SURG consents Flashcards

Question

Laparotomy

Answer 1

``` Deep bleeding Damage to bladder, bowel Infections in abdomen Iléus or long term blockage Adhesions Thickened, red and painful wound Poor wound healing - burst open Fistula Pain may not resolve or worsen No cause found ```

Answer 2

``` OPEN: Trouble passing urine - spasm of sphincter for bladder Swelling of testicle and scrotum Infections Bleeding Chronic groin pain/numbness Postoperative scarring --> chronic pain Testicle sit a little higher Scar can thicken, turn red and may be painful Hernia may come back Operating on a recurrent hernia with or without previously inserted mesh or stitches may increase the risk of infection and bleeding and pain and recurrence More bleeding on blood thinners Small areas of lung collapse ``` Uncommon: Partial vasectomy Heart attack or stroke DVT Rare: Adhesions and bowel obstruction Damage and swelling with testicle loss Death ``` LAPARACOPIC: Trouble passing urine due to spasm Swelling of testitcle and scrotum Partial vasectomy Chronic pain Hernia re-occur Bleeding can occur - More common if on blood thinners Seroma Atelectasis ``` Uncommon: Change to open Damage to large blood vessels, gut or bladder Rarely gas, can cause heart and lung complications Testicle may sit higher Adhesions Hernia where instruments passed in Infections can occur, requiring antibiotics and further treatment Heart attack, stroke DVT Rare: Death

Answer 3

Infections Bleeding - Blood thinning --> more risk Atelectasis Uncommon: Heart attack or stroke Blood clot in leg Rare: Death

Answer 4

Infections Bleeding Atelectasis Skin graft - may not take, will not look normal, look different colour Donor site - fluid discharge for long period of time, healing slow, thickened, discoloured or painful Thickening and contraction of tissues --> difficulty in movements of the burnt area Uncommon: Heart attack or stroke, DVT, rejection of skin Rare: Death

Answer 5

``` Hole in stomach lining Damage to bowel Deep bleeding Ileus Weakness in wound - hernia Vomit for some days after More surgery for more muscle dividing Abnormal wound healing Adhesions ```

Answer 6

``` Poor cosmesis Tip injured Raw and bleeding end of penis More skin may need to be removed Scar --> blockage of urine flow ```

Answer 7

``` Large blood vessels ->> bleeding Damage to gut/and or bladder when instruments Heart and breathing problems from gas May need to change to open Stones found outside gallbladder AND/OR may spill out and be lost Some stones left behind in bile duct Clips or ties may come off Damage to bile tubes Abnormal wound healing Hernia Adhesions No improvement in symptoms Allergic reaction to contrast ``` IF NOT DONE 50% recurrence in 5 years, or can get o0pen or cholecystomy (Longer stay and longer hospital recovery time)

Answer 8

Damage to blood vessels Gallstones spilt --> abscesses --> drainage Left behind in bile duct (stones) T tube out of position - further surgery required to re-insert the T-Tube Metal clips may come off --> bile leak or bleeding Damage to bile tubes --> chronic leakage or blockage problems 2-3 weeks T tube taken out --> bile leak into abdomen Infection Wound abnormal healing Bleeding into wound Hernia Adhesions Symptoms persisting Allergic reaction to contrast

Answer 9

1/20 pancreatitis - pain relief, usually settles but can be severe N+V Headache Pain, redness or bruising at sedation injection site Muscle aches and pains Allergy to medications ``` Uncommon: <1/200 bleed 1/100 tear through bowel or duct wall - drainage tube Bacteraemia Technical issues Heart and lung problems GA from LA Dead aarm Worse existing medical condition ``` ``` Rare: Systemic and cerebral air embolism Stroke --> brain damage Anaphylaxis Death ```

Answer 10

``` Leakage of pancreatic, bile or gastric juices Difficulty in passing urine Deep bleeding Damage to bowel Infections Ileus Weakness in wound Abnormal wound healing Adhesions Feeling after meals called dumping Nutritional problems due to removal of part of stomach ```

Answer 11

``` Bleeding Late bleeding Mild to moderate difficulty with erection Urinary retention Retrograde ejaculation Inability to pass urine - reinsertion of catheter Swelling and pain in testicles Stricture - urethra or at bladder neck Incontinence urinary Damage to rectum 1/6 no improvement of symptoms ```

Answer 12

Slowed heart beat and feel faint during operation Bruise in scrotum Alternative contraception until ejaculate tested Repeat operation required Small chance vas rejoins spontaneously --> no longer sterile (Reversals not available under medicare and expensive) Painful area in testicle and swollen Cyst back of testicle Inflammatory nodules around cut ends of vas or in epididymis Long term aching Fistula between cut vas and skin - surgery

Answer 13

Allergic reaction to contrast Rarely damage to urethra Damage to bladder Swelling at exit of bladder - need catheter Bacteria in blood stream Tube passes outside ureter into tissues Bleeding may stain urine and cause blockage Burning and scalding of urine for a few days after usually settles No catheter passed through due to blockage Indwelling stent --> irritation and blood occasionally - usually removed after a few weeks Damage to ureter --> stricture --> further operation

Answer 14

``` Damage to urethra Damage to bladder Swelling at exit of bladder --> urianray retention Bacteria in blood Bleeding stains or blocks urine Burning and/or scalding Catheter not able to be passed through ureteric opening Damage to ureter --> stricture ```

