HTHSCI 1DT3 Lecture Notes - Lecture 4: Comorbidity, Cecum, Acetylcholinesterase Inhibitor
26 Dec 2020
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Cdt: c. diff may complicate or mimic. Hydrocortisone: iv + pr if rectal disease. Liquid prep of amino acids, glucose and fatty acids. 50-80% need 1 operation in their life. Defunction distal disease c temporary loop ileostomy. True = composed of complete wall (e. g. meckel"s) False = composed of mucosa only (pharyngeal, colonic) 30% of westerner"s have diverticulosis by 60yrs. Low fibre diet: no osmotic effect to keep stool wet. Mucosa herniates through muscularis propria at points of weakness where perforating arteries enter. Elderly pt. c prev hx of constipation. Axr: fluid level / air in bowel wall. 1 small confined pericolic abscesses surgery rarely needed. 2 large abscess extending into pelvis may resolve w/o. Can be treated at home c bowel rest (fluids only) and augmentin metronidazole. After diverticulitis, colon may heal c fibrous strictures. 1 obstructing point + no vascular compromise. Central but level depends on gut region. Constant / localised pain suggests strangulation or impending perforation.
