Abdo Flashcards
Achalasia Definition
Focal motility disorder due to degeneration of myenteric plexus of Auerbach
Achalasia Radiology findings
Proximal dilatation of the oesophagus with smooth distal tapering and characteristic Bird’s Beak
Achalasia Investigations
Barium swallow
Manometry (failure to relax and decreased peristalsis)
OGD to exclude oesophageal SCC
Achalasia Management
Medical: CCBs and Nitrates
Interventional: Botox and Endoscopic Balloon Dilatiation
Surgical: Heller’s Cardiomyotomy
Oesophageal Cancer Risk Factors
GORD-->Barrett's alcohol smoking Achalasia Plummer-Vinson
Truelove and Witt Criteria for IBD Exacerbation
'She Hasn't Even Finished Pooping!' Stools >6 per day Hb 30 Fever >37.8 Pulse Rate >90
UC Indications for Surgery
Acute:
Megacolon
Perforation
Severe GI bleed
Chronic:
Malignancy
Medical management failed
Maturation failure in children
Crohn’s Indications for Surgery
Acute:
Obstruction secondary to stricture
Perforation
Severe GI bleed
Chronic: Peri-anal disease Intra-abdominal abscess Medical management failed Fistulae (enterocutaneous)
Diverticulum Definition
Outpouching of tubular structure
Saint’s Triad
Diverticular Disease
Hiatus Hernia
Cholelithiasis
Hinchey Grading for Diverticulitis and Mx
- Small Pericolic Abscess
- Large Abscess extending to pelvis
- -> NBM, antibiotics, fluids - Purulent Peritonitis–> Washout
- Faecal Peritonitis–> Hartmann’s
Complications of Diverticular Disease
Luminal:
Obstruction
Mural: Diverticulitis ulceration Perforation Haemorrhage Abscess
Extramural:
fistula (eg bladder)
Small Bowel Obstruction Causes
Commonest:
Adhesions
Hernias
Ileus
Also: Intraluminal, Mural, Extramural, Ileus
Large Bowel Obstruction Causes
Commonest:
Carcinoma
Diverticular Stricture
Volvulus
Also: Intraluminal, Mural, Extramural, Ileus
Glasgow Criteria for Pancreatitis
PANCREAS PaO2 55 Neutrophils >15 Calcium 16 Enzymes LDH>600, AST>200 Albumin 10
Mild=1, Moderate=2, Severe=3
Gallstone Complications
In the gallbladder: Biliary colic Acute or chronic cholecystitis Mucocele Carcinoma
In the Common Bile Duct:
Obstructive Jaundice
Pancreatitis
Cholangitis
In the gut:
Gallstone ileus
Lap Cholecystectomy Indications
Cholecystitis
Biliary Colic
Gallbladder Cancer
Lap Chole Complications
Conversion to open Common Bile Duct Injur Bile Leak Retained Stones Intra-abdominal haemorrhage
Jaundice after Lap Chole, Causes
Gallstone Retention
Biliary Sepsis
Thermal injury during op
Ligation to common hepatic or common bile duct
Polycystic Kidney Disease Genetics
Autosomal Dominant:
PKD1: Chr 16 coding for Polycystin 1
PKD2: Chr 4 coding for Polycystin 2
Autosomal Recessive:
rarer and presents in childhood
Polycystic Kidney Disease Complications
MISSHAPE
Mass Infected Cysts Systolic Murmur Systolic BP elevated Haematuria Aneurysms predisposing to Subarachnoid Haemorrhage Polyuria and Nocturia Extrarenal cysts eg in Liver
Causes renal enlargement
PHONOS
PKD Hypertrophy due to renal agenesis Obstruction Neoplasia Occlusion secondary to renal vein thrombosis Systemic disease eg DM or Amyloidosis
Haemodialysis Complications
Failure Ischaemia (Steal Syndrome) Bleeding Aneurysm Taking blood no longer possible
Chronic Renal Failure Complications
REACH-O Renal Osteodystrophy Electrolyte Abnormalities Anaemia Cardiovascular Problems Hypertension Oedema
5 Functions of the Kidney
Excretion of Water Soluble Waste Excretion of Water Acid Base Homeostasis Electrolyte Control Endocrine: RAAS, EPO, Vit D