Colorectal Surgery

What is a major treatment difference between colon cancer and rectal cancer?

Colorectal cancer gets chemotherapy; rectal cancer receives both chemotherapy and radiation.

What surgical procedure may result in a permanent colostomy for rectal cancer patients?

Sphincter removal.

What type of carcinoma is rectal cancer generally associated with?

Squamous cell carcinoma, although adenocarcinoma is also present.

How are hemorrhoids located below the dentate line classified?

They are classified as painful.

What are common symptoms of bowel obstruction?

Colicky abdominal pain, fever, nausea, and vomiting.

What is the first step in assessing a patient suspected of bowel obstruction?

Assess the patient's symptoms, including the onset, duration, and severity of pain.

What indicates a strangulated bowel obstruction?

Tachycardia, localized tenderness, fever, high WBC, and acidosis.

What does abdominal compartment syndrome occur at?

When pressure exceeds 25 mmHg.

What tests are better than CBC for assessing infection?

ProCal, CRP, and ESR.

What is CMP and how is it different from BMP?

CMP includes electrolytes with liver function tests; BMP contains only electrolytes, making it cheaper.

What imaging is best for RUQ pain investigation?

CT scan with contrast, as it includes liver function tests.

What should be included in an acute abdomen series?

Upright chest and abdominal views, as well as a supine abdominal X-ray.

What is the purpose of a small bowel follow-through series?

To evaluate motility and any abnormalities in the small intestine.

What is Gastrograffin enema used for?

To visualize the colon and identify issues like strictures or inflammatory bowel diseases.

What is diagnostic laparoscopy done for?

To evaluate suspected intra-abdominal pathology when other imaging isn't clear.

How can acute ascites be identified on a CT scan?

It may be indicated by obstruction causing pressure buildup, potentially rupturing capillaries.

What does the mesenteric whorl indicate?

A twisted appearance of the mesentery around the obstructed segment of the bowel.

How is colonic distension visually described?

As looking like the Michelin Man, indicating swelling due to gas or fluid accumulation.

What can cause functional bowel obstruction in scleroderma patients?

Poor propulsion and decreased peristalsis.

What treatments are involved in bowel obstruction management?

IV fluids for hydration, Foley catheter, NG tube, antibiotics if perforation, and prompt surgical intervention.

What can be done therapeutically for constipation besides diagnostic measures?

Gastrograffin enema.

What are common medications that can lead to chronic volvulus?

Anticholinergics, antiparkinson medications, or TCAs.

What is a major concern for non-occlusive mesenteric ischemia?

It occurs more frequently in patients who have coded, as the gut is the first organ to shut down.

What is the medical treatment option for acute pseudocolonic obstruction?

Neostigmine, which enhances colonic motility.