Surgery Flashcards
What are the 3 main GI risks of surgery?
Ileus
Anastomotic dehiscence
Adhesions
What is an ileus?
Paralysis of intestinal motility
What can cause and ileus?
Handling of the bowel Peritonitis Retroperitoneal injury Immobilisation Hypokalaemia Drugs
What is the clinical presentation of an ileus?
Vomiting
Abdominal distension
Dehydration
Silent abdomen
How can you prevent an ileus?
Reduce operative trauma
Use laparascopic techniques
Avoid intra-abdominal sepsis
What is anastomotic dehiscence
The breakdown of antastamosis;
Intestinal
Vascular
Urological
How can you prevent anastomotic dehiscence?
Good surgical technique
Good blood supply
Reduce tension on anastomoses
How does intestinal anastomotic dehiscence present?
Peritonitis
Abcess
Ileus
Fistula
Where can you find adhesions?
Bowel to bowel
Bowel to abdominal wall and other structure
Also Lung to chest wall
What causes adhesions?
Inflammatory response and ischaemia
How do GI adhesions present?
Vomiting
Pain
Abdominal distension
Constipation
How can you prevent adhesions?
No powder on gloves
Avoid infection
Laparscopic surgery
Sodium hyaluronidate
How would a wound infection present?
Pyrexia Redness Pain Swelling Discharge
