Flashcards in General & Colorectal Surgery Deck (13):
What is a pseudo-obstruction?
Which patients are more at risk?
What is the radiological sign that suggests this?
Large bowel obstruction without mechanical causes
Trauma, severe infection, post ortho/cardiac/pelvis surgery patients (leads to abnormal bowel motility)
Air throughout colon down to the rectum
When should you be worried about perforation in patients with large bowel obstruction?
When there is a fever and signs of peritonitis (suggests ischaemia)
When there is dilation above 10cm
What are the aetiological factors for perianal abscess formation?
Pelvic abscess may form secondary to IBD/diverticulitis
Most are idiopathic
What are the differentials in female patient with RIF pain?
- Acute appendicitis
- Mesenteric adenitis
- Diverticulitis (with floppy sigmoid)
- Ruptured ovarian cyst
- Ectopic preg
- Ovarian torsion
- Haemorrhage/Rupture of ovarian mass
- Ureteric colic
- Acut pyelonephritis
What is the rule of 2s?
- 2% of population
- 2 inches from ileocaeacal valve
- 2 inches long
Surgical treatment of rectal cancer?
If within 5cm of anal verge => abdomino-perineal resection of anus and rectum with permanent end colostomy
If more the 5cm from anal verge => anterior resection +/- temporary defunct toning colostomy
What are the dispositions to a sigmoid volvulus?
Long, narrow mesocolon, chronic constipation or high roughage diet
What are the commonest causes of large bowel obstruction?
Diverticulitis (repeated diverticulitis leads to strictures)
What is the Dukes staging for colon cancer?
A - Cancer does not breach the muscularis propria
B - Cancer breaches the MP but no lymph nodes
C - Local lymph node involvement
D - Distant metastases
What are the histological findings of Crohn's disease?
Non-casaeting granulomata with transmural inflammation of bowel mucosa and frequent lymph aggregates in the subserosa
What are the extra-intestinal manifestations of Crohn's?
Conjunctivitis and iritis
Cirrhosis of liver
Primary sclerosing cholangitis
Renal stones and gallstones
What are the histological features of UC?
Acute and chronic inflammatory cells that are confined to the mucosa (Infiltrative in Crohn's)
BUT in severe disease there is fissuring and transmural inflammation (making differentiation difficult)