4: Benign conditions of the large bowel Flashcards Preview

Gastrointestinal Week 4 2016/17 > 4: Benign conditions of the large bowel > Flashcards

Flashcards in 4: Benign conditions of the large bowel Deck (36):
1

What is a diverticulum?

Mucosal herniation through muscle coat

2

Are diverticulae, seen in diverticular disease, false or true?

False

Not a true outpouching of GI tract - herniation of mucosa

3

What dietary deficiency is diverticular disease associated with?

Low fibre

4

Where do diverticulae tend to appear?

Sigmoid colon

5

What is the difference between diverticulosis and diverticulitis?

Diverticulitis is inflammation

6

Which investigation can be used to view diverticular disease?

Barium enema

Endoscopy

7

Are people with diverticulosis guaranteed to get diverticulitis?

No

8

Diverticulosis tends to be (symptomatic / asymptomatic).

asymptomatic

9

Where does pain associated with diverticulitis appear?

Left iliac fossa

10

What is a fistula?

Communication between two visceral surfaces

11

Do patients with uncomplicated diverticulitis need to be managed in hospital?

No

12

What are patients with uncomplicated diverticulitis treated with?

Oral antibiotics

13

How is complicated diverticulitis (e.g abcesses, peritonitis) treated?

Drainage

Surgery

14

What causes colitis?

Crohn's disease

Ulcerative colitis

Infection

Ischaemia

15

cxr slide 16 - right colon is lumpy bumpy, left colon is smooth and featureless

on left side, characteristics features of the colon have been lost due to colitis

16

What imaging modality can be used to view the colon?

Abdominal X-ray

17

What is used to treat patients with severe Crohn's / UC once they have been resuscitated with IV fluids?

IV steroids (if infective/ischaemic ruled out)

18

Which type of colitis is caused by occlusion of the arteries?

Ischaemic colitis

19

The risk factors of which disease process increase your chances of developing ischaemic colitis?

Atherosclerosis

20

Ischaemic colitis tends to appear in the (young / elderly).

elderly

21

What is an uncommon cause of rectal bleeding, caused by arterial/venous malformation?

Colonic angiodysplasia

22

Which investigation is used to diagnose colonic angiodysplasia?

CT angiogram

23

How would you be able to tell that a patient had colonic angiodysplasia from a CT angiogram?

Leakage

24

Colonic angiodysplasia can be treated by cauterising the haemorrhaging blood vessels. What complication may this cause?

Ischaemia

25

What can cause large bowel obstruction?

Colorectal cancer

Benign strictures

Volvulus

Hernia

26

What causes small bowel obstruction?

Adhesions

Hernia

Caecal cancer

27

slide 24 - small bowel mainly with bits of large bowel, very dilated due to obstruction - omental appendices coming off colon, white stripes are teniae coli

28

What are the four cardinal symptoms of GI obstruction?

Constipation

Distension

Pain

Vomiting

29

What palliative procedure can be used to alleviate symptoms of large bowel obstruction, e.g in cancer with metastasis?

Stenting

30

Which part of the colon has the most mesentery and is therefore the most mobile?

Sigmoid colon

31

When the sigmoid colon twists around its mesentery and the blood supply is blocked, what is this called?

What are the complications?

Sigmoid volvulus

Ischaemia, infarction, gangrene

32

slide 27 - coffee bean distension pointing into LIF

33

Which disease mimics large bowel obstruction but, upon investigation, yields no actual cause?

Pseudo-obstruction

34

Who gets pseudo-obstruction?

Those with underlying medical probs (elderly/dehabilitated)

35

What is a true diverticulum?

Diverticulum involving all layers of bowel wall, proper outpouching

36

What is a false diverticulum?

Herniation of mucosa through muscle wall, only mucosa and serosa are involved