17. Left Iliac Fossa Pain Flashcards Preview

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Flashcards in 17. Left Iliac Fossa Pain Deck (17)
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1

What are the main differentials for LIF pain in a 76yo female?

Acute diverticulitis
Constipation
IBD
Ischaemic colitis
Leaking AAA
Pseudomembranous colitis
Locally perforated sigmoid carcinoma

2

Describe the pain experienced in Acute diverticulitis?

Pain initially poorly localised, midline + colicky
Migrates to LIF + becomes constant

3

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
Bloating: IBS
Weight Loss
Gynaecological problems

4

What examinations are important to consider in someone with LIF pain?

Abdo exam, DRE + vaginal examination

5

How would you manage diverticulitis in the acute phase?

Analgesia
Bowel rest
IV fluid
Antibiotics
VTE prophylaxis
Monitor

6

What may be offered 2-6 weeks after resolution of acute diverticulitis?

Colonoscopy to confirm the diagnosis + assess the extent of diverticulosis + exclude cancer

7

What is diverticulosis?

Presence of diverticula in the bowel

8

What is diverticular disease?

Symptomatic diverticulosis: painless bleeding, altered bowel habit

9

What is diverticulitis?

Painful inflammation in patients with diverticular disease

10

What is pseudomembranous colitis? What is used to treat this?

Acute inflammatory condition of the bowel usually caused by Clostridium difficile
Oral vancomycin

11

In younger adults, what other causes of LIF must be considered?

F: gynae pathologies e.g. ectopic pregnancy
M: Testicular torsion/ tumour

12

What drugs can dampen the inflammatory response, thus masking how ill a patient truly is?

Steroids

13

What drugs predispose patients to pseudomembranous colitis?

Antibiotics
PPIs

14

What is the imaging modality of choice for diagnosing Acute diverticulitis?

Abdominal CT with contrast

15

What investigations are contraindicated in patients with Acute diverticulitis?

Colonoscopy
Barium enema

16

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

17

What is an end stoma?

proximal bowel limb brought to the surface of the abdomen to create a stoma
Distal bowel limb removed, or surgically closed + left inside the abdomen