Lower GI diseases (surgery) Flashcards
1
Q
Anastomosis
A
a connection between 2 structures
2
Q
Dissect
A
to separate 2 structures
3
Q
…centesis
A
incision and drainage
4
Q
…ostomy
A
a new permanent opening
5
Q
…orrhaphy
A
surgical repair or suture
6
Q
…opexy
A
surgical fixation
7
Q
…oplasty
A
surgical repair or reconstruction
8
Q
Meckel’s diverticulum usually presents symptomatically, and at about 2 years old. True/false?
A
False
Usually asymptomatic
BUT if symptomatic, presents at 2yrs
9
Q
Atresia is the most common congenital deformity of the GI tract. True/false?
A
False
Meckel’s diverticulum
10
Q
Meckel’s diverticulum
A
Persistence of the vitelline duct which forms an outpouching (diverticulum) of the ileum - kindof like a second appendix
11
Q
In Meckel’s diverticulum, some contain gastric mucosa, which can secrete ——– and cause ———–
A
Secrete HCl and cause ulceration.
12
Q
Vitelline duct
A
tube between the yolk sac and the primitive midgut - usually disappears during embryonic development
13
Q
Vitelline duct is also called ————
A
omphalomesenteric duct, omphaloenteric duct, yolk stalk
14
Q
Meckel’s diverticulum is twice as common in males. True/false?
A
True
15
Q
Condition that mimics appendicitis.
A
Meckel’s diverticulum
16
Q
Appendicitis - symptoms
A
Abdominal pain Guarding (abdominal muscles tense to protect the inflamed structure) Nausea Fever Tachycardia
17
Q
Meckel’s diverticulum - complications
A
Ulceration, perforation and haemorrhage ( in the presence of gastric mucosa)
Diverticulitis (acute inflammation)
Obstruction
Malignant change (rare)
18
Q
Meckel’s diverticulum should be surgically removed if complications arise. True/false?
A
True
19
Q
The rule of 2’s is associated with which GI condition?
A
Meckel’s DIverticulum
- 2% of the population
- 2 inches (5cm) long
- 2 feet (60cm) from ileocecal valve
- 2 years of age
- Twice as often in males
20
Q
Atresia
A
Congenital absence or abnormal closure of a body cavity
21
Q
Atresia is usually due to ——-
A
problems in GI tract development
22
Q
Atresia - types
A
Oesophageal atresia
Intestinal atresia
Biliary atresia
23
Q
Atresia presents in newborns. True/false?
A
True
24
Q
Swallowing or breathing difficulties in a newborn suggests oesophageal atresia. True/false?
A
True
oesophagus abnormally connects to trachea
25
Green (bile) vomit and swollen abdomen in a newborn suggests biliary atresia. True/false?
False.
This would be intestinal atresia.
Biliary atresia = jaundice
26
Meconium Ileus
Intestinal obstruction caused by meconium that is difficult to pass because it is too sticky
27
Meconium
a newborn’s first stool
28
90% of patients with meconium ileus have -------
CF
29
Meconium Ileus - symptoms
Green (bile) vomit
| Swollen abdomen
30
Omphalocele
Intestinal loop does not return to the abdomen during development, and herniates out into the umbilical cord (and is contained in the peritoneal layer of the cord).
31
Gastroschisis
Protrusion of the abdominal contents through a defect (hole) in the anterior abdominal wall lateral to the umbilical cord
Not covered in peritoneum
32
Gastroschisis occurs when a loop of bowel herniates into the umbilical cord. True/false?
False.
This is an omphalocele.
Gastroschisis = protrusion lateral to umbilical cord
33
What part of the small intestine is the vitelline duct found in?
Ileum
34
Intestinal malrotation
A congenital issue in which the intestines are twisted into the gut incorrectly, due to incorrect connection to the back wall.
35
A volvulus is a rare complication that can occur in intestinal malrotation. True/false?
False
| Volvulus is very common in intestinal malrotation, but can happen to anyone.
36
Major risk factors for volvulus include ----------
abdominal anatomy abnormalities
colonic enlargement
pregnancy
abdominal adhesions
37
Intestinal malrotation can be accompanied by abnormal tissue called --------
Ladd’s bands
| these can cause obstructions in the small intestine
38
Why is intestinal malrotation dangerous?
The twisting can obstruct the lumen of the intestine or block off the blood supply
There can be other complications e.g. a volvulus
39
Volvulus
when a loop of intestine is wrapped around its own mesentery
40
Malrotation is most commonly diagnosed in teenagers. True/false?
