TeacherOfMedicine: autoimmune disease

Showing posts with label autoimmune disease. Show all posts

Saturday, 21 March 2020

Disease class: Colitis

Disease class: Sigmoid diseases

Proctocolitis refers to inflammation spanning from the anus and rectum (proctitis) up a segment of colon (colitis).

Rectosigmoiditis: inflammation of the rectum, and sigmoid colon
Proctosigmoiditis: inflammation of the anus, rectum, and sigmoid colon
Distal colitis: inflammation of the entire distal colon up to the splenic flexure (the junction between descending colon and transverse colon)
Hemicolitis: inflammation of the entire distal colon including half of the transverse colon
Extensive colitis: inflammation of the entire distal colon up to the hepatic flexure (the junction between transverse colon and ascending colon)
Pancolitis: inflammation of the entire colon

Disease class: Megacolon

Faecal loading can cause small areas of dilatation.
It is normal for some segments of bowel to have a relatively large diameter. The "369 rule" refers to the approximate normal diameters of small bowel (up to 3cm), large bowel (up to 6cm), caecum + sigmoid colon (up to 9cm).
If the clinical history and physical examination support a diagnosis of toxic megacolon and the AXR may show abnormal dilation, it is worth discussing the AXR with a specialist colleague.
If there is a strong suspicion of toxic megacolon, inform senior colleagues, request an arterial blood gas analysis, request an urgent abdominal radiograph (if not done already) and seek specialist advice immediately.

Depends on severity and underlying cause

A megacolon is a colon with a significantly increased diameter, usually throughout a large continuous segment of bowel.

Faecal loading can cause small areas of dilatation.
It is normal for some segments of bowel to have a relatively large diameter. The "369 rule" refers to the approximate normal diameters of small bowel (up to 3cm), large bowel (up to 6cm), caecum + sigmoid colon (up to 9cm).