Surgery Halo-halo 4 Flashcards
congestive hepatopathy characterized by obstruction to venous outflow
BUDD-CHIARI SYNDROME
- primary: endoluminal hepatic venous thromboses
- secondary: veins compressed / invaded by a neighboring lesion
Factor V Leiden
AD
point mutation in Factor V
m/c inheritic thromboPHILIC condition among caucasians
normally, activated protein C inhibits Va
in FVL, factor Va is RESISTANT to inhibition by activated protein C
=THROMBOSIS
“Activated Protein C Resistance”
Diagnostics in budd chiar syndrome
initial: abdominal US
definitive: HEPATIC VENOGRAPHY
tx of budd-chiari syndrome
systemic anticoagulation
noormal portal venous pressure
5-10 mmHg
Banti’s syndrome
massive splenomegaly
-prehepatic portal hpn
schistosomiasis is what type of portal hypertension
INTRAhepatic, PREsinusoidal obstruction
gold standard for diagnosis of achalasia
manometry
- identifies EARLY diseaes before esophageal dilatation and food retion
- MOST SENSITIVE DIAGNOSTIC TEST
- endoscopy - to rule out malignancy
- bird’s beak esophagus - seen in esophagogram
remarks on achalasia
“Second only to reflux disease, ACHALASIA is the most common functional disorder of the esophagus to require surgical intervention.”
treatment of nutcracker esophagus
aimed at treatment of GERD
Most common surgical tx for achalasia
[laparoscopic] HELLER MYOTOMY + partial fundoplication
-goood to excellent results in 62-100%
- pneumatic dilation
- most effective non-surgical (endoscopic)
- reported efficacy of 32-98%
Leading cause of intestinal obstruction in the young child
intussusception
idiopathic intussusception occurs in children between the ages of
6 and 24 months of age
Dance’s sign
elongated mass in the RUQ or epigastrium with absence of bowel in the right lower quadrant
management of intussusception
in the absence of peritonitis, the child should undergo radiographic reduction
AIR ENEMA: preferred method of DX and TX
(+) PERITONITIS / appears systemically ILL —> urgent LAPAROTOMY