Colorectal surgery Flashcards
Name 3 functions of the rectum and colon?
electrolyte balance
continence
waste management
What arteries supply the colon and rectum?
superior and inferior mesenteric arteries and their branches
What epithelium is found in the anal canal?
stratified squamous non keratinised epithelium
What 3 structures are important in continence?
pelvic floor muscles and internal and external anal sphincters
Can malabsorption lead to large or small volumes in the rectum?
large
What are some categories and examples for surgery?
tumours/cancer
Abnormal function - continence, IBD, constipation
congenital - atresia, Hischsprung disease
inflammation - crohns, colitis
degeneration - diverticular disease
What symptoms can patients come complaining of?
pain, change in bowel habits, blood, non intestinal general symptoms
What do pain receptors in visceral pain run with and what does this cause for the sensation of the pain?
embryonic vessels
foregut, midgut, hindgut poorly localised pain
Describe rectal bleeding protocol for low risk patients
under 40, < 6 weeks transient, anal symptoms
6 week surveillance and waiting
either discharge or follow same treatment as initial high risk patients
Describe rectal bleeding protocol for high risk patients
persistent, >40, more than 6 weeks, no anal symptoms, rectal or abdominal mass
VISUALISE COLON
colonoscopy, sigmoidoscopy, CT colonography
What are the aims of bowel screening?
Detect cancer earlier and reduce mortality
Investigations for suspected cancer of the colon and rectum include..
CT colonography
MRI
colonoscopy + biopsy
barium enema
What are some complications of colorectal surgery?
sepsis
bleeding
VTE
wound hernia
What is teachback?
Asking a patient to explain in their own words what they have understood from your consultation
Why is rejoining the bowel in surgery important?
perfusion, blood flow, faeces and must be tension free whether stitches or glue was used
