Surgery: Miscellaneous Flashcards
Post-operative fever 1-2 days later
WIND
- pneumonia
- aspiration
- PE
Post-operative fever 3-5 days later
WATER
- UTI
Post-operative fever 5-7 days later
WOUND
- infection site
- abscess
Post-operative fever 5+ days later
WALKING
- DVT
- PE
No food before operation for
6 hours
No clear fluids before operation for
2 hours
When do you stop COCP before operation?
4 weeks before
Anticoagulation before operation
Stop warfarin
Start LMWH
Post-operation anticoagulation
LMWH 6 hours post operation
Complications of laparoscopy
Vasovagal reaction
Subcutaneous emphysema
Damage to tracts/vessels
Ginko-leaf sign on an X-ray
Subcutaneous emphysema
- air under skin
Air under skin
subcutaneous emphysema
Abnormal connection between two epithelial surfaces
Fistulas
Fistula connecting intestine to skin
Enterocutaneous fistula
Fistula connecting two parts of the intestines
Enteroenteric/ enterocoelic fistula
Fistula from the end of the bowel to the skin around anus
Fistula in ano
Fistula connecting intestine to bladder
Enterovesicular fistula
Fistula connecting intestine to vagina
Enterovaginal fistula
Gas bubbles during urination
recurrent UTIs
Enterovesicular
Discharge to perineum
Abscess
Fistula in Ano
Inv: Endoanal US / MRI
Management of fistula in ano
Simple: Keep open (fistulotomy)
Complex: Seton band insertion
Ligation of intersphinteric tract (LIFT)
Bacterial overgrowth
Malabsorption syndrome
Worse in IBD patients
Enteroenteric fistula
High output enterocutaneous fistula
> 500ml
Low output enterocutaneous fistula
<250ml
Electrolyte rich secretions from an enterocutaneous fistula
Duodenal/jejunal cutaneous fistula
Leaky faeculent material from an enterocutaneous fistula
Colocutaneous fistula
Common causes of fistulas
IBD (Crohns)
Diverticulitis
Radiotherapy
Management of most fistulas
Self resolving
When do you stop anti platelets before surgery
Stop for 7 days (half-life) as they block PLTs irreversibly
- Aspirin
- Clopidogrel etc
Other drugs to stop before general anaesthetic
NSAIDs
ACE Inhibitors