On this page
Study tools
Write your answer
Saved on this device. No marking — you are the marker.
Q1: UC Surgery (3 min)
"What are the indications for surgery in UC?"
- Acute severe colitis failing IV steroids + rescue therapy (ciclosporin/infliximab)
- Toxic megacolon, perforation, uncontrolled haemorrhage
- Dysplasia or colorectal cancer
- Definitive: proctocolectomy + IPAA (J-pouch)
Q2: Crohn's Surgery (3 min)
"What are the principles of surgery in Crohn's disease?"
- Surgery is NOT curative (recurrence expected)
- Bowel conservation paramount (risk of short bowel syndrome)
- Strictureplasty for short strictures (under 10 cm Heineke-Mikulicz)
- Limited resection for longer segments
- Treats complications: stricture, fistula, abscess, perforation
Q3: Pouchitis (2 min)
"What is pouchitis and how is it treated?"
- Inflammation of ileal pouch after IPAA
- Lifetime incidence: 40-50%
- Treatment: ciprofloxacin + metronidazole 14 days
- Chronic: probiotics (VSL#3), biologics
- Pouch failure: 5-10% require excision
Q4: Post-op Recurrence (2 min)
"How do you prevent Crohn's recurrence after surgery?"
- Endoscopic recurrence at 1 year: 70-80%
- Clinical recurrence at 5 years: 50%
- Prevention: metronidazole, thiopurines, or anti-TNF (high-risk)
- Rutgeerts endoscopic score: i0 (normal) to i4 (severe)