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G.I. > Complications of surgery > Flashcards

Complications of surgery Flashcards

1
Q

Cardiovascular complications

A

Haemorrhage - reactionary, or secondary

M.I.

DVT

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2
Q

Reactionary haemorrhage

A

Immediate postoperative

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3
Q

Secondary haemorrhage

A

Infection (5-10 days)

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4
Q

Presentation of haemorrhage

A

Over
Tachycardia
Hypotensive
Oliguria

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5
Q

Prevention of haemorrhage

A

Meticulous technique
Avoidance of sepsis
Correction of coagulation disorders

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6
Q

MI presentation

A

Often silent (due to anaesthetics)

Cardiac failure/cardiogenic shock

Arrhythmias

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7
Q

MI Prevention

A

Delay surgery after an MI

Avoidance of preoperative hypotension

Correction of ischaemic HD first (stents)

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8
Q

DVT - risk, caused by

A

Increased risk - Age>40

Previous DVT
Majour surgery
Obesity
Malignancy

Caused by//

Immobility during surgery
Hypercoagulable state

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9
Q

DVT presentation

A 
Low grade fever
Unilateral ankle swelling
Calf or thigh tenderness
Increased leg diameter
Shiny skin
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10
Q

DVT investigation

A

D dimer test - rule out test

Doppler ultrasound

Venography

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11
Q

DVT prevention

A

Compression stockings
Low does SC heparin

Early mobilisation

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12
Q

Respiratory

A

Atelectasis
Pneumonia
PE

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13
Q

Atelectasis

A

Collapse of lung tissue –> infection

Anaesthesia - increases secretion, inhibits cilia

Postoperative pain
- inhibits coughing

Aspiration
- stomach contents

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14
Q

Chest infection - presentation

A

Low/high grade fever

Dyspnoea
Productive cough
Confusion

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15
Q

What is confusion related to?

A

Hypoxia

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16
Q

Chest infection - prevention

A

Stop smoking
Adequate analgesia
Physiotherapy

17
Q

Pulmonary embolism

A

DVT

Tachypnoea
Dyspnoea
Confusion
Pleuritic pain
Haemoptysis
Cardiopulmonary arrest
18
Q

Ileus (paralytic)

Causes

A

Paralysis of intestinal motility

Causes/

Handling of bowel

Peritonitis

Retroperitoneal injury

Immobilisation

Hypokalaemia

Drugs

19
Q

Ileus - presentation

A

Vomiting
Abdo distension
Dehydration
Silent abdomen

20
Q

Ileus - prevention

A

Minimal operative trauma

Laparoscopy

Avoidance of intra-abdo sepsis

21
Q

Anastomotic dehiscence

A

Breakdown of anastomosis (connection of tissue surgically)

Caused by/

Poor technique
Poor blood supply
Tension on anastomosis

22
Q

Anastomotic dehiscence - presentation

A

Intestinal

  • peritonitis
  • abscess
  • ileus
  • fistula

Vascular
- bleeding, haematoma

Urological
- leakage of urine/urinoma

23
Q

Anastomotic dehiscence - prevention

A

Good technique
Good blood supply
No tension

24
Q

Adhesions

  • what is it
  • caused by
A

Fibrin –> Fibrous tissue

  • bowel to bowel
  • bowel to abdominal wall
  • lung to chest wall

Caused by

  • inflammatory response
  • ischaemia
25
Q

Adhesions - presentation

A

Asymptomatic - to chest wall

Intestinal obstruction

  • vomiting
  • pain
  • distension
  • constipation
26
Q

Adhesions - prevention

A

Avoidance of infection

laparoscopic surgery

Sodium hyaluronidate

27
Q

Wound infection

A

Trauma
- exogenous

Intestinal surgery
- endogenous (bacteria in the intestine spills into peritoneal cavity/ wound)

28
Q

Wound infection - presentation

A 
Pyrexia
Redness
Pain
Swelling
Discharge
29
Q

Wound infection - prevention

A

Pre-op prep

Skin cleansing

Aseptic technique

Avoidance of contamination

Prophylactic antibiotics - high risk ops

30
Q

Urinary complications

A

Acute retention of urine

UTI - catheter

Urethral stricture - can occur after prolonged use of catheters

31
Q

Neurological complicaitons

A

Confusion - hypoxia, PE, MI
Stroke

Peripheral nerve lesions

  • ulnar nerve
  • radial nerve
  • sciatic nerve
  • common perineal nerve
32
Q

Confusion - causes

A 
Hypoxia
Chest infection
PE
MI
Oversedation
Sepsis
Electrolyte imbalance
Stroke
Hyper or hyopglycaemia
Alcohol or tranquilliser withdrawal
33
Q

Confusion - presentation

A

Disorientation

  • time
  • place

Paranoia

Hallucinations

34
Q

Confusion - prevention

A

Maintain oxygenation
Avoid dehydration
Avoid sepsis
Send home ASAP

35
Q

Enhanced recovery after surgery (EHAS)

A

Enhanced care

Minimise post-op complications

Promotes - pain control, GI function, mobility

Pre op: Admission counselling, no prolonged fasting

Periop - short acting anaesthetic agents
- no drains

Post-op - early removal of catheter, early oral nutrition, no NG tubes

G.I. (20 decks)

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