Vomiting Diarrhea Constipation

Surgery

Assumptions
Student understand the anatomy, embryology and physiology of the gastrointestinal tract.

Knowledge Objectives
Through their reading and patient care experiences, at the end of the rotation students should be able to:

Vomiting
Discuss in general, the differential diagnosis for a patient with emesis.

  • Consider timing and character of the emesis and associated abdominal pain.
  • Contrast etiologies in infants, children and adults.
  • Contrast dysmotility vs. ileus vs. mechanical obstruction.

Describe the clinical presentation and etiologies of gastric outlet obstruction.

Describe the types of neoplasms that occur in the stomach and discuss diagnosis and prognosis for each.

Discuss the principles of curative and palliative surgery for patients with gastric neoplasm.

Discuss the diagnosis and management of obstructive ulcer disease.

Describe the signs and symptoms of small bowel obstruction.

Describe the common etiologies of mechanical small bowel obstruction.

Describe the pathology and relative frequency of malignant and benign small bowel neoplasms.

Discuss the potential complications and management of small bowel obstruction.

Outline the initial management of a patient with mechanical small bowel obstruction, including laboratory tests and x-rays.

Contrast the presentation and management of partial vs. complete small bowel obstruction.

Differentiate the signs, symptoms and radiographic patterns of paralytic ileus and small bowel obstruction.

Diarrhea

Discuss the differential diagnosis of diarrhea in adults.

  • Consider chronicity, absence or presence of blood and associated pain.
  • Consider infectious causes.

Describe the presentation and potential complications of ulcerative colitis and Crohn’s disease.

Contrast the pathology, anatomic location and pattern, cancer risk and diagnostic evaluation of ulcerative colitis and Crohn’s disease.

Discuss the role of surgery in the treatment of patients with ulcerative colitis and Crohn’s disease.

Discuss the clinical manifestations, risk factors, diagnosis and management of pseudomembranous colitis.

Outline the risk factors, presentation, diagnosis and management of ischemic colitis.

Constipation

Discuss the potential etiologies of constipation in adults and children.

  • Consider chronic vs. acute.

Describe the clinical presentation and etiologies of large bowel obstruction.

List the diagnostic methods utilized in the evaluation of potential large bowel obstruction, including contraindications and cost effectiveness.

Outline the diagnosis and management of colonic volvulus, diverticular stricture, fecal impaction and obstructing colon cancer.

Outline the treatment of carcinoma located at different levels of the colon, rectum and anus. Include a discussion of the use of radiotherapy and chemotherapy for each.

Describe the postoperative follow-up of patients with colorectal carcinoma.

Discuss the staging and survival of patients with colorectal carcinoma.

Describe the presentation and treatment of acute and chronic colonic pseudo-obstruction.

List indications for and methods of screening for colorectal carcinoma.

Describe use of surveillance endoscopy in ulcerative colitis.