Bowel adhesions + Incisional hernia Flashcards

1
Q

Symptoms of bowel adhesions

A

Ther are generally asymptomatic, but the effect of the adhesions presents with symptoms such as:
* Obstruction
* Infertility
* Chronic pelvic pain

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2
Q

When is surgical management warranted for bowel adhesions?

A
  • Ischaemia or
  • Perforation or
  • Failed conservative management
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3
Q

Surgery for bowel adhesions

A
  • Adhesiolysis - cutting through adhesions
  • Should be limited to adhesions causing the problem to reduce risk of recurrent adhesional disease
  • Laparascopic is preferred BUT low threshold for conversion to open approach due to it being challenging with distension of the bowel
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4
Q

Preventing bowel adhesions

A
  • Correct surgical technique
  • Reducing intraperitoneal organ handling
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5
Q

RF for incisional hernia

A
  • Emergency surgery
  • BMI >25
  • Midline incision
  • Post op wound infection
  • DM, CTD, steroid use
  • Advancing age
  • Current smoker
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6
Q

Presentation of incisional hernia

A
  • Reducible, soft, non-tender swelling
  • At or near site of previous surgical wound
  • If incarcerated can become painful, tender and erythematous
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7
Q

Investigation for incisional hernia

A
  • Usually clinical but can use CT imaging to confirm
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8
Q

Management incisional hernia

A
  • Depends on size, defect in wall, clinical features, patients age and co-morbids
  • Surgery is possible
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9
Q

Types of surgical repairs for incisional hernias

A
  • Suture repair
  • Laparoscopic mesh repair
  • Open mesh repair
  • If large - abdominal wall reconstruction
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10
Q
A
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