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The Bowel (Small bowel (Meckel’s Diverticulum (Ileal remnant of…

- - - - Commonest place for DUs
        Overlapped by gallbladder
        Stones can erode into D1 → ileus
    - - Contains Major Duodenal Papilla (mid → hind gut)
    - - Can be compressed by SMA aneurysm
    - - Ends at DJ flexure / Ligament of Trietz
    - - Posterior DU can erode into GDA → massive
        haematemesis
      - Anterior DU → pneumoperitoneum and peritonitis
  - - - Retro-caecal: 75%
      - Sub-caecal and pelvic: 20%
      - Retro- or pre-ileal: 5%
    - - Initially visceral pain carried by sympathetic afferents in the
        lesser splanchnic nerve which refers to T10 dermatome
        
        Later peritonitis → somatic pain and localisation to RIF.
  - - - Joins yoke sac to midgut lumen
- - - - Lined by squamous epithelium
      - Sensate
      - Middle and inf. rectal arteries and veins
      - Superficial inguinal nodes
    - - Lined by columnar epithelium
      - Insensate
      - Sup. rectal artery and vein
      - Internal iliac nodes
  - - - Thickening of rectal smooth muscle
    - - Three rings of skeletal muscle
        
        Deep
        
        Superficial
        
        Subcutaneous
    - - Deep segment of external sphincter which is
        continuous w/ puboretalis muscle (part of levator ani)
      - Palpable on PR ~5cm from the anus
      - Demarcates junction between anal canal and rectum.
      - Must be preserved to maintain continence