Surgical Abdomen- Beloy Flashcards
______ have significantly reduced surgical intervention for gastric ulcers
Antacids
This type of ulcer has a strong association with H. pylori
Duodenal ulcer
This surgery involves resection of the vagus nerve for peptic ulcer dz so that pepsin is not produced
Vagotomy
This surgery is done so that gastrin decreases secretion
Antrectomy
This type of surgery is done for the purpose of restrictive/malabsorptive purposes
Gastric bypass
Removal of all or part of the stomach is called?
Gastrectomy
Post-op complication of gastric bypass, vagotomy or other stomach resection?
Dumping syndrome: Post prandial tachycardia, diaphoresis, abdominal pain, & diarrhea
What kind of diet is recommended s/p gastric surgery?
Post gastrectomy diet: Eat small frequent meals, high fiber, avoid simple sugars, do not drink fluids with meals, wait 30-60 mins after meals
What condition is this?
Partial paralysis of the stomach, is a disease in which the stomach cannot empty itself of food in a normal way. If you have this condition, damaged nerves and muscles don’t function with their normal strength and coordination — slowing the movement of contents through your digestive system.
Gastroparesis
How is gastroparesis treated?
NPO, IV fluids, may include total parental nutrition
T/F: enteric feeding is better than IV?
True
PEG vs NG tube?
PEG is placed in the stomach percutaneously (through the skin) and an NG tube is done through the nose to the stomach
Which vein in the liver is the detoxifying vein?
The portal vein
If it is blocked, can lead to death because doesn’t filter toxins
What is rim enhancing?
Any mass that is rim enhancing (has a line around it on CT) is an infection until proven otherwise
Is a hepatic hemangiomata a concerning finding?
No, just clusters of blood cells (benign vascular malformation)
What duct SHOULD we cut with gallbladder surgery
We should Cut the Cystic duct, not the common hepatic duct
What duct should we NOT cut in gallbladder surgery?
Common hepatic
CUT the Cystic
Murphy’s sign is pathomnemonic in what disease?
Seen in acute cholecystitis
Procedures for acute cholecystitis?
HIDA scan, MCRP, ECRP
An infection that same from stomach to the gallbladder is what?
Ascending cholangitis and can cause inflammation of the bile duct
How do you treat Ascending cholangitis?
IV fluid and broad-spectrum abx
In a cholecystectomy, what should we cut?
CYSTIC DUCT
When you hear porcelain gallbladder, think _____
cancer. This is calcification of the gallbladder that leads to higher risk of adenocarcinoma
What is the only essentially “hail mary” way of buying patients time who have pancreatic cancer?
Pancreaticoduodenectomy “Whipple”
Resection of the head of the pancreas, gallbladder (including part of the common bile duct), a portion of the duodenum, sometimes the pyloric sphincter
