GI Surgery Flashcards
What is the breakdown of enteric bacteria in the GI tract?
Stomach - acid kills majority of bacteria
Small intestine - 10^2 - 10^6 colony forming bacteria per ml, 50% anaerobes
Colon - 10^9 - 10^11 colony forming units of bacteria per ml, 79% anaerobes
In which GI surgery are antibiotics always indicated?
small intestine and colon
What type of antibiotic would you use in small intestinal surgery?
broad spectrum with anaerobic cover
- 2nd gen cephalosporin
or - amoxycillin calvulanate
What antibiotic cover would you use when performing colonic surgery?
Conbination of 2 antibiotics including one that specifically targets anaerobes
- metronidazole
- 2nd gen cephalosporin or amoxycillin calvulanate
Which is the strongest layer in the GI tract and why?
Submucosa
has a high collagen content
How much strength does the small intestine regain by day 14 post surgery?
75% - 80%
Which section of bowel is wound breakdown the highest risk?
Large intestine.
What properties must suture material have to be used in GI surgery?
monofilament
absorbable
retain strength for 5 days
What is an intussuception?
invagination of one portion of the GI tract into the lumen of the adjoining segment
Which part of the intestine do you need to preserve if possible when removing bowel?
illeocaecolic junctions - prevents retrograde flushing of colonic bacteria into SI
What suture pattern should be used when performing an anastamoses?
simple interrupted - appositional
What is Megacolon?
Flaccid enlargement of colon with loss of function of colonic muscle.
What are some symptoms of megacolon?
Chronic Constipation Tenesmus Vomitting Anorexia Poor BCS Dehydration Large Colon
