Benign conditions of the large bowel Flashcards Preview

Gastro > Benign conditions of the large bowel > Flashcards

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

Name 5 common diseases of the large bowel

Carcinoma of the colon and rectum
Colonic polyps
Crohns colitis and UC
Diverticular disease
Functional disorders

2

Define diverticular disease

mucosal herniation through the muscle coat

3

What part of the colon is affected in diverticular disease

Sigmoid

4

What type of diet causes diverticular disease

Low fibre and high fat - western diet

5

What is the difference between diverticulitis and diverticulosis

Diverticulitis - the presence of diverticular disease with inflammation or infection
Diverticulosis is the presence of diverticular disease without any inflammation or infection

6

What are the findings of diverticular disease

Outpouching of the epithelial lined track

7

What is the difference between true and pseudodiverticula diverticular disease

True diverticula contain all layers of the parent structure. False or pseudodiverticula are mucosal projections through the muscular layer.

8

What type of condition are true diverticular disease

Congenital disease

9

How can we diagnose diverticular disease

Using a barium enema or an endoscopy

10

Describe the onset of diverticulitis

Gradual onset becoming increasingly severe.

11

What are the signs of diverticulitis

tenderness in the left ileac fossa
generally feeling unwell
altered bowel habit

12

How do we treat uncomplicated diverticulitis

Nothing - oral antibiotics if anything

13

What are the complications of diverticulitis

Pericolic abscess which can perforate, bleed or fistulate

14

How do we treat complicated diverticulitis

Hartmann's procedure (removal of part of the bowel)
Primary resection
anastomosis
drainage

15

Describe colitis

Inflammation of the lining of the colon

16

What 2 types of colitis can we get

Acute and chronic

17

What 5 things can cause colitis

Infective colitis
Ulcerative colitis
Crohn's colitis
Iscaemic colitis
Infective colitis - usually campyylobacter

18

What are the 4 signs of colitis

Pain
Blood in stool
Diarrhoea
History of feeling unwell

19

What 5 tests can we do for colitis

Stool sample
Blood tests
Plain X ray
Sigmoidoscopy and biopsy
Barium enema

20

What specific blood tests would be requested in colitis

WBC
CRP
Hb

21

Why would we not perform a full colonoscopy in an acute situation

Due to the high risk of perforation if there is extensive inflammation

22

What 4 things can we use to treat colitis

IV steroids - first line
IV fluids
Iron supplement
GI rest

23

Who is most likely to get ischaemic colitis

Elderly
Those with previous arteriopathy

24

What 3 types of arteriopathy should we suspect ischaemic colitis with

Coronary artery disease
Cerebral artery disease (stroke)
Peripheral vascular disease

25

Define colonic angiodysplasia

Angiodysplasia of the colon occurs when blood vessels in the colon enlarge. They may become fragile and result in occasional bleeding in the gastrointestinal (GI) tract.

26

How can we treat colonic angiodysplasia

Angioplasty - embolise blood vessels using coil or chemicals

27

What are the 4 symptoms of large bowel obstruction?

Abdominal pain
constipation
abdominal distension
vomiting

28

What are 5 causes of bowel obstruction

Colorectal cancer
Benign stricture
Sigmoid or caecal voluvulus (twist in the bowel)
Pseudo-obstruction
Faecal impaction

29

How do we treat bowel obstruction

Resuscitate
Operate
Stent

30

Define pseudo-obstruction

clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterised by the signs and symptoms of intestinal obstruction without any lesion in the intestinal lumen.

31

Is pseudo-obstruction pathological or functional

Functional

32

Who is most likely to present with pseudo-obstruction?

Elderly / debilitated patients

33

How do we treat pseudo-obstruction

We cant.
We can only check that it is not a medication causing it and that there is no electrolyte imbalance causing it

34

How do we determine if the patient has chronic constipation?

Determining what is normal for them

35

What usually treats chronic constipation

Diet
Laxatives

36

What is a small cause of chronic constipation?

Motility disorder

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