Chapter 87: Complications of General Surgical Procedures Flashcards
Causes of post operative fever
- Wind (atelectasis or pneumonia)
- Water (urinary tract infection), - Wound
- Walking (deep vein thrombosis)
- Wonder drugs (drug fever or pseudomembranous colitis)
Predominant cause of fever in the first 72 hours
Atelectasis and IV catheter-related problems
Occurs up to 6 weeks postoperatively
Antibiotic-induced pseudomembranous colitis
Becomes evident between 24 and 96 hours postoperatively
Pneumonia
Antibiotic for post operative UTI
- Ciprofloxacin, 500 milligrams PO twice daily
- Levofloxacin, 750 milligrams PO once daily
Wounds not involving the perineum and not associated with entry into the GI or biliary tract are most often infected with _____
Wounds not involving the perineum and not associated with entry into the GI or biliary tract are most often infected with S. aureus or streptococci
C scan of necrotizing fasciitis reveal
Asymmetric fascial thickening, gas tracking along fascial planes, or focal fluid collections
Hallmark of necrotizing fasciitis
Presence of marked systemic toxicity and pain out of proportion to local findings
Antibiotic for necrotizing fasciitis
Penicillin or a cephalosporin, an aminoglycoside, and clindamycin
Superficial thrombophlebitis of the lower extremities is most frequently secondary to stasis in ____
Superficial thrombophlebitis of the lower extremities is most frequently secondary to stasis in varicose veins
The preferred diagnostic test for deep venous thrombosis
Doppler US
Greatest concern in complication of drug therapy
Pseudomembranous colitis
How to diagnose C. difficile
- Nucleic acid amplification tests
- Glutamate dehydrogenase
- Enzyme immunoassay
Drug class most commonly implicated with fever
Antibiotic
After surgery, how many day will the tone of small bowel and colonic function returns?
Small bowel tone usually returns to normal within 24 hours, and colonic function returns within 3 to 5 days
Ileus can also occur after non-GI procedures and is usually secondary to _____
Ileus can also occur after non-GI procedures and is usually secondary to anesthetic agents
True or False
Fistulas involving the distal GI tract are frequently high output and are of the greatest concern
False
Fistulas involving the proximal GI tract are frequently high output and are of the greatest concern
Anastomotic leaks occur most frequently after ____
Anastomotic leaks occur most frequently after esophageal and colonic surgeries
A common complication of the Roux-en-Y gastric bypass is ____
A common complication of the Roux-en-Y gastric bypass is dumping syndrome
Dumping symptoms happens because?
Pylorus is bypassed or removed
Dumping syndrome associated with reactive hypoglycemia
Late dumping syndrome (2-4 hours)
Mainstay of treatment for dumping syndrome
The mainstay of treat- ment is dietary modification; consumption of small, dry meals; and separation of solids from liquids
Vitamin deficiency that require emergent intervention after Roux-en-Y gastric bypass and biliopancreatic diversion is?
Vitamin B12 deficiency is the only one that requires emergent intervention
The two most commonly placed stomas are
The two most commonly placed stomas are the ileostomy and the colostomy
Occurs when the surgeon has not removed all redun- dant mucosa during hemorrhoidectomy and is much more common than rectal prolapse
Mucosal prolapse occurs when the surgeon has not removed all redun- dant mucosa during hemorrhoidectomy and is much more common than rectal prolapse
Can occur after any anorectal surgical procedure and likely is related to injury of the puborectalis muscle
Rectal prolapse can occur after any anorectal surgical procedure and likely is related to injury of the puborectalis muscle
