Non-acute Abdominal Conditions Nick Harvey
Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Ga...
Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Ga...
Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Ga...
Non-acute Abdominal Conditions: Jaundice Jaundice Pre-hepatic Haemolytic Hepatocellular Post-hepatic Obstructive Pale stoo...
Non-acute Abdominal Conditions: Obstructive Jaundice Causes <ul><li>Benign </li></ul><ul><ul><li>CBD stones </li></ul></ul...
Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dila...
Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dila...
Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dila...
Non-acute Abdominal Conditions: Suspected Bowel Cancer Clinical Presentation <ul><li>Right Colon </li></ul><ul><ul><li>Ana...
Non-acute Abdominal Conditions: Suspected Bowel Cancer Other Features <ul><li>PR Bleeding </li></ul><ul><li>Change in Bowe...
Non-acute Abdominal Conditions: Suspected Bowel Cancer PR Bleeding <ul><li>Colour? </li></ul><ul><li>Mixed? </li></ul><ul>...
Non-acute Abdominal Conditions: Suspected Bowel Cancer Change in Bowel Habit <ul><li>Constipation </li></ul><ul><li>Diarrh...
Non-acute Abdominal Conditions: Suspected Bowel Cancer Investigations <ul><li>FBC / U&Es / LFTs ?CEA </li></ul><ul><li>Rig...
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007 Non Acute Abdominal Conditions - Introduction to Clinical Surgery Lectures

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Lecture on non-acute abdominal conditions from a series of lectures on an introduction to clinical surgery. It has been devised with medical students in mind.

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007 Non Acute Abdominal Conditions - Introduction to Clinical Surgery Lectures

  1. 1. Non-acute Abdominal Conditions Nick Harvey
  2. 2. Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Gastric Ulcer Duodenal Ulcer/Ca Stomach Biliary Gallstones Retrosternal Pain Burning Increased on lying down Relieved by antacids NSAIDS Haematemesis Melaena Weight loss RUQ pain Colicky Radiates to back Referred to shoulder Vomiting Jaundice OGD + Biopsy 24 hours pH monitoring Manometry OGD + Biopsy CT USS
  3. 3. Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Gastric Ulcer Duodenal Ulcer/Ca Stomach Biliary Gallstones Retrosternal Pain Burning Increased on lying down Relieved by antacids NSAIDS Haematemesis Melaena Weight loss RUQ pain Colicky Radiates to back Referred to shoulder Vomiting Jaundice OGD + Biopsy 24 hours pH monitoring Manometry OGD + Biopsy CT USS
  4. 4. Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Gastric Ulcer Duodenal Ulcer/Ca Stomach Biliary Gallstones Retrosternal Pain Burning Increased on lying down Relieved by antacids NSAIDS Haematemesis Melaena Weight loss RUQ pain Colicky Radiates to back Referred to shoulder Vomiting Jaundice OGD + Biopsy 24 hours pH monitoring Manometry OGD + Biopsy CT USS
  5. 5. Non-acute Abdominal Conditions: Jaundice Jaundice Pre-hepatic Haemolytic Hepatocellular Post-hepatic Obstructive Pale stools Dark urine ?pale stools ?dark urine Urine & stools Normal colour
  6. 6. Non-acute Abdominal Conditions: Obstructive Jaundice Causes <ul><li>Benign </li></ul><ul><ul><li>CBD stones </li></ul></ul><ul><ul><ul><li>Female </li></ul></ul></ul><ul><ul><ul><li>Biliary colic </li></ul></ul></ul><ul><ul><ul><li>Fluctuating jaundice </li></ul></ul></ul><ul><ul><ul><li>No weight loss </li></ul></ul></ul><ul><ul><li>Benign biliary stricture </li></ul></ul><ul><li>Malignant </li></ul><ul><ul><li>Ca pancreas </li></ul></ul><ul><ul><ul><li>Male </li></ul></ul></ul><ul><ul><ul><li>Painless </li></ul></ul></ul><ul><ul><ul><li>Progressive jaundice </li></ul></ul></ul><ul><ul><ul><li>Weight loss </li></ul></ul></ul><ul><ul><li>Cholangiocarcinoma </li></ul></ul>
  7. 7. Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dilated Biliary Tree Normal Biliary Tree MRCP ERCP CT PTC
  8. 8. Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dilated Biliary Tree Normal Biliary Tree MRCP ERCP CT PTC
  9. 9. Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dilated Biliary Tree Normal Biliary Tree MRCP ERCP CT PTC
  10. 10. Non-acute Abdominal Conditions: Suspected Bowel Cancer Clinical Presentation <ul><li>Right Colon </li></ul><ul><ul><li>Anaemia </li></ul></ul><ul><ul><li>RIF Mass </li></ul></ul><ul><ul><li>Acute Appendicitis! </li></ul></ul><ul><li>Left Colon </li></ul><ul><ul><li>Change in bowel habit </li></ul></ul><ul><ul><li>PR bleeding </li></ul></ul><ul><ul><li>Mass </li></ul></ul><ul><li>Rectum </li></ul><ul><ul><li>PR bleeding </li></ul></ul><ul><ul><li>Tenesmus </li></ul></ul><ul><ul><li>‘ Morning diarrhoea’ </li></ul></ul>
  11. 11. Non-acute Abdominal Conditions: Suspected Bowel Cancer Other Features <ul><li>PR Bleeding </li></ul><ul><li>Change in Bowel Habit </li></ul><ul><li>Mucous </li></ul><ul><li>Weight loss </li></ul><ul><li>Sense of incomplete evacuation </li></ul><ul><li>History of IBD </li></ul><ul><li>FH of bowel cancer </li></ul>
  12. 12. Non-acute Abdominal Conditions: Suspected Bowel Cancer PR Bleeding <ul><li>Colour? </li></ul><ul><li>Mixed? </li></ul><ul><li>Pan? </li></ul><ul><li>Paper? </li></ul><ul><li>Mucous? </li></ul>
  13. 13. Non-acute Abdominal Conditions: Suspected Bowel Cancer Change in Bowel Habit <ul><li>Constipation </li></ul><ul><li>Diarrhoea </li></ul><ul><li>Morning diarrhoea </li></ul><ul><li>6 weeks </li></ul>
  14. 14. Non-acute Abdominal Conditions: Suspected Bowel Cancer Investigations <ul><li>FBC / U&Es / LFTs ?CEA </li></ul><ul><li>Rigid sigmoidoscopy </li></ul><ul><li>Flexible sigmoidoscopy </li></ul><ul><li>Barium enema </li></ul><ul><li>Colonoscopy </li></ul><ul><li>CT colonography </li></ul><ul><li>Pre-op staging: Bx, CXR, U/S, CT, MRI </li></ul>

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