Gen Surgery Flashcards
abdominal pain severe, of sudden onset and out-of-keeping with physical exam findings.
acute mesenteric ischaemia = i.e. occlusion of superior mesenteric artery
“thumb print” on AXR at splenic flexure
Ischaemiac colitis
features of small bowel obstruction
central abdominal pain
nausea and vomiting
‘constipation’ with complete obstruction
abdominal distension
what is seen on abdo xray in small bowel obstruction
small bowel loops with fluid levels
most common place a volvulus occurs
sigmoid colon
post-op + abdo distension + vomiting + no bowel sounds = ?
paralytic ileus
Tx = NG tube
where is a femoral hernia located
inferior and lateral to pubic tubercle
where is a inguinal hernia located
medial and superior to pubic tubercle
indirect = lateral to inferior gastric artery [young men] direct = medial [old men]
surgery for emergency colon perforation etc
Hartmann’s
surgery for low/upper rectum
anterior resection
surgery for sigmoid colon
high anterior resection
left hemi-colectomy
surgery for distal transverse and descending colon
left hemi-colectomy
surgery for caecal or ascending colon
right hemi-colectomy
surgery for severe perianal fistulae
protectomy
how long does COCP have to be stopped for prior to surgery
4 weeks
surgery for emergency presentation of poorly controlled colitis that fails to respond
sub total colectomy
what is most common cause of HCC in europe
Hep C
what lung cancer is most associated with smoking
squamous cell carcinoma
1st line Ix for PSC
MRCP [non invasive]
Tx of acute cholecystitis
IV antibiotics [IV cefuroxime] + Early Lap Cholecystectomy
how can you broadly differentiate between biliary colic, acute cholecystitis, acute cholangitis
biliary colic = RUQ after meals, comes and gos
cholecystitis = systemically unwell, constant pain, no jaundice
cholangitis = jaundice, fever, RUQ pain