False.
| Malrotation is in kids, with 90% diagnosed by age 1
41
Most people with malrotation will have other associated deformities of the GI tract. True/false?
True
42
Intestinal malrotation +/- volvulus symptoms
Follow an obstructive pattern
| e.g. bile vomiting (green), abdominal pain, abdominal distension, failure to thrive
43
Bilious vomiting in babies should be taken as intestinal atresia until proven otherwise. True/false?
False
| Should be taken as MALROTATION
44
Intestinal malrotation - management
Ladd’s procedure - Ladd's bands are dissected off
| + prophylactic appendectomy
45
Intussusception
When one segment of the intestine “telescopes” inside another
46
Intussusception is a mechanism of intestinal blockage. True/false?
True
47
Intussusception can occur anywhere but is commonly at the sigmoid colon. True/false?
False.
| commonly at the ileocaecal junction
48
------------ is a large risk factor for intussusception in adults
Previous abdominal surgery
| polyps/tumours and long term inflammation due to IBD are risk factors; but scar tissue (adhesions) is a major risk
49
Malrotation is the most common cause of bowel obstruction in children under 3. True/false?
False
| Intussusception is most common
50
“(red)currant jelly" stools in newborns
Intussusception
51
Intussusception - symptoms
Blood and mucus stool
Vomiting and diarrhoea
Lethargy
Abdominal mass
52
90% of intussusception cases can be fixed with an enema. True/false?
True
| surgery = 2nd line
53
Anal fissures
A small tear in the mucosa (soft skin) that lines the anus (can be very small to severe)
54
Anal fissures - causes
Traumatic: passing large/hard stools, recurrent straining, chronic diarrhoea, anal intercourse, childbirth
Non traumatic: IBD, anal cancers, HIV, TB, Syphilis
55
Anal fissures - symptoms
Pain during or after bowel movements
Bright red blood on paper after wiping
A visible crack in the skin or small lump/tag
56
Anal fissures - treatment
Topical nitroglycerin
Topical anaesthetic (lidocaine)
Botox injection
Surgical treatment (lateral internal sphincterotomy)
57
Why is nitroglycerin used to treat anal fissures?
Promotes blood flow and promotes healing; it also relaxes the sphincter which reduces further damage
58
Why is botox used to treat anal fissures?
Botox paralyses the sphincter muscles to reduce damage
59
Colorectal cancer - risk factors
red meat, low fiber diet, smoking, IBD
60
Familial adenoma polyposis causes the development of 1/10 of adenoma polyps through the GI tract. True/false?
True
61
Lynch syndrome is another genetic condition that increases the risk of cancers through the entire GI tract but mostly in the ileocaecal region
False
| Lynch syndrome is also known as hereditary nonpolyposis colorectal cancer.
62
How does colorectal cause anaemia?
By gastrointestinal bleeds or by malabsorption.
63
Duke’s criteria can be used for staging colorectal cancer. True/false?
False
Duke's criteria = infective endocarditis
Duke's system = colorectal cancer
64
Adhesions are a massive problem in large colonic surgery. True/false?
True
65
What does it mean for the intestines to be anastomosed functionally during a surgery?
To assure the patient still has a functional digestive tract it must be watertight and the mucosa must be arranged in such a way that no external tissue is exposed to the lumen as this can cause functional problems.
66
Colorectal cancer surgery
removal of part of a colonic segment =
full removal of a colonic segment =
```
part = hemicolectomy
full = colectomy
```
67
Colorectal cancer can involve the perineum. True/false?
False
| Anorectal cancer involves perineum.
68
Cancers of the anus can be either adenocarcinomas from the colon or SCC from the adjacent skin. True/false?
True
69
Structural Lower GI Conditions
```
Diverticular disease and diverticulitis
Colonic polyps
Hernias
Haemorrhoids
Rectal varices
```
70
Diverticulum
an outpouching of the gut wall
71
Diverticulosis
presence of diverticula
72
Diverticular disease
diverticula which are symptomatic
73
Diverticulitis
inflammation of a diverticulum
74
Complicated diverticular disease/complicated diverticulitis
diverticulitis with complications
75
Uncomplicated diverticular disease/uncomplicated diverticulitis diverticulitis without complications
diverticulitis without complications
76
Diverticular disease is the presence of diverticula. True/false?
False
Diverticulosis = diverticula
Diverticular disease = symptomatic diverticula
77
Diverticula are caused by a diet with excessive fibre. True/false?
