Complications post op

Question 1

What are the early complications of bowel surgery?

Answer 1

Anastomotic leak
Paralytic ileus
Enterocutaneous fistulae
Abscesses
Antibiotic associated colitis

Question 2

What are the late complications of bowel surgery?

Answer 2

Adhesions causing obstruction

Incisional hernia

Question 3

What is Paralytic ileus?

Answer 3

Patient has constipation, distension, absent bowel sounds, may be vomiting.
Usually caused by bowel handling during surgery, anaesthetic or electrolyte imbalances
Treatment is fluids + NGT if needed

Question 4

What are the immediate surgical complications?

Answer 4

Oropharyngeal damage from intubation
Surgical trauma to local structures
Primary (bleeding during surgery) or reactive (bleeding at the end of surgery) haemorrhage

Question 5

What are the early surgical complications? 1day-1month

Answer 5

Secondary haemorrhage (bleeding >24hrs post op, usually due to an infection)
VTE
Urinary retention
Pneumonia
Wound infection
Antibiotic associated colitis

Question 6

What are the late surgical complications? >1 month

Answer 6

Scarring
Neuropathy
Failure/recurrence

Question 7

What are the risk factors for post op infection?

Answer 7

Increasing age
Co morbidities eg DM
Pre existing infection
Pt colonisation
Type of surgery
Duration
ABx given, aseptic technique
Contamination of wound from staff post op

Question 8

What are the orthopaedic specific post op complications?

Answer 8

Mal/non union
Osteomyelitis
Avascular necrosis
Compartment syndrome
VTE
Dislocation
Damage to surrounding structures eg nerves
Leg length discrepancy post hip op

Question 9

What is Atelectasis?

Answer 9

Collapse or closure of lung resulting in reduced or absent gas exchange
Can effect all or part of lung
Usually unilateral
Cough, may have chest pain, breathing difficulty (fast and shallow), low oxygen saturation, pleural effusion (transudate type)
Physiotherapy for treatment