Colon and Rectum Flashcards
What is the difference between a true and a false diverticulum?
True diverticulum (eu congenital) involves all layers of colon False diverticulum = only mucus membrane, eu where blood vessel --> colon (Diverticulosis)
What is the difference between diverticulosis, diverticular disease and diverticulitis?
Diverticulosis = pouch itself
Diverticular disease = symptomatic pouch
Diverticulitis = pouch with infection/inflammation
Do you get diverticulosis in the rectum?
No, surrounding musculature and large diameter prevents and protects
How would a patient with diverticular disease present? And how is it different from diverticulitis?
Constipation, PR bleeding (fresh), left lower abdo pain
Diverticulitis = pyrexial
What is the cause of diverticulosis and what are the risk factors?
Cause == ^ intrabdominal Pa
Rx = anything –> ^ Pa, eg obesity, recurrent cough and diet (low fibre –> constipation –> straining –> ^Pa)
How would you image suspected diverticular disease?
Endoscopy/colonoscopy
Barium enema - if not comfortable with/not suitable for endoscopy
CT - if cannot give enema or endoscopy OR to stage lesions
USS if pt to unwell for CT scan
What are the complications of diverticulitis?
Uncomplicated = mild fever, pain, bleeding
Complicated = high fever, pain, bleeding AND perforation (rigid abdo), Abscess (air bubbles CT), fistula, stricture, sepsis, obstruction etc,
How would you manage diverticulitis?
Conservative (oral aB uncomplicated, IV aB complicated) UNLESS perforation or large abscess then surgical
aB = metronidazole and cephalexin?
What is a stoma?
An opening which connects a body cavity to the outside
What is the difference between an ileostomy and a colostomy?
Ileostomy - eu right sided, green, more fluid, spouted (contents irritate skin)
Colostomy - eu left sided, more faecal and solid, not spouted
What are the complications of stoma?
Prolapse/retraction Necrosis of distal end Fistula formation Stenosis of orifice Colostomy hernia Colostomy diarrhoea Bleeding