False
| Low fibre diet
78
What causes diverticula?
Low fibre diet
Colon has to work harder to move faeces → higher pressure in the lumen → diverticula form as mucosa herniates through the muscle layer to form an outpouching
79
Diverticula are most common in the ascending colon. True/false?
False.
| Most common in the sigmoid colon because it is already the narrowest part of the colon
80
Diverticula - patient group/risk factors
Western lifestyle → processed foods with low fibre diet
| Older patients
81
Colic
fluctuating abdominal pain
82
Altered/erratic bowel habit and left iliac fossa colic is most likely IBS. True/false?
False.
| Possibly IBS, but left iliac fossa pain points to diverticular disease
83
Fever, tachycardia, and tenderness and guarding of the left side of the abdomen on examination is likely appendicitis. True/false?
False
Appendicitis = right
Diverticulitis = left
84
Diverticular disease - investigations
Colonoscopy/sigmoidoscopy
| Barium enema
85
Diverticulitis - investigations
↑ESR and ↑CRP (inflammatory markers)
| CT
86
Sigmoidoscopy should be used to investigate diverticulitis. True/false?
False.
DON’T DO SCOPE in acute attack (can cause perforation
Use CT instead
87
Diverticulitis can be acute or chronic. True/false?
True
88
What are the CT findings of diverticulitis?
Diverticula present and signs of inflammation like wall thickening, any abscesses present
89
Complicated diverticulitis - symptoms
Perforation (peritonitis, abscess)
Haemorrhage
Fistula (bladder, vagina, another part of the bowel)
Stricture
90
How can diverticulitis cause peritonitis?
If diverticulitis progresses to complicated diverticulitis >> can result in perforation >> abscess formation, then rupture - causing peritonitis OR no abscess formation, and the peritoneum is directly irritated/contaminated by the contents of the perforation (e.g. faecal matter)
91
Massive amount of painless rectal bleeding is a sign of complicated diverticulitis. True/false?
True.
| Haemorrhage is a sign
92
Hinchey classification is used for ---------
acute diverticulitis
(based on CT findings and used to determine the best treatment in diverticulitis complicated by abscess formation and peritonitis)
93
Surgery is usually required to treat uncomplicated diverticulitis. True/false?
False.
94
Diverticular disease - management
```
Balanced diet (enough fibre/fluid intake)
Analgesia for pain (paracetamol)
Bulking laxative (if diarrhoea/constipation persist)
```
95
Uncomplicated diverticulitis - management
Analgesia (paracetamol) if necessary
Systemically well = watchful waiting
Suspected infection = antibiotics (co-amoxiclav + metronidazole)
Systemically unwell, comorbidities = IV fluids, IV antibiotics and bowel rest
96
Complicated diverticulitis - management
Percutaneous drainage of large abscess
Laparoscopic peritoneal lavage and drainage
Hartmann’s procedure (sigmoid colon removed)
Primary resection/anastomosis
97
Colonic polyps
abnormal growth of tissue projecting from the colonic mucosa
98
Colonic polyps - types
***Adenoma (dysplastic = premalignant)
Serrated
Inflammatory (IBD)
Hamartomatous (Peutz-Jeghers syndrome)
99
Al adenoma polyps are premalignant. True/false?
True
| All are dysplastic
100
Serrated polyps are found in Peutz-Jeghers syndrome. True/false?
False.
| Hamartomatous polyps
101
Inflammatory polyps are the most common type of colonic polyp. True/false?
False.
Adenoma polyps are most common.
Inflammatory polyp = IBD
102
What type of cancer can adenoma polyps become?
Adenocarcinoma
103
What is FAP?
Familial adenomatous polyposis
| Mutation in the APC gene (tumour suppressor)
104
FAP is caused by Mutation in DNA mismatch repair gene. True/false?
False.
This would be Lynch syndrome
FAP = APC gene mutation (tumour suppressor)
105
What is Lynch Syndrome (HNPCC)?
Adenomas - usually polyps on the right side.
| Mutation in DNA mismatch repair gene
106
What cancer is Lynch Syndrome associated with?
Colorectal as well as others e.g. gastric, endometrial
107
What does HNPCC stand for?
Hereditary non-polyposis colon cancer
(Lynch syndrome)
MISLEADING - there are polyps present
108
Which hereditary cancer results in 100-1000s of adenomatous polyps, with the risk of developing colonic cancer almost 100%?
FAP
109
What are the defining factors of Peutz-Jeghers syndrome?
