URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
Obstructive jaundice is one of the important surgical topics. In this playlist I have discussed the introduction, choledocholithiasis, Carcinoma Pancreas and biliary atresia. If you watch all these videos together you will become confident in Managing obstructive jaundice.
Splenic trauma - Causes, Complications, ManagementVikas V
Splenic Trauma - A detailed Presentation about Splenic Trauma, anatomy of the spleen, Causes of Trauma, Mechanism of Injury, Diagnosis, Management, Surgical management, Steps of Splenectomy, and Complications
URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
Obstructive jaundice is one of the important surgical topics. In this playlist I have discussed the introduction, choledocholithiasis, Carcinoma Pancreas and biliary atresia. If you watch all these videos together you will become confident in Managing obstructive jaundice.
Splenic trauma - Causes, Complications, ManagementVikas V
Splenic Trauma - A detailed Presentation about Splenic Trauma, anatomy of the spleen, Causes of Trauma, Mechanism of Injury, Diagnosis, Management, Surgical management, Steps of Splenectomy, and Complications
Definitions of GI bleeding
GI Bleeding include Upper and Lower of GIB
Causes of GI bleeding
Pathogenesis of GI bleeding
Diagnosis of GI bleeding
Clinical of GI bleeding
Management of GI bleeding
Recommendation of GI bleeding
Clinical guideline of GI bleeding
Seminar presentation by 5th-year medical students under the supervision of in house lecturer. He was previously working as a consultant surgeon in Syria. Reference as mentioned in the slides.
ANEURYSMS , TYPES AND THERE MANAGEMENT.pptxBipul Thakur
Discussion about different types of Aneurysm, details about Abdominal aorta aneurysm and brief discussion about some important peripheral aneurysms.
Includes approach to different forms of Abdominal aortic aneurysm, its management and complications related to the surgery.
Definitions of GI bleeding
GI Bleeding include Upper and Lower of GIB
Causes of GI bleeding
Pathogenesis of GI bleeding
Diagnosis of GI bleeding
Clinical of GI bleeding
Management of GI bleeding
Recommendation of GI bleeding
Clinical guideline of GI bleeding
Seminar presentation by 5th-year medical students under the supervision of in house lecturer. He was previously working as a consultant surgeon in Syria. Reference as mentioned in the slides.
ANEURYSMS , TYPES AND THERE MANAGEMENT.pptxBipul Thakur
Discussion about different types of Aneurysm, details about Abdominal aorta aneurysm and brief discussion about some important peripheral aneurysms.
Includes approach to different forms of Abdominal aortic aneurysm, its management and complications related to the surgery.
DEFINITION:
An aortic aneurysm is an enlargement (dilation) of the aorta to greater than 1.5 times normal size.
1)Abdominal aortic aneurysm:
2)Thoracic aortic aneurysm:
1)Hardening of the arteries ( Atherosclerosis).
2)Genetic conditions:
Aortic aneurysms in younger people often have a genetic cause –people who are born with Marfan syndrome.
3)Other medical conditions: Inflammatory conditions ,such as giant cell arteritis.
4)Problems with your hearts aortic valve:
Some times people who have problems with the valve.
5)Untreated infection: Such as syphilis or salmonella, and HIV.
6)Traumatic injury: Rarely ,some people who are injured in falls or motor vehicle crashes develop thoracic aortic aneurysms.
RISK FACTORS-1)Age
2)Male gender
3)Hypertension
4)Coronary artery disease
5)Family history
6)High cholesterol
7)Lower extremity
8)Carotid artery disease.
9)Previous stroke
10)Tobacco use
11)Excess weight.
SIGN & SYMPTOMS-
THORACIC AORTIC ANEURYSM.
•Constant boring pain, which may occur only when the patient is in the supine position.
Dyspnea, cough( parpoxysmal and brassy).
Hoarseness , stridor ,weakness or completer loss of the voice( aphonia).
Dysphagia.
Dilated superficial veins on chest ,neck, neck or arms.
Edematous areas on chest wall.
Cyanosis
Unequal pupils.
1.Patients complaints of “ heart beating” in abdomen when lying down or a feeling of an abdominal mass or abdominal throbbing.
2.Cyanosis and mottling of the toes if aneurysm is associated with thrombus.
DIAGNOSTIC MEASURE-Chest x.ray , CT angiography ( CTA), and transesophageal electrocardiography( TEE) , are done to reveal abnormal widening of the thoracic aorta.
Abdominal aortic aneurysm : Pulsation of pulsatile mass in the middle and upper abdomen , duplex ultrasonography or CTA is used to determine the size ,length and location of the aneurysm.
Dissecting aneurysm : Arteriography ,CTA,TEE duplex ultrasonography and magnetic resonance angiography ( MRA).
COMPLICATION
•Rupture of an aneurysm is the most serious complication.
•If rupture occurs into the retroperitoneal space , bleeding may be controlled by surrounding anatomic structures, preventing exsanguination and death.
MEDICALMANAGEMENT
•The goal of both medical and surgical management is to prevent aneurysm rupture.
