GI Misc. - Postoperative Complications Flashcards Preview

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Flashcards in GI Misc. - Postoperative Complications Deck (56)
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1

What are the 2 possible types of postoperative complications?

General (any operation)
Specific (this operation)

2

Main CV complications of any operation?

Haemorrhage
MI (mainly if the patient has history of this)
DVT

3

What are the 2 types of haemorrhages - postoperative complications?

Reactionary (immediately pos-operative e.g. if not tied vessels properly)
Secondary (related to infection - 5-10 days post-surgery)

4

How does a haemorrhage present? (3)

Normally can't see it as inside a cavity:
Tachycardia
hypotension
oliguria (poor urine output)

5

Haemorrhage prevention? (3)

Meticulous technique in surgery
Avoidance of sepsis
Correction of coagulation disorders

6

2 types of MI related to surgery?

Post-operative
Peri-operative

7

What causes an increased risk of having a peri-post-operative MI?

Severe angina
Previous MI

8

What are the symptoms of a peri/post-operative MI?

Often silent when peri-operative
cardiac failure/ cardiogenic shock
Arrhythmias

9

How to prevent a peri/post-operative MI?

Delay surgery after MI
Avoidance of preoperative hypotension
Correction of ischaemic heart disease

10

What are the risk factors for a DVT?

Age > 40
Previous DVT
major surgery
Obesity
malignancy

11

What causes a DVT during/ after surgery?

Immobility during surgery
Hyper-coagulable state

12

How does a DVT present?

Low grade fever (5-14 days)
Unilateral ankle swelling
Calf or thigh tenderness
Increased leg diameter
Shiny skin

13

Investigations for a DVT?

D-dimer test (good rule-out test)
If D-dimer abnormal, Doppler US
Venography
(if you think they have a DVT, start them on heparin)

14

How to prevent DVT?

Compression stockings
Low-dose subcutaneous heparin
Early mobilisation

15

3 main respiratory surgery complications?

Atelectasis
Penumonia
PE

16

Atelectasis?

Collapse of lung tissue which leads to infection (pneumonia)

17

How does surgery lead to atelectasis/ pneumonia?

Anaesthesia = increases secretion, inhibits cilia
Postoperative pain = inhibits coughing
Aspiration = stomach contents

18

How does a post-operative chest infection present?

Low grade fever (0-2 days)
High grade fever (4-10 days)
Dyspnoea
Productive cough
Confusion (due to hypoxia)

19

How to prevent a chest infection?

Stopping smoking (even for a couple of days prior to surgery)
Adequate analgesia (blocks pain = coughing, stronger analgesics can cause respiratory suppression)
Physiotherapy

20

What causes a PE?

A DVT (same risk factors as a DVT)

21

How does a PE present?

Tachypnoea
Dyspnoea
Confusion (due to hypoxia)
Pleuritic pain
Haemoptysis
Cardiopulmonary arrest

22

What type of radionucletide is used in the ventilation part of the V/Q scan?

Inhaled gaseous radionuclide

23

What type of radio nucleotide is used in the perfusion part of the VIQ scan?

Injection of albumin tagged with radionuclide

24

What are the test for a PE?

Abnormal V/Q scan
Usually perform a CTPA if you suspect a large PE

25

Prevention of PE?

Same way as we prevent DVT:
Compression stockings
Early mobilisation
If DVT, anticoagulation
Low-dose subcutaneous heparin

26

Complications of GI surgery?

Ileus
Anastomotic dehiscence
Adhesions

27

What is ileus?

Paralysis of intestinal motility

28

What is ileus caused by?

Handling of bowel
Peritonitis
Retroperitoneal injury
Immobilisation
Hypolalaemia
Drugs

29

How does a patient with ileus present?

Vomiting
Abdominal distension
Dehydration
Silent abdomen

30

How is an ileus prevented?

Minimal operative trauma
Laparoscopy
Avoidance of intra-abdominal sepsis