```
Mucocutaneous hyperpigmentation (regions in the body where mucosa transitions to skin)
Hamartomatous polyps
```
110
Colonic polyps are usually asymptomatic. True/false?
True
111
Colonic polyps - signs/symptoms
```
Often asymptomatic - incidental finding
Can have:
Rectal bleeding → anaemia
Mucus in stool
Abdominal pain
Diarrhoea or constipation
```
112
The transformation of polyp to cancer is about 3-5 years. True/false?
True.
113
Which patients groups are screened with a colonoscopy for polyps?
FAP, Lynch syndrome
People with adenomatous polyps removed before
People who have IBD for 10+ years
114
If polyps are found during a colonoscopy, they are removed. True/false?
True.
| All adenomas need removed due to cancer risk - hence, polypectomy at the point of colonoscopy
115
A colectomy is rarely performed as a prophylactic surgery for patients with FAP. True/false?
False.
| All patients with FAP should have a colectomy performed in their late teens/early 20s
116
In FAP, a screening is still done even if the colon is removed. True/false?
True.
| Upper GI endoscopy is done to look for polyps in the remainder of the tract
117
Hernia
Protrusion of an organ or tissue out of the body cavity it is supposed to be in
118
What two factors cause hernias?
Structural weakness + increased pressure
119
Examples of structural weakness that can lead to herniation.
Normal anatomical weakness
Congenital abnormality (e.g. collagen disorders)
Surgical scar
120
Examples of increased pressure that can lead to herniation.
Strenuous activity
Chronic cough
Pregnancy
Straining e.g. bowel movements or urination
121
Hernias are often seen in structures that have openings for vessels etc to pass through. True/false?
True.
This is an example of normal anatomical weakness, resulting in structural weakness
e.g. diaphragm, inguinal canal, femoral canal
122
Reducible hernia =
| Irreducible hernia =
```
Reducible = hernia can be pushed back into the abdomen
Irreducible = hernia can’t be pushed back into the abdomen
```
123
Incarcerated hernia
The contents of the hernia are stuck inside it by adhesions - so it is irreducible.
124
Obstructed hernia
Hernia causes bowel obstruction and bowel contents are unable to pass - but blood supply still viable.
Can progress to strangulation
125
Obstructed hernias can progress to strangulation. True/false?
True.
126
Strangulated hernia
Vascular supply to the hernia contents is compromised → ischaemia occurs and surgery is needed
127
Hernia - signs/symptoms
Swelling in a particular location (depends on type of hernia)
Patient may be able to reduce the hernia
May protrude on coughing or standing
Pain and tenderness at the site of hernia (in strangulation)
128
Irreducible hernias, incarceration, strangulation and obstruction are complications that can arise from hernias. True/false?
True.
129
Inguinal hernia
Part of the abdominal contents protrudes through the inguinal canal.
130
An indirect inguinal hernia occurs when the bowel herniates through a weakness in the floor of the inguinal canal and out the superficial ring. True/false?
False.
This is a direct inguinal hernia.
Direct = through floor weakness >> superficial ring
Indirect = through deep ring >> superficial ring
131
On examination, how can you tell the difference between a direct and indirect inguinal hernia?
Lump reappears after reduction = direct
| Lump doesn’t reappear after reduction = indirect
132
It is important to know whether the inguinal hernia is direct or indirect because the management is different for each. True/false?
False.
| Management is the same
133
Hassel Bach’s Triangle
Marks an area of potential weakness in the abdominal wall through which direct inguinal herniation can occur
Borders = rectus abdominis, inferior epigastric artery, inguinal ligament.
134
Hiatal hernia
Herniation of the stomach through the diaphragm (at oesophageal hiatus)
135
Sliding hiatus hernia =
| Paraoesophageal hernia =
Sliding hiatus hernia = gastro-oesophageal junction + part of the stomach SLIDE into chest
Paraoesophageal hernia = part of stomach herniates up into the chest ALONGSIDE the oesophagus
136
Hiatal hernia - presentation
Reflux (reduced efficacy of the LOS) - can lead to GORD
137
Hiatal hernia - management
```
Conservative = lose weight, treat GORD
Surgical = persistent symptoms despite medical treatment, complications of GORD
```
138
Epigastric hernia
Fascial defect in the linea alba in the epigastric region that the bowel herniates through
139
Spigelian hernia
Hernia through the spigelian fascia
140
Midline lump between xiphoid and umbilicus, usually asymptomatic (can be painful). What hernia?
