Post Op Complications Flashcards
What are general post op complications?
haemorrhage sepsis pain N+V delirium
When would you suspect an anastomotic leak?
patient not progressing or deteriorating post op
abdo pain, fever 5-7 days post op
How would you investigate a suspected anastomotic leak?
CT CAP with contrast
How is an anastomotic leak managed
urgent senior review
IV Abx
drain collections
exploratory lap with wash outs
What is a post op ileus?
functional bowel obstruction
bowel not working properly after an operation
What are the clinical features of an ileus?
features of obstruction
How is an ileus managed?
correct electrolyte abnormalities, monitor for AKI
reduce opiate use
encourage mobilisation
?NG tube
CT scan - to rule out leaks and collections
What prophylactic measures can be taken to reduce chance of an ileus?
reduce intra op intestinal handling
reduce opiate use
early mobilisation
avoid fluid overload
What are bowel adhesions?
fibrous bands of scar tissue
secondary to surgery or inflammation
What can bowel adhesions cause?
obstruction
How do bowel adhesions present?
the adhesions themselves are asymptomatic present with effects - obstruction - infertility - chronic pain
How are bowel adhesions managed?
manage obstruction: tube decompression, NBM, analgesia, IV fluids
adhesiolysis
How is post op constipation managed?
adequate hydration sufficient fibre early mobilisation treat cause laxatives enema
How would you manage post op ileus or opiod induced constipation?
stimulant laxative e.g. Senna
How would you manage chronic constipation/hard stool?
stool softening laxative e.g. lactulose