•Early detection and prompt treatment are essential .
•Conservative therapy of small asymptomatic AAA’s ( 4-5.5) is the best practice.
This consists of risk factor modification ( ceasing tobacco use , decreasing B.P, optimizing of aneurysm size using ultrasound ,CT, or MRI.
•Growth rates may be lowered with B- adrenergic blocking agents ( eg. Propranolol) , Statins ( eg. Simvastatin) and antibiotics( eg. Doxycycline).
SURGICAL MANAGEMENT-Surgical repair is recommended in patients. with asymptomatic aneurysm 5-5 cm in diameter or larger.
•Surgical procedure are
1)Open aneurysm repair (OAR)
2)Endovascular graft procedure
By the end of the module, you will be able to:
Define Arterio Venous Fistula and Arterio Venous Graft
Identify Complications and Management
Familiarise and use the Pre Needling Cannulation Tool
Neha diwan presentation on aortic aneurysmNEHAADIWAN
An aortic dissection is a serious condition in which a tear occurs in the inner layer of the body's main artery (aorta).Aortic rupture is when all the layers of the aorta wall tear, causing blood to leak out from the aorta often due to a large aortic aneurysm that bursts. This will stop blood being pumped around the body and is life threatening. Ideally an aortic aneurysm will be repaired before a rupture can occur.
In this presentation I am talking about the overview of So-Hum meditation- the universal mantra.
I have discussed the meaning, how to do it, it's advantages and an advanced visualisation technique.
This is a small handbook on individual surgical disease and its management . I have discussed about Acute Appendicitis and then step by step I explain both open and laparoscopic appendicectomy in this book.
The operative surgery part is very useful for surgical trainees.
POWER OF YOUTUBE IN MEDICAL EDUCATION- Surgical Educator Channel
#powerofyoutube #surgicaleducator #babysurgeon #usmle
Website Link: www.surgicaleducator.com
Dear viewers,
• Greetings from “Surgical Educator’
• In this episode, I am talking about the Power of YouTube in medical education
• I will be discussing the various benefits of using YouTube in medical education. YouTube is definitely revolutionize the way in which we are teaching our students.
• You can enjoy all my videos in the following links:
•
/ surgicaleducator surgicaleducator.com
• Thank you for watching the video.
All my videos are problem-based, because patients are coming to us with problems and not with a diagnosis.
• I have made modules for each surgical problem which consists of
many of my YouTube videos and my PPT slides
• I request you all to watch all the videos in a playlist together, so
that you will become confident in dealing with these problems.
• Links to the Playlists based on the Surgical Problems:
• Module 1: Scrotal Swellings:
https://www.youtube.com/playlist?list...
uXwt0JH0YG8m4JmzgAli9jj
https://www.slideshare.net/babysurgeo...
• Module 2: Groin Swellings:
https://www.youtube.com/playlist?list...
uVaDboG_ddw2S6xInNnB80D
https://www.slideshare.net/babysurgeo...
• Module 3: Abdominal Pain:
https://www.youtube.com/playlist?list...
uUcXb96A3tFpTrWOVa2F7j1
https://www.slideshare.net/babysurgeo...
case-based-learning-82091549
• Module 4: Abdominal Lumps:
https://youtube.com/playlist?list=PLx...
uWBKVnBkhdE4XkW-xEoiIwB
• Module 5: Obstructive Jaundice:
https://www.youtube.com/playlist?list...
uX6MsQnsCTGl8YDFN1TYiQm
https://www.slideshare.net/babysurgeo...
127314632
• Module 6: Upper GI Hemorrhage:
https://www.youtube.com/playlist?list...
uUtV67AdUQYEUKdhX9vL576
https://www.slideshare.net/babysurgeo...
227888333
• Module 7: Lower GI Hemorrhage:
https://www.youtube.com/playlist?list...
https://www.slideshare.net/babysurgeo...
• Module 8: Thyroid Pathologies:
https://www.youtube.com/playlist?list...
uWg55odQfB_7JT0NYIP8ELp
https://www.slideshare.net/babysurgeo...
benign-diseases-and-carcinoma-thyroid
• Module 9: Breast Pathologies:
https://www.youtube.com/playlist?list...
uVTLcGtam1kFBzjY4NAf7MZ
https://www.slideshare.net/babysurgeo...
diseases-and-carcinoma-breast
• Module 10: Peripheral Arterial Diseases:
https://www.youtube.com/playlist?list...
6VIbQR4g8MdOi0z
https://www.slideshare.net/babysurgeo...
106254612
• Module 11: Venous Diseases:
https://www.youtube.com/playlist?list...
uVf1aYodgILbxVpC-fkdqNo
https://www.slideshare.net/babysurgeo...
127314847
• Module 12: Dysphagia:
https://www.youtube.com/playlist?list...
4DlU1Lp
# Dear Viewers/Friends/Colleagues,
# Greetings from Surgical Educator YouTube channel
# I am sharing an E-book where you can find out the hyperlinks for all my surgery teaching videos and their PPTs
# In this E-book you will learn the purpose of my YouTube channel Surgical Educator, core clinical problems you should master, how to utilize the channel effectively, statistics and analytics for the channel, all the teaching modules with hyperlinks to all my teaching videos and their PPTs and other learning resources created by me like the android app for the channel and other E-books.
