Benign Conditions of Large Bowel

Question 1

what is diverticular disease

Answer 1

mucosal herniation through muscle coat (lining of intestine)

Question 2

where does diverticular disease most common

Answer 2

sigmoid colon

Question 3

causes of diverticular disease

Answer 3

low fibre intake

incidental finding

Question 4

what is diverticulitis

Answer 4

mucosal herniation through muscle coat become inflamed or infected

Question 5

tests for diverticular disease

Answer 5

clinical diagnosis
CT
sigmoidoscopy
hinchey classification

Question 6

symptoms of diverticulitis

Answer 6

left iliac fossa pain/tenderness 
sepsis 
altered bowel habit
diarrhoea +/- PR bleeding
elevated inflammatory markers

Question 7

complications of diverticular disease

Answer 7

pericolic asbcess 
perforation 
haemorrhage 
fistula 
stricture

Question 8

treatment for uncomplicated diverticulitis

Answer 8

oral antibiotics

Question 9

treatment for complicated diverticulitis

Answer 9

percutaneous drainage
Hartmann’s procedure
laparoscopic lavage and drainage
primary resection/anastomosis

Question 10

what is colitis

Answer 10

inflammation of the inner lining of the colon

Question 11

causes of colitis

Answer 11

infection
ulcers
crohn’s
ischaemia

Question 12

symptoms of colitis

Answer 12

diarrhoea +/- blood
abdominal cramps
dehydration 
sepsis 
weight loss 
anaemia

Question 13

tests for colitis

Answer 13

ACR
sigmoidoscopy and biopsy
stool culture
barium enema

Question 14

treatment for ulcerative colitis/Crohn’s colitis

Answer 14

IV fluids
IV steroids (only if infection and ischaemia ruled out)
GI rest
surgery - last step

Question 15

epidemiology of ischaemic colitis

Answer 15

elderly

arteriopaths

Question 16

where does ischaemic colitis effect in GI tract

Answer 16

can be an acute or chronic occlusion affecting the inferior mesenteric artery

Question 17

what is colonic angiodysplasia

Answer 17

small vascular malformation of the gut - submucosal lakes of blood
Lesions are multiple

Question 18

causes of colonic angiodysplasia

Answer 18

unexplained GI bleeding (e.g. rectal bleeding)

anaemia

Question 19

where does colonic angiodysplasia found in the GI tract

Answer 19

usually right side of colon
caecum
ascending colon

Question 20

tests for colonic angiodysplasia

Answer 20

angiography
colonoscopy
infection or surgical resection

Question 21

treatment fo colonic angiodysplasia

Answer 21

embolisation
endoscopic ablation
surgical resection

Question 22

causes of large bowel obstruction

Answer 22

colorectal cancer
benign stricture
volvulus

Question 23

treatment for large bowel obstruction

Answer 23

resuscitate
operate
stenting

Question 24

causes of volvulus

Answer 24

bowel twists on mesentery

may become gangrenous

Question 25

tests for volvulus

Answer 25

AXR | rectal contrast

Question 26

treatment for volvulus

Answer 26

flatus tube | surgical resection

Question 27

describe pseudo-obstruction of large bowel

Answer 27

motility disorder no real mechanical obstruction intestine cannot push food through

Question 28

symptoms of pseudo-obstruction

Answer 28

no lesions in intestinal lumen | hypoxia

Question 29

epidemiology of pseudo-obstruction

Answer 29

elderly | debilitated

Question 30

what is chronic constipation

Answer 30

functional bowel disorder

Question 31

causes of chronic constipation

Answer 31

common - diet | uncommon - motility disorder

Question 32

what is faecal impaction

Answer 32

functional bowel disorder | constipation

Question 33

epidemiology of faecal impaction

Answer 33

bed ridden | elderly

Question 34

treatment for faecal impaction

Answer 34

``` strong analgesics (painkiller) manual evacuation ```

Question 35

tests for faecal impaction

Answer 35

enemas