Pathology of the Colon Flashcards

1
Q

I left most of this lecture out as it was repeated in better detail in the IBD and CRC lectures later on.

A

This stuff is just what wasn’t included elsewhere

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2
Q

What is ischaemic enteritis?

A

Occluded vessel leads to ischaemic lesions in the gut with location depending on the involved vessel

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3
Q

What happens if one of the 3 major vessels of hte gut is occluded?

A

Infarction!

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4
Q

What happens if one of the gut arteries is occluded gradually?

A

Very little as it the anastomotic circulation compensates

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5
Q

Ischaemic enteritis can be caused by an arterial thrombosis, embolism or non-occlusive ischaemia. What are some common sources for these?

A

Thrombosis:
- Atherosclerosis
- Vasculitis
- Hypercoagulability
- Oral Contraceptive
- Dissecting Aneurysm

Embolism:
- Cardiac vegetations
- Acute Atheroembolism
- Cholesterol Embolism

Non-occlusive Embolism:
- Cardiac Failure
- Shock/dehydration
- Vasoconstrictive drugs

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6
Q

How does the affected part of the gut appear during ischaemic enteritis?

A

Congestion leads to a dusky blue/purple color and sanguinous mucous in the lumin

Histologically:
- You get Oedema, Interstitial Hemorrhages & vascular dilatation due to congestion
- You also get Sloughing necrosis of the mucosa & within 1-4 days bacteria cause gangrene & perforation due to lack of blood supply causing tissue death.

Chronically you get inflammation, ulceration and fibrosis/strictures.

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7
Q

What is radiation colitits?

A

Where abdominal irradiation impairs normal proliferative activity of the bowel epithelium

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8
Q

What is the presentation of radiation colitis?

A

Anorexia
Abdominal cramps
Diarrhoea
Malabsorption

The damage depends on the dose and location

Chronically it mimics IBD

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9
Q

How does radiation colitis appear histologically?

A
  • Nuclear hypertrophy
  • Inflammation causing crypt abscesses & eosinophils

Chronically or in large doses it can also cause:
- Arterial stenosis
- Ulceration
- Necrosis
- Haemorrhage
- Perforation

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10
Q

What causes appendicitis?

A

Infection - Often via a stomach or other GI infection

Obstruction, most often due to feocolith or enterobius vermicularis (giant roundworm)

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11
Q

Waht is a feocolith?

A

A stone of faecaes often with calcification caused by faecal impaction.

When it occurs in the appendix its called appendicolith

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12
Q

How does appendicitis present?

A

Poorly localised colic pain progressing to sharp pain in right iliac fossa
N&V
Diarrhoea
Anorexia
Fever

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13
Q

MAnagement of appendicitis?

A

Appendectomy

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