Epigastric
141
Reflux, sometimes progressing to GORD.
| What hernia?
Hiatal
142
Lump below and lateral to the umbilicus.
| What hernia?
Spigelian
143
Lump in groin, that doesn't reappear after reduction.
| What hernia?
Indirect inguinal
144
Spigelian hernias must be treated surgically. True/false?
True.
145
Lump in the upper medial thigh.
| What hernia?
Femoral
146
Lump in the back.
| What hernia?
Lumbar
147
Femoral hernia
Herniation through the femoral canal
148
Lumbar hernia
Herniation through the lumbar triangles
149
Inguinal and femoral hernias are more common in males. True/false?
False
Inguinal = males
Femoral = females
150
Incisional hernia
Hernia post-surgery
151
Lump along line of previous incision.
| What hernia?
Incisional
152
How are incisional hernias treated?
Surgical (mesh)
153
Parastomal hernia
Hernia through abdominal wall defect created when a stoma is formed
154
Lump at site of stoma
| What hernia?
Parastomal
155
Paraumbilical
Herniation occurs through an acquired weakness of the abdominal wall around the umbilicus
156
Lump at/near the umbilicus, often painful.
| What hernia?
Paraumbilical
157
Lump at the umbilicus.
| What hernia?
Umbilical
158
Umbilical hernia
Herniation occurs due to congenital weakness from the persistence of an abdominal wall defect at the site of the umbilicus
159
Umbilical hernias usually resolve spontaneously. True/false?
True.
| Some cases need surgical treatment though
160
How is an umbilical hernia different from an omphalocele?
Umbilical hernias are covered with skin
161
Painless, bright red bleeding PR
Perianal itch
(no change in bowel habit or weight)
Diagnosis?
Haemorrhoids
162
Haemorrhoids
Enlargement of the vascular cushions (rectal venous plexuses) in the wall of the anus and rectum due to increased pressure
(also called piles)
163
Haemorrhoids are the common cause of rectal bleeding. True/false?
True
164
In what cases is a flexible sigmoidoscopy performed to investigate haemorrhoids?
In patient > 50 to rule out other pathology
165
Haemorrhoids - complications?
Can become strangulated causing pain
166
Haemorrhoids - management
```
Conservative = increased fluid/fibre to prevent constipation, bulking laxatives/analgesia if necessary, anal hygiene.
Non-surgical = sclerosation therapy (medicine injected), rubber band ligation
Surgical = haemorrhoidectomy, stapled haemorrhoidectomy (avoids open wound), HALO/THD procedure (artery ligation)
```
167
Rectal varices are caused by ----------
```
portal hypertension
(when portal venous system resistance increases, the blood will travel through the path of least resistance, through anastomoses into systemic circulation - there are also no valves in these veins so blood flows both ways)
```
168
Haemorrhoids and rectal varices both cause --------
PR bleeding
169
Diverticular disease is diagnosed by ------------
| while diverticulitis is diagnosed by -------------
Diverticular disease = colonoscopy, barium enema
| Diverticulitis = CT, raised inflammatory markers
170
Appendicitis
Inflammation/infection of the appendix
171
Appendicitis infection is most commonly viral. True/false?
False.
| Infection is most commonly bacteria
172
Appendicitis - complications
Rupture of the appendix
| which can, rarely, spread the infection and potentially cause peritonitis
173
Appendicitis - patient group
Anyone!
| exam classic = young child (7/8 Yo) or teenager (15/16 Yo)
174
Rovsing sign
pressing on the LIF causes pain on the RIF
175
Psoas sign
patient keeps right hip flexed
176
Obturator sign
flexing and internally rotating hip causes pain
177
McBurney's sign
point of max pain
178
Abdo pain that starts in the umbilical and shifts to RIF.
| Diagnosis?
Appendicitis
179
McBurney’s point
⅓ the distance of the ASIS to the pubic synthesis
180
Appendicitis should always be investigated with USS. True/false?
False.
| Only for women (as some gynaecological emergencies present like appendicitis) and children.
181
Why are CRP and WCC bloods done in appendicitis?
to distinguish infectious from inflammatory appendicitis
182
Management of appendicitis - presurgical
Analgesia (NSAIDs)
Antipyretics (NSAIDs)
Antibiotics (normal surgical prophylaxis)
183
Bowel obstruction is a blockage of the bowel, leading to ------------
accumulation of fluid/gas, ischaemia or perforation
184
Tumours and Crohn’s can both lead to intraluminal obstruction. True/false?
