surgergy Flashcards
(40 cards)
3 causes of early post op pyrexia (0-5 days)
- Physiological systemic inflammatory reaction
- pneumonia/atelectasis
- UTI?IV line infection
3 causes of late causes of post op pyrexia
- surgical site/wound infection
- PE/DVT
- anastamotic leak
what is an anastomotic leak?
leak of bowel contents at surgical site
presentation of anastomotic leak?
- abdo pain
- pyrexia
- tachycardia
- more than 5 days post op
what is post op ileus
pseudo-obstruction of the bowel due to a loss of peristalsis post op
when does post op ileus present?
within few days
presentation of post op ileus?
- N & V
- abdominal distension
- abdominal pain
- failure to open bowels
- hiccups
management of post op ileus
- NG tube: drip & suck
- IV electrolyte replacement
- NBM
- IV fluid/nutrition
- mobilise to encourage peristalsis
triad of mesenteric ischaemia?
- high lactate
- soft & non tender abdomen
- Cardiovascular disease
what bowel does mesenteric ischaemia typically affect
small bowel
2 conditions that involve ischaemia to lowe GI tract?
- mesenteric ischaemia
- ischaemic colitis
what part of bowel does ischaemic colitis affect?
large bowel
presentation of ischaemic colitis
bloody diarrhoea
markings visible on small bowel and describe them?
valvulae conniventes - cross entire width of bowel
name 3 causes of bowel obstruction
- hernias
- cancer
- adhesions
what are Valvulae conniventes
mucosal folds that form lines that extend the full width of the small bowel
name or markings seen on large bowel?
haustra
Abdominal xray – coffee bean sign
sigmoid volvulus
air under diaphragm
pneumoperitoneum
blood supply to the ascending colon?
2 branches of the superior mesenteric artery (ileocolic & right colic arteries)
3 branches of the ileocolic artery
- colic
- anterior caecal
- posterior caecal
3 branches that supply the transverse colon and what do they branch from?
left, middle & right colic artery
right & middle colic arise from the superior mesenteric
left colic arise from the inferior mesenteric
blood supply to the descending colon?
left colic artery (branches off from the inferior mesenteric)
arterial supply of the sigmoid colon?
sigmoid arteries - branches of the inferior mesenteric artery
