Wednesday, August 20, 2014

LARGE INTESTINE Diagnostic studies


DIAGNOSTIC STUDIES

All  patients with suspected colonic or rectal  disorders  should
have  a complete history of their bowel complaints  and  physical
examination  including  pelvic anal rectal examination  with  the
finger and visualisation with a proctascope.

Stool  examination  for occult blood is  essential  in  suspected
cases of carcinoma. 

In  chronic  diarrhea  cases, blood level  of  gastic  vasoactive
intestinal  peptides  (VIF) and other enterohormones  may  be  of
diagnostic help.

BARIUM ENEMA

The  small  lesions may escape detection.  A  dialogue  with  the
radiologist will help him define his use of the correct  modality
(double contrast) and focus on the site of the lesion.


ENDOSCOPY

The use of this instrument for diagnosis and treatment has become
routine  in most equiped medical centres.  It requires a  trained
endososcopist   to  retrieve  diagnostic  data.   It  enables   a
visualisation of the entire colon from anus to cecum.  the  bowel
needs   to  be  cleaned  by  enema  and  bowel  irrigation   with
commercially available polyethyle glycal (PEG).

PRE-OPERATIVE PREPARATION

The  fecal bacterial content has a high colony count  nearly  one
third  of  the dry weight of feacus is because of  bacteria  thus
cleaning  using  PEG has become a safe and  effective  to  ensure
success in preparing the bowel for surgery.

ORAL

Oral use of neomysin, erythromycin or metronidazole are the  most
commonly  used  drugs for limiting  post-operative  infection  in
colonic  surgery these agents are administered at 1 pm, 2 pm  and
11 pm on the day prior to surgery.

Any questions be sent to drmmkapur@gmail.com
www.otmanage.blogspot.com   www.surginstruatlas.blogspot.com

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