False.
| These are causes of luminal obstruction
185
Intraluminal bowel obstruction - causes
Gallstones, food/faeces, bezoar
186
Luminal bowel obstruction - causes
tumours, Crohn’s, radiation
187
Extraluminal bowel obstruction - causes
adhesions, herniation, masses
188
Colicky central abdo pain, absolute constipation, vomiting and borborygmus.
Diagnosis?
bowel obstruction
189
Absolute constipation
no flatulence or bowel movements
190
In bowel obstruction, vomiting shows ------
late stage obstruction or proximal obstruction
191
In bowel obstruction, feculent vomiting shows ------
obstruction of the ileum
192
Bowel obstruction - management
AXR or contrast CT
ABGs and bloods (metabolic distress)
Laparotomy (if suspected complication)
193
Tinkling bowel sounds
Bowel obstruction
194
Ischaemic colitis is the commonest problem of bowel ischaemia. True/false?
True.
195
Why is ischaemic colitis "abdominal angina"?
As it is inflammation but not total tissue death due to ischemia, most commonly due to atherosclerotic narrowing is intestinal blood vessels.
196
What is the most commonly affected vessel area in ischaemic colitis?
the splenic flexure
197
Apart from atherosclerosis, what are the other causes of ischaemic colitis?
hypotension, obstruction, cocaine & meth, iatrogenic
198
Those with coagulopathy or AF may also suffer ischemic colitis due to -----------
throwing clots
199
Why do intra-abdominal masses compressing arteries not always cause total ischaemia?
Because of the collateral circulation
200
Abdominal pain/cramping, fresh blood in the stool, urgency, diarrhoea, nausea.
Diagnosis?
Likely ischaemic colitis
201
Ischaemic colitis - investigations
USS/AXR/CT (view the bowel)
CT/MRI angiography
Colonoscopy
202
Mild cases of ischaemic colitis are treated with embolectomy (bypass of the afflicted artery). True/false?
False.
Mild cases = self-resolve (analgesia, treat cause)
Major cases = embolectomy or colectomy (if non-salvageable)
203
What is the difference between true bowel ischemia and ischaemic colitis?
In true bowel ischemia, the bowel is dead/necrotic whereas ischemic colitis it is damaged by ischemia but not dead.
Bowel ischaemia = "ACS"
Ischaemic colitis = "angina"
204
Bowel ischaemia/infarction is most often caused by obstruction. True/false?
False.
| Most often due to an atherosclerotic event
205
Bowel ischaemia/infarction - symptoms
Sudden (often severe) abdominal pain
Blood in the stool
Forceful/painful bowel movements
206
When is an MRI angiography done to investigate bowel ischaemia/infarction?
Second-line to CT angiography.
| Used if the patient has renal problems or is intolerant to the contrast needed for CT
207
Bowel ischaemia/infarction - treatment
Colectomy to remove the infarcted tissue
| Restore the vasculature best as possible (by embolectomy, bypass, grafting)
208
Classification of surgical complications
Immediate =
Early =
Late =
```
Immediate = within 24hr
Early = within 2-3 weeks
Late = any subsequent period after discharge from hospital
```
209
Tachycardia, hypotension and oliguria following a surgery. Diagnosis?
Post-op complication: haemorrhage
210
Cardiovascular post-op complications
MI, haemorrhage, DVT
211
Respiratory post-op complications
Atelectasis, pneumonia, PE
212
GI post-op complications
Ileus, anastomotic dehiscence, adhesions, short gut syndrome.
213
Ileus
Paralysis of intestinal motility
214
Anastomotic dehiscence
Breakdown of anastomosis
215
Adhesions
Formation of scar tissue that can cause organs/tissues to stick to each other
Can cause bowel obstruction
216
Short gut syndrome
Malabsorption due to insufficient residual small bowel (after small bowel surgery)
Leads to metabolic abnormalities
217
Wound - post-op complications
Infection
Dehiscence (rupture)
Hernia (incisional)
218
Urinary post-op complications
Retention of urine
UTI
Urethral stricture
AKI (acute kidney injury)
219
Neurological post-op complications
Confusion (lots of causes)
Stroke
Peripheral nerve injury
220
Pyrexia post-op causes
5 W's
Wind → atelectasis or pneumonia (24-48hrs)
Water → UTI (3-5days)
Wound → wound infection (4-6days)
Walking → DVT (5-7days)
Wonder drugs → drug-induced fever (anytime)
