Ward round 1 Flashcards
2 symptoms of ischaemic bowel
acute onset diarrhoea
PR bleeding
When wouldn’t you conduct a colonoscopy or flexi sigmoidoscopy?
Risk of perforation
What should you check before using contrast in CT?
Allergic to contrast, renal function
What is the sepsis 6?
Give 3, Take 3
Give: high flow oxygen, fluid challenge, IV antibiotics within the hour
Take 3: urine, lactate, blood cultures
What is a diverticulum?
outpouching of bowel
What is diverticular disease?
When diverticuli become symptommatic
What is diverticulitis?
Inflammation of the diverticuli
Most common area of colon for diverticulum in Western world?
descending/sigmoid colon
Most common area of colon for diverticulum in Asian population?
Ascending colon
Pathogenesis of diverticulitis
abnormal collagen cross linking results in decreased bowel elasticity, resulting in stasis. This leads to bacterial overgrowth and inflammation.
How can diverticular disease lead to perforation?
via vascular compromise
how can diverticular disease lead to obstruction?
scar tissue causes narrowing and obstruction
5 risk factors for diverticulae
low fibre diet age genetics high animal fat diet obesity NSAIDs
How does diverticular disease present?
colicky lower abdominal pain which is exacerbated by eating and relieved by defecation
altered bowel habits
PR bleeding
bloating
Presentation of diverticulitis
constant LLQ pain- tender mass, guarding anorexia nausea febrile altered bowel habits PR bleeding distended abdomen