Answer 15

``` Allergic reaction to contrast Damage to urethra - false passage Damage to bladder Damage to ureter Blocked catheter due to blockage Swelling at exit of bladder Staining of blood / blockage Bacteria in blood stream Burning and scalding of urine for a few days ```

Answer 16

``` Bleeding Erection difficulty Incontinence No ejaculation Damage to rectum or ureters Late bleeding Bladder muscle weakenss Swelling and pain in testicles Urinary leak Stricture Cancer recur Hernia of wound Death due to complications 1/200 ``` 6 week recovery 1-2 weeks in hospital with catheter

Answer 17

``` Failure of kidney function Major bleeding Urine leak from remaining kidney Removal of rib sometimes Difficulty in passing urine - catheter usually temporary Damage to bowel Ileus Abnormal wound healing Adhesions ```

Answer 18

Graft block and no improvement --> worse circulation Infection in the wounds Groin wounds may discharge clear fluid called lymph for sometime Healing abnormal - keloid scar (MOST VASC and thyroid have keloid scars FYI) Leak --> false aneurysm Leg usually swells after surgery Nerve injury Synthetic graft if no vein Graft infected --> limb loss

Answer 19

``` Minor or major stroke Immediately after - Bleeding, breathing issues, 1/25 stroke, vein patch rupture in 1/100 Blood loss - transufions Cranial nerve injury 1/20 - 1/50 wound may leak Patch infection 1/100 Hyperperfusion syndrome - headache, fitting and haemorrhage Healing of wound --> abnormal --> keloid scar Numbness in neck Difficulty swallowing and talking Horaseness in voice - usually temporary Block in artery ```

Answer 20

Graft leak Deep bleeding Damage to blood supply kidney, gut --> strictures or peritonitis Failure of lungs Damage to bowel --> colostomy Infections Ileus Weakness in wound, rupture False aneurysm Graft may stick to gut --> connection --> 1/2 chance of death Adhesions Paraplegia (blood supply spinal cord) --> 1/1000 permanent disability Blockage of the graft --> loss of limb Blockage of blood flow to buttock --> pain on walking Retrograde ejaculation 1/6 Inability to pass urine --> catheter - can be long term Death 1/20, Major complications 1/10

Answer 21

Blood supply to tissue not sufficient - further amputation Woundd slow healing Phantom limb Fixed in position - unable to use prosthesis Keloid scar Loose skin adjustment No functional return

Answer 22

``` Hard tender lumps Skin about lower leg is thin --> ulcers Damage to deeper veins Some remain Nerve --> numbness in foot Keloid scar ```

Answer 23

Lips, teeth, gums, tongue injury, dental too Perofration or rupture of oesophagus --> larynx injury, prolonged stay Voice change

Answer 24

``` Laparascopic: Open 1/20 failure of TV Damage to Large BV, Gut Gas --> lung and heart issues in 1/100 Deep bleeding Damage to oesophagus Damage to bowel Damage to spleen Male - difficulty in urine Infections Ileus Swallowing, belching and vomiting difficulty Vagus nerve damage - delay in empyting Adhesions Recurrence Healing abnormal ``` OPEN: Same as above

Answer 25

``` Common: Pain in abdomen and shoulders N and V Menopause Infection Bleeding Lapartomy from less invasive Atelectasis No cause for symptoms Wound infection, chest, heart and lung Blood clot ``` ``` Uncommon: Poor wound healing Wound thickened (abdominal) Prolapse (for vaginal only) Dyspareunia (vaginal only) Adhesions DVT Hernia ``` ``` Rare: Damage to ureters, bowel blockager Fistula Heart attack or stroke Death very rare ```

Answer 26

``` Damage to cervix, uterus (perforation sometimes) Severe bleeding Infgection Tissue may not all be removed Air in blood stream - fatal 10-14 days bleeding Late first period after ```

Answer 27

``` Common: Pain in abdomen and shoulders (gas) N and V Open may be needed Infection Bleeding Atelectasis No cause for symptoms ``` ``` Uncommon: Menopause Blockage of bowel Poor wound healing Keloid Hernia Adhesions Need to take out ovaries when not originally planning too DVT ``` Rare: Damage to ureters, Gas causing lung and heart issues

Answer 28

``` SURGICAL: Common: Infections Bleeding Atelectasais ``` Uncommon: Damage to cervix, heart attack, blood clot Rare: Scarring, damage to uterus (perforation), damage to bowel (colostomy - may be permanent) Air embolism MEDICAL: Infections, bleeding, incomplete passage --> surgery Uncommon - DVT Rare - Rupture of uterus, further attempt after 2-3 days --> laparotomy --> hysterectomy --> somtimes even hysterectomy Heart attack or death very rare

Answer 29

``` Difficulty passing urine Bladder and bowel habit changes Failure of procedure and recurrence of prolapse Temporary local irritation pain in pelvic area, even during intercourse Infection Bleeding Atelectasiss ``` Uncommon: Stress incontinence Scarring or narrowing or shortening of vagina Perineal pain Chronic permanent nerve buttock pelvic pain Adhesion Seroma Lacerations of vessels nerves, structures, or organs - ureter, vagina or bowel DCT Rare - Fistula between vagina and bladder OR rectum Heart attack, stroke or death

SURG consents Flashcards

(53 cards)