Abdo Flashcards
Reasons for laparoscopy?
A laparoscopy can be used to diagnose conditions such as appendicitis, pelvic inflammatory disease, endometriosis and some cancers, such as liver cancer and ovarian cancer.
It’s also used for surgery to treat conditions, such as:
removing organs such as the appendix or gallbladder
repairing hernias or burst or bleeding stomach ulcers
removing organs affected by cancer, such as the ovaries, prostate or liver
treating an ectopic pregnancy
removing the womb (hysterectomy) or fibroids
weight loss surgery
What are the complications of a renal transplant?
Early:
acute rejection
ureteric injury
haemorrhage
Late:
incisional hernia
ureteric stricture
vesicoureteral reflux
AV fistula
Causes of left iliac fossa mass and right iliac fossa mass?
appendicular mass
appendicular abscess
appendicular mucocele
appendicular neoplasms
ileocaecal tuberculosis (hyperplastic type)
intussusception
carcinoma caecum
tubo-ovarian mass, e.g. abscess
undescended testis
transplanted kidney
ectopic kidney
psoas abscess
non-Hodgkin lymphoma
diverticulitis, colon cancer, ovarian mass, fibroids, lymph node swelling, enlarged undescended testis, loaded colon
Midline laparatomy indications?
Traumatic abdominal injury.
Infection in your peritoneal cavity (peritonitis).
Gastrointestinal perforation or uncontrolled gastrointestinal bleeding.
Emergency appendectomy for complicated appendicitis.
Emergency splenectomy for a ruptured spleen.
Ovarian cystectomy for ovarian cysts or ovarian endometrioma.
Endometriosis staging and treatment (endometriosis surgery).
Whipple procedure or total pancreatectomy for pancreatic cancer.
Ovarian cancer staging and treatment.
Hodgkin lymphoma staging and treatment.
Reasons to have an end vs loop ileostomy?
A permanent end ileostomy is indicated in a variety of circumstances. Many still consider it the operation of choice after proctocolectomy for chronic ulcerative colitis (CUC) or familial adenomatous polyposis.13 Patients with Crohn colitis and concomitant severe proctitis may also benefit from end ileostomy.14 In patients with spinal cord injury, an end ileostomy can reduce the time spent on bowel management and improve quality of life.
loop: IBD, perforation/ischaemia/obstruction
What are the complications of stomas?
parastomal hernia
ischaemia
fistula
prolapse
stricture
What are the indications of a mini thoracotomy scar?
mitral valve and aortic valve replacement
Closure of a hole in the heart, such as atrial septal defect or patent foramen ovale.
Atrioventricular septal defect surgery.
Maze procedure for atrial fibrillation.
Heart valve repair or replacement.
Surgery to remove tumors from the heart.
What is PKD and its complications?
Autosomal dominant polycystic kidney disease is an important cause of renal failure. It is inherited as an autosomal dominant trait with penetrance approaching 100% in those surviving until their seventh or eighth decade. The condition most usually presents in adult life but may develop at any time, including in utero.
patients with PKD1 mutations typically have a more severe phenotype than those with PKD2 mutations
acute loin pain with/without haematuria due to haemorrhage into a cyst
vague abdominal or loin discomfort due to increasing size of kidneys
hypertension
features of uraemia
Renal USS
Liver USS - liver cysts
berry aneurysm - CT head
Mx: tolvaptan or renal transplant
What is in the Child Pugh score?
liver cirrhosis mortality
bilirubin
INR
ascites
encephalopathy
albumin
Indications for a liver transplant
acute liver failure
malignancy -> HCC
cirrhosis
What drugs are used in renal transplant?
Top 3 causes for renal transplant?
immunosuppressants e.g. tacrolimus, ciclosporin
blood pressure meds (ciclosporin)
blood thinning meds
GN
DN
PKD
Indications for urostomy?
bladder cancer
spinal cord injury
birth defect e..g spina bifida
Midline laparotomy scar in renal transplant patient?
simultaneous kidney-pancrease transplant
What is a gallstone ileus and how does this differ from a paraileitic ileus?
A gallstone erodes through the duodenum and becomes impacted in ileum
non-mechanical blockage of bowel due to reduced peristalsis -> surgery, stress, diff abdo infections
What are the complications of TPN?
Dehydration and electrolyte Imbalances
Thrombosis (blood clots)
Hyperglycemia (high blood sugars)
Hypoglycemia (low blood sugars)
Infection
Liver Failure
Micronutrient deficiencies (vitamin and minerals)
