Pathology of the Colon Flashcards Preview

Yr2 Alimentary > Pathology of the Colon > Flashcards

Flashcards in Pathology of the Colon Deck (13)
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1
Q

I left most of this lecture out as it was repeated in better detail in the IBD and CRC lectures later on.

A

This stuff is just what wasn’t included elsewhere

2
Q

What is ischaemic enteritis?

A

Occluded vessel leads to ischaemic lesions in the gut with location depending on the involved vessel

3
Q

What happens if one of the 3 major vessels of hte gut is occluded?

A

Infarction!

4
Q

What happens if one of the gut arteries is occluded gradually?

A

Very little as it the anastomotic circulation compensates

5
Q

Ischaemic enteritis can be caused by an arterial thrombosis, embolism or non-occlusive ischaemia. What are some common sources for these?

A

Thrombosis:

  • Atherosclerosis
  • Vasculitis
  • Hypercoagulability
  • Oral Contraceptive
  • Dissecting Aneurysm

Embolism:

  • Cardiac vegetations
  • Acute Atheroembolism
  • Cholesterol Embolism

Non-occlusive Embolism:

  • Cardiac Failure
  • Shock/dehydration
  • Vasoconstrictive drugs
6
Q

How does the affected part of the gut appear during ischaemic enteritis?

A

Congestion leads to a dusky blue/purple color and sanguinous mucous in the lumin

Histologically:

  • You get Oedema, Interstitial Hemorrhages & vascular dilatation due to congestion
  • You also get Sloughing necrosis of the mucosa & within 1-4 days bacteria cause gangrene & perforation due to lack of blood supply causing tissue death.

Chronically you get inflammation, ulceration and fibrosis/strictures.

7
Q

What is radiation colitits?

A

Where abdominal irradiation impairs normal proliferative activity of the bowel epithelium

8
Q

What is the presentation of radiation colitis?

A

Anorexia
Abdominal cramps
Diarrhoea
Malabsorption

The damage depends on the dose and location

Chronically it mimics IBD

9
Q

How does radiation colitis appear histologically?

A
  • Nuclear hypertrophy
  • Inflammation causing crypt abscesses & eosinophils

Chronically or in large doses it can also cause:

  • Arterial stenosis
  • Ulceration
  • Necrosis
  • Haemorrhage
  • Perforation
10
Q

What causes appendicitis?

A

Infection - Often via a stomach or other GI infection

Obstruction, most often due to feocolith or enterobius vermicularis (giant roundworm)

11
Q

Waht is a feocolith?

A

A stone of faecaes often with calcification caused by faecal impaction.

When it occurs in the appendix its called appendicolith

12
Q

How does appendicitis present?

A
Poorly localised colic pain progressing to sharp pain in right iliac fossa
N&V
Diarrhoea
 Anorexia
Fever
13
Q

MAnagement of appendicitis?

A

Appendectomy