Lecture By Dr. Tarik S. Alnogomi ER Cheif ,Meeqat General Hospital, Madina, KSA

3. THE PROBLEMS ...!!??
DR. TARIK 18 SAFER1439

7. DR.TARIK18SAFER1439

11. ABDOMEN

47. RENAL IMPAIRMENT
NERVOUS SYSTEM
CONFUSION
RESPIRATORY ATELECTASIS , PNEUMONIA &
HYPOVENTILATION.
RENAL IMPAIRMENT
COMMON ESPECIALLY WITH COPD. IHD AGE > 65YO…..UP TO
30% CARDIAC RESERVE, DYSRHYTHMIAS AND
CONDUCTION ABNORMALITIES

51. https://image.slidesharecdn.com/colon-
cancerppt-powerpoint-
presentation4604/95/colon-cancerppt-
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55. https://image.slidesharecdn.com/colon-
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58. Fecal immunochemical test (FIT)
every year90% of cases occurs after
Guaiac-based fecal occult blood test
(gFOBT) every year
Stool DNA test every 3 years

61. Double-Contrast Barium Enema Every 5
Years. 90% of cases occurs after age 50
Colonoscopy Every 10 years
CT Colonography (Virtual Colonoscopy) Every 5
Years.
MRI Colonography

66. Small Incision :
1 Tissue Trauma is less
2 Post op. pain is less
3 Less blood loss
4 Chances of incisional
hernia are less

70. Mini- cholecystectomy is a
minimally invasive operation,
which is well tolerated, and is
associated with minimal
complications and conversions.
When it is carried out with the
surgical tool kit “Mini-assistant”, it
is an alternative to laparoscopic

89. SITUS INVERSUS
TOTALIS

90. SIT IS A CHALLETNGE TO ANY
LAPAROSCOPIC SURGEON

96. MIRIZZI SYNDROM
PROFESSOR PAPLO LUIS MIRIZZI
(1893-1964)

101. CONCLUSIONS:
high association of gallbladder cancer in
Mirizzi syndrome. Elevated CA 19-9 levels in
this syndrome are indicative of a coincidental
gallbladder malignancy.
intraoperative frozen section of the
gallbladder in all patients presenting with
Mirizzi syndrome
MIRIZZI SYNDROM & GB CANCER

126. ‫وفقه‬ ‫إن‬ ‫إنسان‬ ‫لحياة‬ ‫سببا‬ ‫هللا‬ ‫جعله‬ ‫الطبيب‬‫ف‬‫ى‬
‫القرار‬..‫جهل‬ ‫لو‬ ‫الحياة‬ ‫لفقدان‬ ‫سببا‬ ‫ويجعله‬
‫الفرار‬ ‫طريق‬ ‫إلى‬ ‫الروح‬ ‫النتشال‬ ‫السبيل‬.
‫من‬ ‫تكتب‬ ‫حياة‬‫الموت‬..‫يكتب‬ ‫وموت‬
‫الحياة‬ ‫من‬
‫طارق‬‫النجومى‬

129. (‫م‬ ‫ويرزقه‬ ‫مخرجا‬ ‫له‬ ‫يجعل‬ ‫هللا‬ ‫يتق‬ ‫ومن‬‫ن‬
‫اليحتسب‬ ‫حيث‬)‫العظيم‬ ‫هللا‬ ‫صدق‬
AND WHOSOEVER FEARS ALLAH AND KEEPS
HIS DUTY TO HIM , GOD WILL MAKE A WAY
FOR HIM TO GET OUT (from ever difficulty).
AND WILL PROVIDE ( HIM l HER ) FROM
(SOURCES ) HE l SHE NEVER COULD
IMAGINE.
( THE NOBLE QURAN )