Flashcards in 17. Left Iliac Fossa Pain Deck (17)
What are the main differentials for LIF pain in a 76yo female?
Locally perforated sigmoid carcinoma
Describe the pain experienced in Acute diverticulitis?
Pain initially poorly localised, midline + colicky
Migrates to LIF + becomes constant
After characterising the LIF pain what other symptoms should you ask about?
Nausea + vomiting: Acute diverticulitis + PID
Fever: Acute diverticulitis
Change of bowel habit
Rectal bleeding: colitis
What examinations are important to consider in someone with LIF pain?
Abdo exam, DRE + vaginal examination
How would you manage diverticulitis in the acute phase?
What may be offered 2-6 weeks after resolution of acute diverticulitis?
Colonoscopy to confirm the diagnosis + assess the extent of diverticulosis + exclude cancer
What is diverticulosis?
Presence of diverticula in the bowel
What is diverticular disease?
Symptomatic diverticulosis: painless bleeding, altered bowel habit
What is diverticulitis?
Painful inflammation in patients with diverticular disease
What is pseudomembranous colitis? What is used to treat this?
Acute inflammatory condition of the bowel usually caused by Clostridium difficile
In younger adults, what other causes of LIF must be considered?
F: gynae pathologies e.g. ectopic pregnancy
M: Testicular torsion/ tumour
What drugs can dampen the inflammatory response, thus masking how ill a patient truly is?
What drugs predispose patients to pseudomembranous colitis?
What is the imaging modality of choice for diagnosing Acute diverticulitis?
Abdominal CT with contrast
What investigations are contraindicated in patients with Acute diverticulitis?
What is a loop stoma?
loop of bowel brought to surface + half-opened: allows the faecal matter to drain into stoma bag without reaching distal anastomoses.
Colon stays connected to rectum