Emergency Surgery* Flashcards
In which quadrant is the the cecum located?
Right lower quadrant
In which quadrant is the the sigmoid colon located?
Left lower quadrant
In which quadrant is the the pancreas body located?
Left upper quad
In which quadrant is the head of pancreas located?
Right upper quad
……. Sign is ecchymosis (discoloration of skin due to bruises) of flank from retroperitoneal injury
Gray Turner
What are the causes of small bowel obstruction (SBO)?
FAST GRIVB;
Foreign body
Adhesion
Strangulated hernia
Tumors
Gallstones
Radiation
Intussusception(inversion of one portion of the intestine into another)
Volvulus(obstruction caused by twisting)
Bezoar(mass in the gastrointestinal system caused by the accumulation of indigestible ingested materials)
What are the causes of large bowel obstruction (LBO)?
CHEVA FD
Colon cancer
Hernia
Extrinsic cancer
Volvulus
Adhesion
Fecal impaction
Diverticulitis
Within how long can you operate on ischemia and perforation+bleeding+obstruction[B.I.O.P]?
[hours in BIO P]
Hours
Within how long can you operate on obstruction and infeection?
Days
Within how long can you operate on bleeding?
Minutes
What is a sign of retroperitoneal injury?
Gray tuner(echymosis)
When do you seen “Currant jelly stool” or stool with mucus?
In intussusception
What are the complications of intussusception?
[BPSP]
Bowel obstruction
Perforation
Sepsis
Peritonitis
**What is the dx of intussusception ?
Hx and physical exam
X-ray
Ultrasound
Contrast enema
Ct scan
*What are the clinical features of pyloric stenosis?
-Non-bilious vomiting
-Normal appetite
-dehydration
-Hypochloremia, hypokalemia,metabolic alkalosis*
**What are the complications of appendicitis?
Peritonitis
Perforation
Abscess
Generalized abdominal rigidity
Fever
Increased pain with cough
**What is the history of of a person with pancreatitis?
Qualities of current pain(epigastric pain)
Hx of alcohol abuse
Hx of past pancreatitis
Hx of gallstones
inc lipase and amylase
**What are the elevated lab values in pancreatitis?
Elevated lipase and amylase
**What are the symptoms of ascending choliangitis?
CHARCOT’s Triad Combination of : Jaundice, Fever, and RUQ pain
What are the complications of gallstones?
Necrosis/perforation
Gallstone illeus
Ascending choliangitis(charcot’s triad)
Which disease of the intestine is described as small mucosal pockets or pouches?
Diverticulitis
Where can you see **urinary frequency+ Left lower quadrant pain+ Dysuria+ change in bowel habits?
Diverticulitis
During assessment of diverticulitis what is the prominent signs?
**Change in bowel habits
LLQ tenderness*
Occult blood
**Q, upper GIS bleeding causes?
[VARICES]
Varices &vascular malformation(osler weber)
Alcohol and drugs
Ruptures(mallory-weiss tear)
I-peptic ulcers
Carcinoma
Esophagitis
Stomach ulcer
**Q, lower GIS bleeding causes?
[DRAIN-M]
Diverticulosis
Radiation
Angiodysplasia/ AV malformation (AVM)
Ischemia/inflammatory bowel dis
Neoplasm
Meckel’s diverticulum
Enteritis
In which disease are Veins distended and can be fragile and at risk for **tearing and
bleeding*?
Esophageal varices
In which disease do you see clinical features including :• Hematemesis
– “coffee-ground emesis”
• **Hematochezia
• **Melena
• Fatigue
• Hypovolemia
• Tachycardia
upper GIS bleeding such as esophageal varices
In a person with a history of alcohol use, Hematochezia, Melena, Hematemesis
Esophageal varices
When do you see Kehr’s sign and LUQ pain?
Splenic injury/rupture
When do you use Nasogastric tube stomach injury
When are amylase and lipase elevated and epigastric pain?
Pancreatitis