Adhesions Flashcards
Adhesions
Fibrous bands of scar tissue
Clinical Features of adhesions
Asymptomatic
Can cause:
- obstruction
- chronic pelvic pain
Ix for adhesions
AXR
Mx
Obstruction:
- conservative
- tube decompression
- NBM
- Analgesia
- Fluids
- NG tube and catheter
- Adhesiolysis
Adhesiolysis
Only adhesions causing mechanical obstruction or strangulation
Prevention
Correct surgical technique
Reducing intraperitoneal organ handling
Incisional hernia
Protrusion of the contents of a cavity (usually the abdomen) through a previously made incision in the compartment’s wall
Complications of incisional hernias
Incarcerated
Strangulation
Bowel obstruction
Chronic pain
Risk Factors for incisional hernias
Emergency surgery
Wound type - Midline incision
BMI >25
Wound infection
Pre-operative chemotherapy
Intra-operative blood transfusion
Advancing age
Pregnancy
Clinical Features of incisional hernia
Non-pulsatile
Reducible
Soft and non-tender swelling at site of surgical wound
Investigations for incisional hernia
Clinical basis
USS/ CT if unclear
Mx of incisional hernias
Suture repair (for very small hernias),
Laparoscopic mesh repair
Ppen mesh repair.
Complications of incisional hernias after surgery
Seroma
Recurrence
Chronic pain
