surgery- pestanos Flashcards
signs of mechanical intestinal obstruction
high pitched bowel sounds
distended loops of small bowel with air fluid levels
signs of strangulation
fever
leukcystosis
constant pain
peritoneal irritation
signs of strangulated hernia
hernia that was once reducible is no longer so
presentation/treatment for R colon cancer
hypochromic Fe deficiency anemia, 4+ occult blood
R hemicolectomy
presentation of L colon cancer
bloody stool, narrow stool caliber
when do you surgically treat crohns
complications such as bleeding/ stricture/ fistula
proper surgical treatment for UC
removal of rectal mucosa –> need stoma or ileoanal anastomosis
medical therapy for anal fissure
diltiazem topical ointment TID for 6 weeks
higher success rate than botulinum toxin
most common causes of GI bleeding
angiodysplasia
polyps
diverticulosis
cancer
origin of GI bleed is always ______ when there is hemoptysis or blood recovered by NG tube
upper
approach to lower GI bleed
1) EXCLUDE HEMORRHOIDS Next: -angiogram --> agnioembolization -wait to stop, --> colonoscopy -tagged red cell study
blood per rectum in a child
meckel divertic –> technetium scan looking for ectopic gastric mucosa
causes of acute abdomen
perf
obstruction
inflammation
ischemia
acute abdomen: perf
sx: diffuse/ generalized pain, guarding, rebound, PT DOESN’T MOVE
dx: free air under diaphragm
ex: perf peptic ulcer
acute abdomen: obstruction
think of a duct
sx: PT MOVES CONSTANTLY SEEKING COMFORT, typlica location of pain and radiation
things to rule out in generalized acute abdomen before doing ex lap
MI
PE
lower lobe PNA
pancreatitis
findings on xray for sigmoid volvulus
“parrot’s beak sign”
giant air filled loop from RUQ to LLQ
hepatic adenoma
complication of birth controls pills?
can rupture and bleed into abdomen
labs associated with obstructive jaundice
elevations of direct and indirect bili, inc AST/ALT,
INC ALP!!!!
courvoisier terrier sign
malignant biliary duct obstruction (large and THIN WALLED with distended galbladder)