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GI: symptoms and miscellaneous > Postoperative complications > Flashcards

Postoperative complications Flashcards

1
Q

what are the main cardiovascular postoperative complications?

A

haemorrhage, MI and DVT

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2
Q

what are the two types of haemorrhage

A

reactionary (immediate postoperative, this is more common )

secondary (due toinfection)

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3
Q

symptoms of haemorrhage?

A

Tachycardia, hypotension and oliguria

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4
Q

need to be aware of ____ ____ in haemorrhage e.g. jaundiced patients

A

coagulation disorders

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5
Q

what are the risk factors of having an MI postoperatively ?

A

severe angina, previous MI

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6
Q

how does MI present postoperatively

A

the actual event is often silent so often present with cardiac failure/ cardiogenic shock or arrhythmias

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7
Q

how is postoperative MI prevented? 3

A

dont do the surgery !

avoid hypotension

correct the IHD first! - but usually through cabg because stenting requires antiplatelets which could increase risk of haemorrhage

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8
Q

how does postoperative DVT present?

A

Low grade fever (5-14 days)

Unilateral ankle swelling
Pitting oedema

Calf or thigh tenderness

Increased leg diameter

Shiny skin - because stretched

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9
Q

how is DVT investigated?

A

D-dimer (if normal can rule out DVT)

doppler ultrasound

venography

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10
Q

how is DVT prevented?

A

compression stockings

low dose subcutaneous heparin

early mobilisation

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11
Q

how do compression stockings work?

A

Compress the external veins so encourages blood flow to the deep veins of the leg and reduces risk of DVT

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12
Q

what are the main respiratory postoperative complications?

A

atelactasis/ aspiration

chest infection

PE

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13
Q

why may people aspirate ? 3

A

anaesthesia causes increased secretion, inhibits cilia and so you get mucus plugs which are not able to clear properly

post operative pain - prevents cough

vomiting after surgery

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14
Q

what is the presentation of chest infection?

A

Low grade fever (0-2 days) - almost always due to mild chest infection

High grade fever (4-10 days)

Dyspnoea

Productive cough

Confusion - because of hypoxia

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15
Q

how is chest infection prevented in people with pre-existing lung disease

A

physiotherapy

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16
Q

how is PE investigated?

A

D-dimer

multiple-detector computed tomographic pulmonary angiography (CTPA) of chest

ventilation-perfusion scan (V/Q scan) - not as common now

17
Q

how is PE prevented?

A

Compression stockings

Low-dose subcutaneous heparin

Early mobilisation

Anticoagulation in presence of DVT - start with heparin and move onto warfarin

18
Q

what are the main GI postoperative complications?

A

ileus, anastomotic dihiscence and adhesions

19
Q

what is ileus? and what are the causes?

A

This is paralysis of intestinal motility

Handling of bowel
Peritonitis
Retroperitoneal injury
Immobilisation
Hypokalaemia
Drugs
20
Q

how does ileus present?

A

Vomiting
Abdominal distension
Dehydration
Silent abdomen

21
Q

how is ileus prevented?

A

Minimal operative trauma
Laparoscopy
Avoidance of intra-abdominal sepsis

22
Q

what is anastomotic dihiscence? and what are the types ?

A

Breakdown of anastomosis

Intestinal
Vascular - would get bleeding
Urological

23
Q

what are the symptoms of intestinal anastomotic dihiscence?

A

Peritonitis - quite rare
Abscess
Ileus - almost certainly get this
Fistula

24
Q

what are the symptoms of vascular anastomotic dihiscence?

A

bleeding/haematoma

25
Q

what are the symptoms of urological anastomotic dihiscence?

A

Leakage of urine / urinoma

26
Q

why do you get adhesions/

A

caused by a combination of inflammatory repsonse and ischaemia

27
Q

Anyone who has had a major abdominal operation will get adhesions and bowel can get stuck - this is probably one of the commonest causes of ____- _____

A

Anyone who has had a major abdominal operation will get adhesions and bowel can get stuck - this is probably one of the commonest causes of intestinal obstruction

28
Q

when would an adhesion be assymptomatic?

A

adhesion to chest wall

29
Q

what are the other presentations of adhesions?

A

intestinal obstrction - symptoms are vomiting, pain, distension, constipation

30
Q

what may be given to a patients who is at risk of adhesions to prevent them forming? note: this will be certainly given to patients who are undergoing surgery to treat the adhesions

A

sodium hyaluronidate

31
Q

what are the main wound postoperative complications?

A

infection, dihiscence and hernia

32
Q

what do people with wound infection present like?

A 
Pyrexia (5-8 days)
Redness
Pain 
Swelling 
Discharge
33
Q

what are the main urinary postoperative complications?

A

UTI - because of catheter

urethral stricture - associated with prolonged catheter

acute renal failure - prolonged blood loss

34
Q

what are the main neurological postoperative complications?

A

confusion, stroke, peripheral nerve lesions

GI: symptoms and miscellaneous (3 decks)

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