OBJECTIVES

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					                            COLORECTAL DISEASE



SUGGESTED READINGS
COLORECTAL DISEASE
Current Surgical Diagnosis & Treatmetnt, 12th Edition, Ch. 30.


OBJECTIVES
COLORECTAL DISEASE
1. Discuss the risk factors for colorectal cancer.

2. Identify the common symptoms of colorectal cancer.

3. Discuss the evaluation and treatment of colorectal cancer.

4. Discuss the role of radiotherapy and chemotherapy in management of patients with
   colorectal cancer.

5. Using TNM classification, discuss the staging and five-year survival of colorectal
   cancer.

6. Describe the clinical findings of diverticular disease, differentiating the symptoms
   and signs of uncomplicated and complicated diverticulitis.

7. Discuss non-operative management of diverticular disease.

8. Discuss operative therapy for diverticular disease i.e. uncomplicated and complicated.

9. Differentiate ulcerative colitis and Crohn’s disease of the colon in terms of history, x-
   ray findings, prognosis and risk of cancer.


CASE HISTORIES
COLORECTAL DISEASE
1. A 67-year-old white male presents to you with guaiac positive stools. An air contrast
   barium enema study reveals a polyp at the splenic flexure. Discuss appropriate
   management. Discuss the association between polyp size and risk of carcinoma.

2.   A 69-year-old white male presents with a 6 cm carcinoma of the sigmoid colon and
     obstructive symptoms. Work-up reveals widespread metastatic disease in both lungs
     and the right lobe of the liver.

3.   A 64-year-old white male presents with a complaint of passing air in his urine.
     Discuss further evaluation and therapy options.




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                            COLORECTAL DISEASE

4.   A 79-year-old white female with a long history of diverticular disease presents to the
     emergency room with an acute abdomen. Emergency surgical exploration reveals a
     free perforation of a sigmoid diverticular abscess with fecal spillage. Discuss
     treatment options.

5.   A 39-year-old white male with a four-year history of medically managed ulcerative
     colitis presents with a sharp decrease in the number of stools. He is accustomed to
     having three to four slightly bloody stools per day but has had no bowel movements
     over the last three days. Physical exam reveals the patient to be obtunded, febrile
     and with a distended tender abdomen. Abdominal series reveals the transverse colon
     to be dilated to 10 cm. Discuss likely diagnosis and therapy options.

6.   A 41-year-old white male with a three-year history of Crohn's disease presents with
     his fourth episode of small bowel obstruction. An upper GI series reveals a string
     sign in the mid ileum. Discuss further evaluation and therapy options.




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posted:7/27/2011
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