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Operative Review Oral Board > GENERAL ABDOMEN > Flashcards

GENERAL ABDOMEN Flashcards

(18 cards)

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1
Q

What do you do for:

Rectus sheath hematoma - Stable?

A

Observe

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2
Q

What do you do for:

Rectus sheath hematoam - Unstable or enlarging?

A

IR embolization

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3
Q

What are the indications for surgery for a rectus sheath hematoma?

A
  1. Skin necrosis
  2. Failure of IR embolization
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4
Q

PROCEDURE: rectus sheath hematoma repair

A

Incision: Midline or Paramedian with ligation of bleeding vessel

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5
Q

What do you do for:

Peritoneal carcinomatosis discovered intraoperatively?

A

Biopsy and abort

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6
Q

What do you do for:

Peritoneal carcinomatosis WITH extraperitoneal met discovered intraop?

A

Chemo alone

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7
Q

What do you do for:

Peritoneal carcinomatosis WITHOUT extraperitoneal met discovered intraop?

A

Cytoreductive surgery and HIPEC

  • No residual tumors > 2 mm
  • Duration: 90 minutes
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8
Q

How do you diagnose chylous ascites?

A

Paracentesis (trig >/ 110 mg/dL)

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9
Q

What is the treatment for chylous ascites?

A
  • dietary modification (high protein, low fat, MCT supplements)
  • consider total paracentesis if large or symptomatic
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10
Q

What are the surgical options for chylous ascites if refractory to medical management?

A
  1. Lymphangiography with embolization
  2. TIPS if cirrhotic
  3. Laparotomy with ligation of leaking lymphatic
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11
Q

What is the cause of mesenteric cysts?

A

Ectopic lymphatic proliferation

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12
Q

What is the treatment for mesenteric cysts - WITHOUT vascular compromise?

A

Enucleation

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13
Q

What is the treatment for mesenteric cysts - WITH vascular compromise?

A

Resection of mesentery and bowel

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14
Q

Initial management for fascial dehiscence

A
  1. Fluid resuscitation
  2. Abx
  3. Cover any bowel with saline-soaked gauze
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15
Q

What are the indications for surgery for fascial dehiscence?

A
  1. Evisceration
  2. Large defect
  3. Bowel strangulation / ischemia
  4. Bowel obstruction
  5. Undrained infectious fluid collections
  6. Signs of intraabdominal sepsis
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16
Q

PROCEDURE: temporary measures for closure of difficult abdomen

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A
  1. Abthera
  2. Velcro (Wittman Patch)
  3. Bogota Bag
17
Q

PROCEDURE: definitive measures for closure of difficult abdomen

Study These Flashcards
A
  1. Biologic interposition with mesh
  2. Skin-only closure
18
Q

PROCEDURE: peritoneal dialysis catheter insertion

Study These Flashcards
A
  1. Periumbilical port for camera
  2. Tunnel a 2nd port from 2-4 cm left of the umbilicus, through fascia and enter peritoneum 2.-4 cm below umbilicus
  3. PD catheter is inserted through the 2nd port and positioned in the pelvis
  4. Distal cuff should be in preperitoneal space
  5. Proximal catheter is tunneled through the subcutaneous tissue exiting superiorly
  6. Proximal cuff is in the tunnel
  7. Test catheter to confirm fluid instillation and drainage
  8. Close

Operative Review Oral Board (5 decks)

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