Diverticulosis, acute diverticulitis, IBD, Ulcerative Colitis, Toxic Megacolon, Chron's Dz, hemorrhoids, rectal varacies, anal fissues, periananl perirectal abscess, rectal prolapse, pruritius ani, pilonidal cysts
Toxic megacolon
Acute diverticulitis
Diverticulosis
Definite IBD
Hemorrhoids
Greater pressures within the segments of the colon causes hypertrophy, thickening, and out pouching of the mucosa through the muscularis resulting in diverticulosis
Obstruction due to hypertrophy of circular muscle or from inflammation, edema and spasms causing acute diverticulitis
Autoimmunity and impaired immune regulation leading to IBD
Infections leading to IBD
Complications of sever acute colitis leading to toxic megacolon
High fiber diet/ fiber supplements to increased stool bulk and decreased colonic transit times. Only done in non acute phase
Stool softeners (Colace)
Non chronic laxatives
Avoid constipation
Bowel rest
Barium Enema
Digital dis impaction
Abdominal x ray
CBC
Colonoscopy
Diverticulitis
Severe impaction
Toxic megacolon
Hemorrhage
Vagal response
Flexible sigmoidoscopy
Colonoscopy
Barium enema
CT Colonography
Colonoscopy
Flexible sigmoidoscopy
Double contrast barium enema/ air contrast barium enema (ACBE)
CT Colonography
Barium enema
Colonoscopy
Flexible sigmoidoscopy
CT scan
CT colonography
Flexible sigmoidoscopy
Barium enema
CT Colonography
Anoscopy
Colonoscopy
Perforation
Toxic megacolon
Reaction to medication
Vagal response
Hemorrhage
Colonoscopy
Barium enema
Flexible sigmoidoscopy
Ultrasound
CT Colonography
The greater pressures within the segments of the colon causes hypertrophy, thickening, and out pouching of the mucosa through the muscularis
The pouches always lead to abscess formation
The accumulation of gas causes marked dilation and necrosis of the colon
The diverticula pouches have become inflamed or infected (macro or microperforations of the diverticulum)
Bowel becomes inflamed
Abscess formation
Fistula formation
Constipation
Obstruction
Macroperforations
Toxic Megacolon
Adenocarcinoma
Acute Diverticulitis
Diverticulosis
Ulcerative Colitis
Abdominal x ray
Barium enema with water soluble contrast
CT scan
Flexible sigmoidoscopy
Colonoscopy
Bowel rest (clear liquids only)
High fiber diet
Antibiotics
Ciprofloxacin and metronidazole for gram negative rods and anaerobes
Ciprofloxacin and metronidazole for gram positive rods and anerobes
Perforation of diverticulum leads to hemorrhage when mucosal perforation penetrates into a submucosal artery
Perforation of ulcerated diverticulum can lead to bloody stool
Perforation of ulcerated diverticulum allows feces into peritoneal cavity which causes fecal peritonitis and produces septic shock
Pneumaturia leading to death
Diverticular hemorrhage due to mucosal ulceration of a diverticulum that penetrated into a submucosal artery
Colonic obstruction due to the hypertrophy of circular muscle or inflammation, edema, and spasms that accompany diverticulitis
Colovesical fistula as a reult of a chronically inflamed diverticulum that adhered to the bladder and ruptured into the lumen to form a fistula. This is a non-fatal problem and can be surgically resected.
Perforated diverticulum that allowed air and feces into the peritoneal cavity
Colovescial fistula as a result of a perforated diverticulum that allowed air into the bladder. This is a non-life threatening condition and can be surgically resected.
Ulcerative Colitis and Crohn's disease
Toxic Megacolon and Ulcerative Colitis
Toxic Megacolon and Crohn's disease
Diverticulosis and Diverticulitis
Caucasian and European Jewish heritage
Impaired immune regulation and autoimmunity
Genetic Markers/ mutations
Turner's syndrome, Glycogen Storage Dz type I, Hermansky-Pulak syndrome
Familial aggregation
True
False
30-50, 60
20-40, 60
18-25, 50
25-55, 70
22-28, 50
Ileum to cecum, all layers of the intestinal wall, cobblestone appearance, ileocecal region
Ileum to cecum, all layers of the intestinal wall, skip lesions, cecum
Rectum to cecum, mucosa, crypt abscesses, rectum
Rectum to cecum, mucosa, skip lesions, rectum
True
False