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11 Cards in this Set

  • Front
  • Back
Rectum?
your mom.

what? you thought i was gonna say "damn near killed 'em?" i thought about it. liked your mom better. yeah, i did.
What are the basic operative principles for colon surgery?
anatomy
pre-op antibiotics
bowel prep
DVT prophylaxis
patient positioning
diversion
What comprises the intial work-up for diverticular dz?
1. H&P
2. CT
3. way later for endoscopy to confirm dx
Explain the management of diverticular dz.
1. acute diverticulitis: antibiotics, bowel rest, abscess drainage, surgery
2. stricture - resect
3. bleed - conservative tx, if fail, then localize and subtotal colectomy
4. sigmoid volvulus - endoscopic reduction, resection
5. cecal volvulus - gastrograffin enema, resection
6. Ogilvie's syndrome - rule out distal obstruction

NOTE: increase fiber in diet to 25-30 g/day
How does one manage a pt with suspected colonic obstruction?
The main diagnostic tools are blood tests, X-rays of the abdomen, CT scanning and/or ultrasound.
What is the surgical approach/management of colon CA?
1. screen with colonoscopy (ideally)
2. tx with surgery, chemo, radiation for mets. remove all of tumor and margins of normal colon as well as any adjacent organs with mets, remove lymph (at least 12 nodes)
3. follow with H&P with CEA every 3-6 mos for 2 yrs then every 6 mos for 5 yrs
What is the significant anatomy of hemorrhoids?
Grade I - bulge into anal canal, no prolapse
Grade II - prolapse with defecation and spontaenously reduce
Grade III - prolapse with defecation and must be manually reduced
Grade IV - prolapse and are incarcerated

external: painful
internal: painless
How are hemorrhoids tx'ed?
I - dietary fiber, water, band ligation or infrared coag
II - same as I
III - band ligation, surgical excision
IV - surgical excision

external thrombosis: excise, not incise and milk thrombus
external hygiene issues: excise
How are perianal infections typically tx'ed?
I&D (incision and drainage in the OR)
How do perianal infections typically present?
abscesses with pain, ever, redness, swelling, drainage
originate from perianal glands (perianal, ischiorectal, supralevator)

50% progress to fistula-in-ano
How is anal carcinoma managed?
Primary tx - non-surgical per Nigra protocol with chemo + 5-FU combo

APR (Abdominoperineal resection) with failure