Colonitis Flashcards Preview

Hugh's MD2 Core Conditions and Presentations > Colonitis > Flashcards

Flashcards in Colonitis Deck (21):
1

Which arteries supply the colon? Which part of the colon do they supply?

SMA - R and middle colic

IMA - left colic, sigmoid, sup. rectal arteries

Iliac arteries - inferior rectal

2

What are some infectious causes of colitis?

Bacterial - Clostridium difficle

Salmonella

Shigella

Campylobacter

Yersinia

 

Viral - CMV

 

Parasitic - Entamoeba

Cryptosporidium

3

What is the 5 years mortality rate for toxic megacolon requiring surgery?

20%

4

How do you differentiate colitis from gastroenteritis?

Colitis - bloody diarrhoea

- Older age

- Tenderness

 

Gastroenteritis - Vomitting

- Young people

- Less leukocytosis

5

Which part of the colon is most susceptable to low flow ischaemia? Why?

Splenic flexure as it's an area of watershed

 

Sigmoid as inferior mesenteric is susceptable to atherosclerosis

6

When does CMV cause colitis?

In immunosuppressed patients

7

What are the anatomical types of colitis?

Pancolitis

Segmental

Proctitis

8

What are some risk factors for ischaemic colitis?

Age

HTN

Diabetes

Smoking

Hypercoagulable state (28% of ischaemic colitis patients)

Cocaine use

Extreme physical activity

9

Why do you need to test for toxins in C. diff?

Only toxin producing strains cause colitis

(toxins A and B)

10

What are some causes of colitis?

Infectious

Ischaemic

Inflammatory

Diverticulitis

Radiation induced

11

What is the pathophysiology of C. diff colitis?

Disruption of normal flora by abx or chemotherapy - eg clindamycin or fluoroquinolones or penicillins

Ingestion of a toxigenic strain of C. difficle

Spores resist the gastric acid and go onto colonise the colon

12

How does the management of ischaemic colitis differ by location of ischaemia?

Right sided - more likely embolic - need surgery

L sided - more likely low flow - conservative

13

Why are abx given in ischaemic colitis?

Because bacteria can cross the wall

14

What is colitis?

Inflammation of the colon

15

Which part of the colon is more susceptable to an embolic cause of ischaemia?

Caecum as it has a end artery

16

When do you expect C. diff colitis?

Within 1 week of abx but up to 6 weeks after abx

17

How is C. diff treated?

Metronidazole (oral or IV)

2nd line: Vancomycin (oral is tolerable)

 

Sx if not responding to abx within hours

18

What do you have to rule out in entamoebic colitis?

Liver abscess

19

What is toxic megacolon?

Severe inflammation causing dysfunction of muscles > severe distension of the colon > can progress to perforation

20

Which patients typically get ischaemic colitis?

Post open AAA repair

Post-CABs (due to bypass and low flow)

 

21

How does colitis present?

Diarrhoea +/- blood

Pain

Fever