricturoplasty of lesions instead of resection
Balloon dilatation