Surgical complications Flashcards
How can surgical complications be divided?
Immediate/early/late
General/specific
Two examples of immediate complications?
• Intubation → oropharyngeal trauma
• Surgical trauma to local structures
• Primary or reactive haemorrhage
Two examples of early complications?
• Secondary haemorrhage
• VTE
• Urinary retention
• Atelectasis and pneumonia
• Wound infection and dehiscence
• Antibiotic association colitis (AAC)
Two examples of late complications?
• Scarring
• Neuropathy
• Failure or recurrence
Two causes of urinary retention post-op?
drugs- opioids, epidural, anti-AchM
Pain- sympathetic activation
pyschogenic- hosp environment
Two specific complications of cholecystectomy?
• Conversion to open: 5%
• CBD injury: 0.3%
• Bile leak
• Retained stones (needing ERCP)
• Fat intolerance / loose stools
Two complications of inguinal hernia repair?
• Haematoma / seroma formation: 10%
• Intra-abdominal injury (lap)
• Infection: 1%
• Urinary retention
• Chronic pain
• Recurrence
Two complications of appendectomy?
• Abscess formation
• Fallopian tube trauma
• Right hemicolectomy (e.g. for carcinoid, caecal
necrosis)
Two complications of colonic surgery?
§ Ileus
§ Anastomotic leak
§ Enterocutaneous fistulae
§ Abdominal or pelvic abscess
§ Adhesions → obstruction
§ Incisional hernia
Two causes of post-op ileus?
Bowel handling
Anaesthesia
Electrolyte imbalance
Name three common post-op presentations
Pyrexia
DVT
Pneumonia
Cellulitis
Dyspnoea
Hypotension
Reduced urine output
Hypertension
Confused state
Three differentials for post-operative fever
Day 1-2: ‘Wind’ - Pneumonia, aspiration, pulmonary embolism
Day 3-5: ‘Water’ - Urinary tract infection (especially if the patient was catheterised)
Day 5-7: ‘Wound’ - Infection at the surgical site or abscess formation
Day 5+: ‘Walking’ - Deep vein thrombosis or pulmonary embolism
Any time: Drugs, transfusion reactions, sepsis, line contamination.
