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GI > Complications of surgery > Flashcards

Complications of surgery Flashcards

1
Q

what are the cardio complications

A

haemorrhage, MI, DVT

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2
Q

what are the types of haemorrhage complications

A

reactionary (immediate postoperative)

secondary (infection 5-6 days)

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3
Q

how does a haemorrhage present

A

obvious

  • tachycardia
  • hypotension
  • oliguria
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4
Q

how can haemorrhage be avoided

A

meticulous technique, avoidance of sepsis, correction of coagulation disorders

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5
Q

what is the mortality of post op MI

A

50%

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6
Q

how do post op MIs usually present

A

often silent,
cardiac failure/ cardiogenic shock,
arrythmias

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7
Q

how is MI avoided

A

delay of surgery after MI,
avoidance of perioperative hypotension,
correction of ischaemic heart disease

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8
Q

what cause a DVT in surgery

A

immobility, hypercoagulable states

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9
Q

does malignancy increase your risk of DVT

A

yes

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10
Q

how does DVT present

A

low grade fever, unilateral ankle swelling, calf or thigh tenderness, increased leg diameter, shiny leg

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11
Q

how are DVT investigated

A

D dimer test, doppler ultrasound, venography

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12
Q

how are DVTs prevented

A

compression stockings, lose dose subcutaneous heparin, early mobilisation

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13
Q

what are the resp complications

A

atelectasis (partial or complete collaspe of the lung due to deflation of the alveoli)

pneumonia

pulmonary embolus

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14
Q

how are atelectasis and pneumonia linked

A

collapse of lung tissue can lead to infection

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15
Q

what causes infection post op

A

anaesthesia- increases secretion, inhibits cilia

post op pain- inhibits coughing

aspiration- stomach contents

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16
Q

how does a chest infection present

A

low grade fever (0-2 days), high grade fever (4-10),

dyspnoea

productive cough

confusion

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17
Q

how do you prevent chest infestions

A

stopping smoking,
adequate analgesia,
physiotherapy

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18
Q

what causes a post op PE

A

DVT

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19
Q

what is the presentation of a PE

A

tachypnoea, dyspnoea,
confusion,
pleuritic pain, haemoptysis, cardiopulmonary arrest

20
Q

what are the two methods of V/Q scan

A

injection of albumin tagged with radionuclide

inhalation of gaseous radionuclide

21
Q

how is a PE prevented

A

compression stockings, low dose subcutaneous heparin,
early mobilisation,
anticoagulation in presence of DVT

22
Q

what are the GI complications

A

ileus,
anastomotic dehiscence (in colorectal resections),
adhesions

23
Q

what is an ileus

A

paralysis of intestinal motility,

24
Q

what causes an ileus

A

handling of bowel, peritonitis, retropertioneal injury, immobilisation, hypokalaemia, drugs

25
Q

how does an ileus present

A

vomiting, abdo distention, dehydration, silent abdomen

26
Q

how is an ileus prevented

A

minimal operative trauma, laparoscopy, avoidance of intrabdominal spesis

27
Q

what is anastomotic dehiscence

A

breakdown of anastomosis (intestinal, vascular, urological)

28
Q

what causes a anastomotic dehiscence

A

poor technique, poor blood supply, tension on anastomoses

29
Q

how does an intetsinal anastomotic dehiscence present

A

perionitis, abscess, ileus, fistula

30
Q

how does a vascular anastomotic dehiscence present

A

bleeding, haemorrhage

31
Q

how does a urological anastomotic dehiscence present

A

leakage or urine/ urinoma

32
Q

how are anastomotic dehiscence prevented

A

good technique and blood supply, no tension

33
Q

what are adhesions and give examples

A

fibrin turns into fibrous tissue

  • bowel to bowel
  • bowel to abdo wall/ other structures
  • lung to chest
34
Q

what causes adhesion

A

inflammatory response, ischaemia

35
Q

how do adhesions present

A

asymptomatic (to chest wall)

intestinal obstruction (vomiting, pain, distention, constipation)

36
Q

how are adhesions prevented

A

no powder on gloves

avoidance of infection

laparoscopic surgery

sodium hyaluronidate

37
Q

what are the wound complications

A

infections, dehiscence, hernia

38
Q

what are the exogenous and endogenous causes of wound infections

A

trauma- exogenous

intestinal surgery- endogenous

39
Q

how do wound infections present

A 
pyrexia (5-8 days)
redness, 
pain,
swelling,
discharge
40
Q

how are wound infections prevented

A 
pre-op prep,
skin cleaning,
aseptic technique,
avoidance of contaminants,
prophylactic antibiotics
41
Q

what are the urinary complications

A

acute retention of urine,
urinary tract infection,
urethral structure,
acute renal failure

42
Q

what are the neurological complications

A

confusion,
stroke,
peripheral nerve lesions

43
Q

what can cause confusion

A 
hypoxia (chest infection, PE, MI),
oversedation,
sepsis,
electrolyte imbalance,
stroke,
hyper or hypoglycaemia,
alcohol or tranquilliser withdrawal
44
Q

how does confusion present

A

disorientation (time, place),
paranoia,
hallucinations

45
Q

how is confusion avoided

A

maintain oxygenation,
avoid dehydration,
avoid sepsis,
send home ASAP

46
Q

what are the objectives of enhanced recovery after surgery

A 
to minimise post op complications and return patient to normality ASAP
promote 
-pain control 
-GI function 
-mobility

GI (64 decks)

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