Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

SURGERY OF THE THYROID

1,845 views

Published on

Published in: Education, Health & Medicine
  • Be the first to comment

SURGERY OF THE THYROID

  1. 1. Surgical Problems In Typhoid
  2. 2. <ul><li>Perforation </li></ul><ul><li>bleeding </li></ul>
  3. 3. Perforation <ul><li>2% incidence </li></ul><ul><li>Varies in different endemic areas </li></ul><ul><li>Incidence is high in West africa 15–33 % </li></ul><ul><li>Low in Egypt </li></ul><ul><li>3 rd week of illness </li></ul>
  4. 4. <ul><li>Through an ulcerated payers patch </li></ul><ul><li>Typicaly single ulcer in terminal ileum perforates – 85% </li></ul><ul><li>Multiple perforations in ileum not uncommon </li></ul>
  5. 5. Diagnosis <ul><li>Presents with severe lower abd. Pain </li></ul><ul><li>All features of peritonitis </li></ul><ul><li>Chest x-ray shows gas under the diaphram </li></ul>
  6. 6. Management <ul><li>Laparotomy </li></ul><ul><li>Conservative – if poor GC </li></ul>
  7. 7. Single perforation <ul><li>simple closure of perforation after trimming of the edges </li></ul><ul><li>Thorough cleansing of peritoneal cavity </li></ul><ul><li>Drainage </li></ul>
  8. 8. Multiple perforations <ul><li>resection and end to end anasthamosis </li></ul><ul><li>ileostomy if very much friable </li></ul><ul><li>associated with high mortality </li></ul>
  9. 9. Haemorrhage <ul><li>Usually manifest in the 3 rd week </li></ul><ul><li>Gross heamorrhage in 10-20% </li></ul>
  10. 10. Management <ul><li>Conservative management is preferred </li></ul><ul><li>Surgery avoided as bowel is exceedingly friable </li></ul><ul><li>Laparotomy for uncontrollable, life threatening bleeding </li></ul>
  11. 11. Other surgical complications <ul><li>Hepatobiliary system </li></ul><ul><li>Pancreas </li></ul><ul><li>Spleen </li></ul><ul><li>Genitourinary system </li></ul><ul><li>bones </li></ul>
  12. 12. Hepatobiliary system <ul><li>a/c cholecystitis </li></ul><ul><li>c/c cholecystitis </li></ul><ul><li>Gall stones </li></ul><ul><li>jaundice </li></ul>
  13. 13. Pancreas <ul><li>Pancreatitis </li></ul><ul><li>Enzyme abnormalities </li></ul>
  14. 14. Spleen <ul><li>Splenic abscess </li></ul><ul><li>Splenic rupture </li></ul>
  15. 15. Genito urinary system <ul><li>Cystitis </li></ul><ul><li>Orchitis </li></ul>
  16. 16. Bones <ul><li>Osteomyelitis </li></ul><ul><li>Arthritis </li></ul><ul><li>Abscess </li></ul>

×