Flashcards in Pathology of Colon Deck (42):
What does the portal venous system transmit?
Deoxygenated blood from most of the GI tract and GI organs to the liver
Hepatocytes receive oxygenated blood from the
The mixture of oxygenated and deoxygenated blood received by the liver filters through the
The portal vein is formed from
the superior mesenteric and splenic veins
Where does the portal vein lie in relation to the hepatic artery and bile duct?
The portal vein penetrates the right border of the
The porto-systemic/porto-caval anastamosis is the
collateral communication between the portal and systemic venous systems
What are the types of ano-rectal conditions?
What are the most common presentations of ano-rectal conditions?
Ano-rectal conditions can be caused by;
Give an example of A congenital an-rectal condition
Hirschprung's Myenteric Plexus Deficiency
Give 5 examples of acquired ano-rectal conditions
What is the typical presentation of haemorrhoids?
Itching/irritation/pain around the anus
Painful bowel movements
Bleeding from anus after defaecation
What is the typical surgical treatment for haemorrhoids?
Ultrasound guided ligation of haemorrhoids
What are the stagings of anal fissures?
Acute or chronic
At what point is an anal fissure classed as chronic
If it has been [resent for more than 6 weeks
How is an anal fissure treated?
By relaxing internal anal sphincter;
medically - topical nitric oxide, glyceryl trinitrate paste or diltiazem calcium blocker
surgically - internal lateral sphincterotomy
What is the treatment for a peri-anal abscess?
Incision and drainage
At what locations can a peri-anal abscess occur?
What is the typical presentation of fistula-in-ano?
Pain and swelling around the anus and pain during bowel movements
How is a superficial fistula-in-ano treated?
How is a trans-sphincteric fistula-in-ano treated?
Seton suture, fistula plug or permacol paste
What are the causes of anal ulceration?
What is the treatment for anal squamous cell carcinoma?
Radiotherapy and surgery
What is the treatment for rectal adenocarcinoma?
Neo-adjuvant chemo and radiotherapy and laparoscopic resection
Give 6 causes of constipation
Lack of fibre in diet
Change in eating habits
Ignoring urge to defaecate
Immobility/lack of exercise
Low fluid intake
What do the majority of colorectal cancers arise from?
What fraction of colorectal cancers are colonic and what fraction are rectal?
Two thirds colonic, one third rectal
The majority of polyps are
What are the main histological types of polyps?
What appearances can polyps have?
What is the basic pathogenesis of colorectal cancer from polyps?
-> small adenoma (polyp)
-> large adenoma
-> invasive adenocarcinoma
What is the typical presentation of colorectal cancer?
Persistent rectal bleeding
Altered bowel opening (particularly diarrhoea)
Iron deficiency anaemia
Palpable rectal or lower right abdominal mass
Acute colon obstruction (if stenosing tumour)
What are the sites of colorectal cancers?
What is the most common histological type of colorectal carcinoma?
What are the risk factors for developing colorectal carcinoma?
What is the typical presentation of right sided colorectal carcinoma?
What is the typical presentation of left sided colorectal carcinoma?
Altered bowel habit
What investigations would be done to diagnose colorectal cancer?
What is the benefit of a colonoscopy?
Any polyps found can be removed and biopsies can be taken
What staging investigations would be doe after a diagnosis of colorectal cancer had been reached?
CT chest, abdomen and pelvis
MRI scan for rectal tumours
PET/rectal endoscopic ultrasound in selected cases