General/GI Flashcards
Most common causes of acute pancreatitis
alcohol or gallstones
pathophysiology of acute pancreatitis
autodigestion of pancreatic tissue by the pancreatic enzymes leading to necrosis
presentation on acute pancreatitis
severe epigastric pain
vomiting
epigastric tenderness, ileus, low grade fever
diagnosis of acute pancreatitis
epigastric pain, vomiting
raised amylase
+lipase
management of acute pancreatitis
fluid resus
analgesia
NBM
no abx!!
surgery
complications of acute pancreatitis
necrosis of the pancreas
infection in necrotic area
abscess formation
acute peripancreatic fluid collections
pseudocysts
chronic pancreatitis
management of chronic pancreatitis
creon
no alcohol
pain management
subcut insulin
ERCP stenting
surgery
what is an anal fissure
longitudinal or elliptical tears of the squamous lining of the distal anal canal
risk factors for anal fissures
constipation
IBD
STIs
presentation of anal fissures
bright red, rectal bleeding
most common location of anal fissure
posterior midline
management of anal fissure
soften stool: high fibre, bulk forming laxative
lubricants
topical anaesthetics
analgesia
GTN for chronic anal fissure
surgery- sphincterotomy
pathophysiology of appendicitis
pathogens get trapped due to obstruction (faecolith, lymphoid hyperplasia) -> gut organisms invading the appendix wall -> oedema, ischaemia +/- perforation
presentation of appendicitis
periumbilical pain radiating to RIF
pain worse on coughing or moving
vomiting once or twice
mild pyrexia
anorexia
what is mesenteric ischaemia
lack of blood flow through the mesenteric vessels supplying the intestines
what does the foregut include
stomach, part of the duodenum, biliary system, liver, pancreas and spleen
what is included in the midgut
distal part of the duodenum to the first half of the transverse colon
what is included in the hindgut
second half of the transverse colon to the rectum
blood supply of the foregut
coeliac artery
blood supply of the midgut
superior mesenteric artery
blood supply of hindgut
inferior mesenteric artery
presentation of chronic mesenteric ischaemia
central colicky abdominal pain after eating
weight loss
abdominal bruit
diagnosis of chronic mesenteric ischaemia
CT angiography
what is ileus
condition affecting the small bowel where the normal peristalsis temporarily stops.
causes of ileus
injury to the bowel
handling of the bowel during surgery
inflammation or infection
electrolyte imbalance (hypokalaemia or hyponatraemia)
presentation of ileus
vomiting (green bilious)
abdominal distention
diffuse abdominal pain
absolute constipation and lack of flatulence
absent bowel sounds
