GI surgery Flashcards

1
Q

commonest causes of pneumoperitoneum

A

perforated diverticulum and a perforated duodenal ulcer

Free air may persist for several days after abdominal laparotomy.

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2
Q

Which structures cause gas accumulation in the retroperitoneum when they perforate?

A

3rd part of peritoneum

ascending colon

descending colon

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3
Q

Serum amylase can confirm pancreatitis if above

A

1000

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4
Q

first steps in management of acute pancreatitis

A

IV fluids
IV analgesia
Blood gas analysis (for severity scoring)
Start oral feeding

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5
Q

Common complication of pancreatitis

A

Pancreatic psudocyst

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6
Q

First line method for draining a psudocyst

A

endoscopic ultrasound

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7
Q

How can you establish the diagnosis of pancreatic exocrine insufficiency?

A

Faecal elastase measures pancreatic exocrine function, however it is a fairly blunt instrument to determine pancreatic insufficiency. Clinical judgement is just as good.

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8
Q

Calprotectin is a measure of

A

gastrointestinal inflammation (think of it like CRP for the bowel)

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9
Q

SeHCAT scan measures

A

bile salt reabsorption, and is a test used to investigate chronic diarrhoea

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10
Q

treatment for pancreatic exocrine insufficiency

A

oral pancreatic enzyme replacement

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11
Q

initial Ix in bowel obstruction

A

Supine abdo radiograph to assess the bowel gas pattern.

A rectal examination is mandatory to exclude a rectal lesion.

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12
Q

how to manage sigmoid volvulus initially (if no perforation)

A

Large bowel decompression with a flatus tube - relieve symptoms and is relatively non-invasive, suffices in some patients

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13
Q

how to manage recurrent sigmoid volvulus / with perforation

A

sigmoid colectomy

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14
Q

cause of sigmoid volvulus

A

twisting of the bowel on lax mesentery

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15
Q

Which volvulus has association with large bowel malignancy

A

Caecal volvulus

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