Surgical Tut - Colitis Flashcards
colitis presents?
diarrhoea - typically bloody
abdo pain
fever
3 causes of infectious colitis? and their organisms
bacterial: C.diff, salmonella, shigella, camp, yersinia
viral: CMV
parasitic: entamoeba, cryptosporidium
who gets CMV colitis?
immunosuppressed,
transplant patients
history of someone with entamoeba hystolytica?
liver lesions
diarrhoea
recent travel
C.diff two types?
Toxin A - enterotoxin (osmotic diarrhoea)
Toxin B - cytotoxin (kills cells)
what Antibiotic likely to cause C.diff?
clindamycin
augmentin DF
cephs
C.Diff ask Abx therapy within what time frame?
6 weeks
C.Diff worse outcome for colon?
toxic megacolon: adynamic colon of more than 6 cm
subsequent perforation
how to treat C.Diff?
metronidozole
vanco
surg for colectomy
how many C.Diff produce toxin A vs. B
98% produce toxin A
100% produce toxin B
ischaemic colitis risk factors?
age, HTN, DM2,smoking
hypercoagulable
cocaine
extreme physical activity
right side colon/caecum susceptible to what ischaemia?
emboli from SMA
low flow states
sigmoid colon susceptible to ischaemia why?
IMA from atherosclerosis or AAA repair
ischaemic colitis from hospital causes?
post AAA
post CABG
why Abx in ischaemic colitis?
prophylaxis for translocation along wall
how to rule out colitis infections?
faecal MCS
erythema nodosum association?
crohn’s
association of UC?
Primary sclerosing cholangitis
surgery for crohn’s?
Nope, need more surg and higher risk of complications
Risks of enterocutaneous fistula
crohn’s extra intestinal manifestations?
Ankyspon
uveitis
erythema nodosum
UC presents with?
PROCTITIS
frequent bloody stools, tenesmus
fever, weight loss
whatis backwash ileitis?
UC backwashes inflammatory mediators through iliocaecal valve causes local ilietis?
PSC with UC is what?
stricturing of biliary tree
UC plus PSC gives you risk of?
dysplasia and colon cancer
