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Content provided by Jon Lund
Clinical Associate Professor, School of Graduate Entry Medicine & Health, University of Nottingham
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OBJECTIVES
The student should be able to:
- Outline the theories on the aetiology of diverticula of the colon including age, diet and vascular anatomy of the colon.
- Describe the morphology and pathological consequences of diverticula of the colon.
- Describe the clinical features of diverticula of the colon, differentiating the symptoms and signs of diverticulosis from diverticulitis including signs of inflammation and bleeding.
- Describe the management of a patient with asymptomatic diverticula of the colon.
- Outline the complications of diverticula of the colon including bleeding, obstruction, perforation and fistula formation.
- Discuss the investigation of a patient with left lower quadrant pain and fever including:
- a) a list of the differential diagnosis
- b) outline the steps in assessing and stabilising the patient's condition.
- c) discuss appropriate diagnostic studies including abdominal films, ultrasound, sigmoidoscopy and barium enema.
- d) describe the treatment of such a patient, including the indications for antibiotics, drainage and resection.
- In a patient with massive rectal bleeding outline a plan of management, including the
- a) differential diagnosis
- b) outline the steps in assessing and stabilising the patient's condition.
- c) discuss appropriate diagnostic studies
- d) discuss the natural history of each lesion that might be causing the bleeding and outline the preferred treatment for each.
- Describe the treatment of a patient with diverticulitis including indications for antibiotics, drainage and resection.
- Describe the possible sites of fistula formation seen in diverticular disease and outline their presentation and management including colovescical, colovaginal, coloenteric and colocutaneous fistulae.
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