Surgery GI Flashcards
proctitis
nocturnal diarrhoea
incontinence and brigh red blood
anal cancers are?
squamous cell
large bowel obstruction
most common cause?
colon cancer
most common cause of small bowel obstruction?
adhesions from previous surgery
Large bowel obstruction
1st line ix?
absence of flatus / stool
abdo pain
distension
abdominal XR
CT scan
Mx of Large bowel obstruction?
NBM
IV fluids
nasogastric tube with free drainage
surgery
causes of large bowel obstruction
malignancy - tumour
volvulus
Diverticular disease
what is a loop ileostomy and why would you create one?
faecal matter goes from small bowel >
diverts / the colon
if you have an anterior resection of the colon you would connect 2 parts of colon whilst removing the diseased part
= anastomosis
but high risk of leak
so creat an anterior resection with loop ileostomy
end ilestomy?
complete excision of colon
loop colostomy
distal segment of colon
Sigmoid volvulus with peritonitis
skip flexible sigmoidoscopy
treat urgent midline laparotomy
mx of acute mesenteric ischaemia?
immediate laparotomy
A spouted stoma with a double opening in the right iliac fossa
loop ileostomy.
haemorrhoid management
dietary fibre
soften stool
local anaesthetic
rubben band ligation
> injection sclerotherpay
colorectal cancer marker?
CEA
FIT
home based
60-74
if abnormal > colonoscopy
diverticula are most likely found?
sigmoid colon
small bowel obstruction presents?
early vomiting
absolute constipation is a late sign
tinkling bowel sounds
Mx of SBO?
abdo xray > dilated loops
IV fluid - drip
NG tube: suck
erect cxr
> surgical if no improvement
Inguinal hernia location?
superior and medial to pubic tubercle
strangulated hernia signs?
pain
fever
size increase
peritonitic features
bowel obstruction
all pts with suspected perforation should be?
Erect CXR
blood gas > leukocytosis
raised lactate
appendicectomy
open / laproscopic
IV abx prophylaxis
Dx appendicitis
urine analysis
> exclude pregnancy
>Hx
USS (female)
Ct scans most sensitive but we don’t use it
psoas sign
pain on hip extension
retrocaecal appendix
Rovsigns sign
palpation in the LIF
causes pain in RIF
definative diagnostic investigation for SBO?
CT abdomen
SBO imaging?
Abdominal XR
CT
distributive shock?
warm peripheries
due to vasodilatation
interruption of the autonomic nervous system
> spinal cord transection
what is paralytic ileus?
seen after surgery
> loss of peristaltic movements
food/drink not passing
managing femoral hernias?
need repair
due to risk of strangulation
what is a femoral hernia?
femoral ring
flail chest?
multiple rib fractures
ascending cholangitis
RUQ pain
fever
Jaundice
thoracotomy
theatre
