Colorectal Disorders

Anal Abscess

Infection of the anal glands

Tx: I&D (usually performed by colorectal surgeon because of the myriad of vessels in the region)

Anal Fissure

10/10 PAINFUL RECTAL PAIN WHEN MAKING A BOWEL MOVEMENT

**TEARING PAIN***

MC Location : Posterior Midline

Tx: Symptomatic, stool softners, sitz baths

Constipation

Must try and find etiology of the constipation (new medications, cancer, diabetes, etc)

Fantastic break down of the of the treatments and mechanisms in PANCE PREP PEARLS

Advanced organizer from the EM Clerkship Podcast located to the right!!!

Diverticulosis / Diverticulitis

Little out-pouchings in the colon that can become inflamed (leading to diverticulitis)

MC location = Sigmoid Colon

Inflammatory Bowel Disease (IBD)

YOU HAVE TO KNOW THE DIFFERENCE!!!

Tremendous Chart with breakdown, buzzwords, diagnosis, and treatment in PPP

Irritable Bowel Syndrome (IBS)

Generalized abdominal pain with intermittent change in bowel habits (constipation / diarrhea)

ROME IV Criteria

Treatment: Lifestyle modifications + depends on whether constipation or diarrhea is primary complaint

Mesenteric Ischemia

Acute

(Look for the elder patient with Afib who complains of 10/10 generalized abdominal pain)

**PAIN OUT OF PROPORTION TO EXAM**

Meaning = belly is soft/non-distended and when you are palpating, the patient is in extreme pain ready to take a swing at you

Abdominal Xray shows “THUMBPRINTING“

Dx: Angiogram

Chronic

Atherosclerosis of the arteries of the bowel

Cramping abdominal pain AFTER MEALS

Dx: Angiogram

Toxic Megacolon

Colon dilation

Patient is S.A.S. (Sick as shit)

Tx: Admit, bowel rest, ABX

TEST YOUR KNOWLEDGE NOW

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