Abdomen, Oesphagus and Stomach Flashcards
Most common cause of mesenteric infarction
superior mesenteric artery
2 week diffuse abdominal pain, contraceptive pill, -ve pregnancy -
Mesenteric venous thrombosis
Increased P() with intrabdominal sepsis
Appendicular artery
ileocolic
Median arcuate ligament syndrome
post prandial epigastric prain + bruit
Greater omentum contains both
Greater omentum contains both gastroepiploic arteries
Brisk bleed – posterior duodenal ulcer – perforation of…
gastroduodenal artery perf – branch of common hepatic
3 week hx post prandial, intermittent diarrhoea and PR bleeding
mesenteric vascular disease. CT Angio or US Duplex if renal impairment
Management of bleeding inferior splenic pole?
Argos plasma coag
Cervical oesophagus supplied by
inferior thyroid artery
mucinous adenocarcinoma within abdomen - name and management
Pseudomxyoma peritonei – geltanious – sugar baker procedure + peritoneal chemo
Superior mesenteric vein – drains into
Superior mesenteric vein – drains into portal vein
Management of splenic vein thrombosis
Splenectomy
The medial edge of Hassalbach’s triangle =
rectus abdominus
Middle Sacral artery is
posterior to rectum
Normal intraabdominal pressure =
Normal intra abdominal pressure = 5-7mmHg
Laparoscopic insufflation pressure
12- 15mmHg
Abdominal compartment syndrome - sustained >…
Abdominal compartment syndrome - sustained >20mmHg + new organ dysfunction / failure
X% acute cholecystectomy – stone in the common bile duct
10% acute cholecystectomy – stone in the common bile duct
Renal stones in IBD
Calcium Oxalate
Drugs in UC
Steriods • 5 MA (Mesalazine) Immunosupressants (Cyclosporin)
Monoclonal antibody against TNF-a (Infliximab)
Drugs in UC
Steroids 5 ASA (Mesalazine)
Immunosupressants (Azothioprine/Mercaptopurine)
Methotrexate
Monoclonal antibody against TNF-a (Infliximab)
Transverse incision two thirds of the way between umbilicus and the symphysis pubis - Last likely to come across
Posterior lamina of the rectus sheath
stoma with a Low anterior resection + colorectal anastomosis
loop ileostomy
what stoma with a Low anterior resection + colorectal anastomosis
loop ileostomy
Rovsings pressing LIF – negative if
Rovsings pressing LIF – negative if appendicitis is retroceacal
Divide X to access coeliac axis for gastrectomy
Divide lesser omentum to access coeliac axis for gastrectomy
Duodenal Ferrous Fe2+ absorption – bound as
Duodenal Ferrous Fe2+ absorption – bound as ferritin
Crohn’s stricture – terminal ileal/ileocecal – , surgical management after IV Steroid trial
Crohn’s stricture – terminal ileal/ileocecal – right hemicolectomy after IV steroid trial
Colonic polyps – which has highest P() malignant transformation
villous adenoma
Colonic polyps – which has highest P() malignant transformation
villous adenoma
Folate – small intestine absorption not dependant on
jejnum - not pancreas dependant
b12 in terminal ileum
Ileostomy sodium content
120mmol/L Na+
Inflammation, bleeding + mucous from stump post Hartmann’s
Diversion proctitis
Level of blockage for blockade for inguinal hernia repair
T12 blockade for inguinal hernia repair
Short hx (2/52) nocturnal incontinence, diarrhoea + rectal bleeding
IBD
Management of Incarcerated femoral hernia
McEvedy’s>Lothessian (above, not through)
Lockwood inappropriate. Especially with SBO
Management of emergency presentation of low anal cancers
defunction with loop colostomy – then formal staging
Right obstructing colon carcinoma you perform..
rt hemicolectomy + ilocolic anastomosis
Post inguinal hernia repair groin pain…
ilioinguinal nerve entrapment
Coeliac autonomic plexus relative to aorta
Coeliac autonomic plexus – anterolateral to aorta
High output ureterosigmoidostomy will result in
High output ureterosigmoidostomy – acidosis
Devision of what ligament in splenectomy
Division of gastrosplenic ligament containing short gastric arteries in splenectomy
Hernia containing Meckel’s diverticulum known as…and management…
Litter’s hernia, resect before mesh repair.
Open Lichtenstein repair is a…
open hernia repair with mesh
Splenic Immune reticuloendothelial cells are in found in the…
Splenic Immune reticuloendothelial cells are in white pulp
For right adrenalectomy you need tomobilise
Mobilise right colonic flexure for right adrenalectomy
Resected colon cancer with nodal disease - you give…
Resected colon cancer with nodal disease – chemotherapy!
Right hemicolectomy puts at risk
Right hemicolectomy - Gonadal vessels + ureter at risk
Splenic flexure obstruction –
extended rt hemicolectomy
Massive splenomegaly
CGL (chronic granulocytic leukemia)
chronic inflammation resulting in obliteration of calots triangle
Mirizzi syndrome
Fe deficiency, postprandial pain most likely to be
Meckels with gastric>IBD
Annular pancreas will obstruct the
Annular pancreas will obstruct the second part of duodenum
Ca+ - most absorbed in
small bowel
Colorectal screen starts at
Colorectal screen starts at 60
Midgut
Second part of duodenum to 2/3 transverse colon
Hindgut-
Distal 1/3 transverse colon to anus
Divide which attachments of the caecum for retrocaecal appendix
Divide lateral peritoneal attachments of the caecum for retrocaecal appendix
Duke’s survival A/B/C/D
Duke’s survival A/B/C/D 95/75/50/25
What vessel disease will result in splenic atrophy
Coeliac disease – splenic atrophy
small appendiceal carcinoid tumours <2cm
Discharge small appendiceal carcinoid tumours <2cm
Liver mets for carcinoid syndrome diagnosis
Intermittent diarrhoea + RIF pain + weight loss
IBD
Colonic polyp on a stalk termed as..
Colonic polyp on a stalk – dysplasia
For a Serrated not malignant polyp
polypectomy!