*Intestinal Problems (lecture 5 and 6) Flashcards Preview

Study Notes - Gastroenterology > *Intestinal Problems (lecture 5 and 6) > Flashcards

Flashcards in *Intestinal Problems (lecture 5 and 6) Deck (48)
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1

What is GI diverticulum?

Mucosal herniation through muscle coat

2

What is the difference between diverticulum, diverticular disease, and diverticulitis?

Diverticulum means they are present
Divertiular disease means they are symptomatic
Diverticulitis means they are inflamed

3

Where do diverticulum most often occur?

Sigmoid colon

4

Do patients who develop diverticular disease tend to have a low or high fibre diet?

Low fibre intake

5

How are diverticulum diagnosed?

Barium enema
Sigmoidoscopy

6

Symptoms of diverticular disease?

Altered bowel habit
Left sided colic relieved by deification
Flatulence
Nausea

7

Symptoms of diverticulitis?

LIF pain/ tenderness
Septic
Altered bowel habit

8

Complications of diverticular disease? (5)

Pericolic abscess
Perforation
Haemorrhage (if it ruptures through a blood vessel)
Fistula
Stricture

9

Treatment of uncomplicated (bacterial infection with possible sepsis) diverticulitis?

Pain relief
Management in the community
Oral antibiotics

10

Treatment of complicated diverticulitis?

Hartmann's procedure (proctosigmoidectomy)
Primary resection/ anastomosis
Precutaneous drainage - access around the bowel
Laparoscopic lavage and drainage - peritonitis

11

Causes of acute and chronic colitis?

Infective colitis
Ulcerative colitis
Crohns colitis
Ischaemic colitis

12

Causes of acute and chronic colitis?

Infective colitis
UC
Crohns colitis
Ischaemic colitis

13

Symptoms of acute and chronic colitis?

Diarrhoea with/ without blood
Abdominal cramps
Dehydration
Sepsis
Weight loss
Anaemia

14

Diagnosis of acute and chronic colitis?

Plain x-ray
Stool culture
Sigmoidoscopy + biopsy
Barium enema (Not usually in acute colitis in order to prevent irritating the bowel)

15

What sign on an AXR is suggestive of colitis?

Thumb-printing - mucosal oedema

16

Treatment for UC/ Crohns colitis?

IV fluids
IV steroids (once infective/ ischaemic colitis ruled out)
GI rest

17

3 main types of bowel ischaemia?

Acute mesenteric ischaemia (almost always small bowel)
Chronic mesenteric ischaemia
Ischaemic colitis

18

Cause of ischaemic colitis?

Low flow in the inferior mesenteric artery

19

presentation of ischaemic colitis?

Lower left sided abdominal pin
+/- bloody diarrhoea

20

Tests for ischaemic colitis?

CT may be useful but colonoscopy and biopsy is the gold standard

21

What is colonic angiodysplasia?

angiodysplasia is a small vascular malformation of the gut. It is a common cause of otherwise unexplained gastrointestinal bleeding and anemia. Lesions are often multiple, and frequently involve the cecum or ascending colon, although they can occur at other places.

22

How is colonic angiodysplasia diagnosed?

Can do a colonoscopy but would see much
Do a angiography and look for bleeding into the colon

23

How is colonic angiodysplasia treated?

Embolisation
Endoscopic ablation
Surgical resection

24

Causes of a large bowel obstruction? (3)

Colorectal cancer
Benign obstruction
Volvolus

25

Symptoms of a bowel obstruction?

Abdominal pain
Distension
Vomiting
Constipation

26

Treatment of a large bowel obstruction?

Resuscitate
Operate

27

What is a sigmoid volvulus?

An obstruction caused by the bowel twisting on it mesentery - may become gangrenous, can also cause ischaemia and subsequent perforation

28

How is a sigmoid volvulus diagnosed?

Plain AXR
Rectal contrast may need to be added
Can use CT non-invasively assess for ischaemia

29

Treatment of sigmoid volvulus?

Flatus tube to decompress colon
Surgical resection (especially in younger patients when it has happened a few times

30

What is pseudo-obstruction?

a clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterized by the signs and symptoms of intestinal obstruction without any lesion in the intestinal lumen - like a mechanical obstruction but no cause found (in comparison to paralytic ileus when there is absence of normal peristaltic contractions (tends to be in elderly/ debilitated)