Flashcards in Clinical Approach - Colorectal Dz Deck (10)
1
How can you tell when a pt w rectal bleeding has pathology located more proximal to the anus?
problem in anus = bright red blood coating stool, on toilet paper, or dripping into toilet
dark blood/mixed blood with stool = pathology in rectum or more proximal
2
How should a digital rectal exam be performed?
feel coccyx, then levator ani muscle, feel sacral hollow, prostate in male or tip of cervix in female
always palpate sphincteric mechanism
3
What is anoscopy?
short scope looks at distal rectum and anal canal
essential for defining hemorrhoids
4
What is proctoscopy?
inspects rectum up to recto-sigmoid junction
can visualize and biopsy
economical
5
What is fiber-optic endoscopy?
asses distal colon, or entire colon
= flexoid sigmoidoscopy
6
What is a barium enema?
gives good outline of bowel
might miss polyps, biopsy and intervention not possible
7
What is virtual colonoscopy?
reconstruction of colon structure using CT and computer 3D modeling
similar accuracy to colonoscopy but not invasive
but cannot biopsy or intervene
8
What are the possible complications of diverticulosis?
diverticulitis - neck becomes obstructed and perfs
abscess - drain
peritonitis from perf - surgery!
fistula - most often to bladder - surgery!
9
What is the clinical presentation of diverticulitis?
LLQ pain, fever, constipation or diarrhea
10