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Flashcards in Small Bowel Diseases Deck (23):
1

How does a small bowel obstruction present?

abdominal pain
vomiting
abdominal distension
constipation

2

What could be found on examination in a patient with a small bowel obstruction?

altered bowel habits
hernia
gallstones
PR bleeding
weight loss

3

What is the management for small bowel obstruction?

IV fluids
Insert nasogastric tube
Catheterise
Monitor urine output
AXR
Antithromboembolism measures

4

what is the surgical management of small bowel obstruction?

laparoscopy
give antibiotics
follow dilated or collapsed bowel to obstruction
Give antithromboembolic treatment

5

What is mesenteric ischaemia?

a condition in which the supply of oxygen is too small to satisfy the needs of the intestines and is caused by an embolus from AF or thrombosis

6

What would suggest a diagnosis of small bowel disease?

Pain that can't be explained
Acidosis
High WCC
CPR is often normal

7

What is Meckle's Diverticulum?

a slight bulge in the small intestine present at birth - where small bowel attaches to the yolk sac

8

Which layers of the small bowel are affected by Meckel's Diverticulum?

All three layers

9

What are the complications of Meckel's diverticulum?

bleeding
ulceration
obstruction
malignant change

10

What is the most common obstruction in appendicitis?

obstruction of the lumen by faecolith - causes problems with blood supply

11

What can cause appendicitis?

bacteria, fungus or parasite

12

What is the pathology of appendicitis?

lymphoid hyperplasia
build up of mucus
venous obstruction
peforation
small bowel adhesion

13

what are the symptoms of appendicitis?

central pain which migrates to the RIF
anorexia
Nausea
Vomiting - episodic
Little bowel movement

14

what are the signs of appendicitis?

mild pyrexia
mild tachycardia
guarding
rebound
localised pain in the RIF

15

what is Rosving's sign?

When pressing on the left of the abdomen causes pain on the right

16

What is the clinical significance of psoas?

when the right hip is flexed the appendix is kept off the psoas and causes relief?

17

Potential differential diagnosis of appendicitis in children?

gastroenteritis
mesenteric adentitis
Meckel's diverticulum
lobar pneumonia

18

Potential differential diagnosis of appendicitis in adults?

pancreatitis
urereric colic
terminal ileitis
ectopic pregnancy (women)

19

Potential differential diagnosis of appendicitis in the elderly?

sigmoid diverticulitis
intestinal obstruction
carcinoma of the caecum

20

Investigation for appendicitis

ultrasound (in women and children)
AXR - excludes constipation
FBC
Urinanalysis

21

What is the management of appendicitis?

analgesia - for pain
antipyretics - for temperature
surgery
antibiotics
appendicectomy

22

When should an appendix mass be operated on?

if complications occur - tachycardia, worsening pain, increasing in size

23

How is an appendix abscess treated?

radiological drain