CAM202 Lecture Notes - Lecture 10: Inflammatory Bowel Disease, Sacroiliitis, Anal Fistula
Document Summary
Lots of findings/symptoms can be explained by 1 unifying diagnosis: the simplest explanation is usually correct, do(cid:374)"t try too hard - hicka(cid:373)"s dictu(cid:373, patients can have as many diseases as they damn well please. 20 y/o male: weight loss, diarrhoea, anaemia, back pain, anal fistula, raised crp, bilateral sacroiliitis on x-ray. Inflammatory bowel disease associated spondyloarthropathy to explain back pain and sacroiliitis. Large bowel: haustra, peripheral, <6cm transverse colon, <9cm caecum. Functional obstruction: post operative (bowel temporarily paralysed, drugs/chemical imbalance, dilated large and small bowel, gas in rectum. Gas outside bowel: pneumoperitoneum, retroperitoneal gas, pneumobilia, portal venous gas, gas in collections, abscess formation may contain gas. Seen as gas under diaphragm on erect cxr. Look on right: normally no gas between diaphragm and liver, but can have gas on left between diaphragm and stomach, causes, penetrating trauma/surgery, peptic ulcer, diverticular perforation. Retroperitoneal gas: perforation of retroperitoneal structure, duodenum, ascending/descending colon, bubble, irregular appearance.