In this presentation, I discussed the various liver swellings- both cystic and solid swellings. Cystic lumps are Pyogenic liver abscess, Amebic liver abscess and hydatid cyst. Benign solid swellings are Hepatic adenoma, Focal nodular hyperplasia and Hemangioma. The malignant solid swelings are secondary carcinoma of the liver, primary Hepatocellular carcinoma and Hepatoblastoma.
In this presentation, I have shown how to do open anterior resection both high and low varieties in a step-by-step manner with clear pictures as if reading an atlas of operative surgery.
The surgical causes for jaundice in children- both in neonates and infants- are Biliary atresia, Choledochal cyst, Biliary hypoplasia, Inspissated bile syndrome, and spontaneous perforation of CBD. How to Diagnose & Treat all these causes.
I am sharing a 10 paged e-book that consists of the hyperlinks to all my surgery teaching videos and to all the PPTs used for these videos from SlideShare. You can watch these videos problem based and can become competent to deal with it. You can read this to cover the whole undergraduate curriculum.
In this presentation I discussed 5 scrotal swellings case scenarios with my MBBS students. I have shared these case scenarios prior to the PBL class and asked the students to come prepared to the class. In the class i tested the knowledge gaind by the students by watching my didactic YouTube videos on the subject by asking so many questions. So this online class was highly interactive based on flip class model.
I have included in this PPT slides the various causes for acute abdomen- Ac Appendicitis, Ac Cholecystitis, Ac Pancreatitis, Peptic Ulcer Disease, Small Bowel Obstruction, Mesenteric Ischemia and sigmoid Colon. you can read and learn all these acute abdominal problems in this one PDF file.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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4. ABDOMINALAORTIC ANEURYSM
Aneurysm—permanent focal dilation of an
artery to at least 1.5 times of its diameter
A normal adult male has an aorta that is
approximately 2 cm in size (anything >3 cm is
considered abnormal).
Arterial dilation less than 50% increase in
diameter is called vascular ectasia
Diffuse enlargement of several arterial
segments that are 50% greater than the
normal diameter is called arteriomegaly
Epidemiology
Abdominal aortic aneurysm (AAA) is the most
common type of aneurysm for which patients
present for treatment.
Male/female ratio of 3:1
Relative risk for first-degree relatives of
affected individuals is 11.6 times greater than
the general population.
Those with known popliteal or femoral
aneurysms have a 50% likelihood of also
having an AAA.
5. ABDOMINALAORTIC ANEURYSM
Acquired factors:
Cigarette smoking—strongest modifiable
risk factor
Hypertension
Age greater than 50 years old
Heart transplant recipient
Risk Factors
Inherited factors:
Connective tissue disorders—Marfan
syndrome, type IV Ehlers–Danlos
First-degree relative with an AAA
6. Abdominal Aortic Aneurysm
Causitive factors:
Arterial wall degeneration from
atherosclerosis with concurrent loss of
elastin caused by proteolysis and
inflammation leads to a fusiform (spindle-
shaped) aneurysm.
An infectious process in the arterial wall
leads to a mycotic aneurysm. Caused by
Salmonella or Staphylococcal infection
Etiopathogenesis
Pathology:
Location:
Infra renal 95%
Juxtarenal- extends to renal arteries
Supra renal-extends to Superior mesenteric
artery & coeliac axis
Thoraco-abdominal
10 to 20% involves iliac arteries
40% are hypertensive
30% are CAD patients
4% femoral or popliteal aneurysms
7. Abdominal Aortic Aneurysm
GENERAL CONSIDERATIONS:
Diameter is the strongest predictor of
rupture
Increased size = increased rate of rupture
Laplace law—A larger radius increases wall
tension, which in turn increases the
risk for rupture of the aneurysmal wall.
Average growth is 0.4 cm/year.
Growth is often staggered, and an aneurysm
may be stable for one period and then grow
rapidly in another period.
NATURAL
HISTORY
STATISTICS:
Risk of rupture is based on size
Women have a higher rate of rupture at
smaller diameters.
Renal artery involvement, chronic
obstructive pulmonary disease, and diastolic
hypertension also increase the rate of
rupture.
RISK OF RUPTURE BASED ON SIZE:
AAA Diameter (cm) Risk of Rupture per Year
<4= 0
4–5= 0.5–5
5–6= 3–15
6–7= 10–20
7–8= 20–40
>8 =30–50
8. Abdominal Aortic Aneurysm
SYMPTOMS:
Most AAAs are asymptomatic
Two-thirds of known AAAs are incidental
findings on imaging studies done for other
reasons
Most common symptoms include new-onset
abdominal pain and low back pain. May also
present as flank, inguinal, or genital pain.
Symptoms may be caused by compression of
surrounding structures— inferior vena
cava, ureter, duodenum.
If ruptured AAA patient present with shock
Triad of severe abdominal pain, hypotension
and pulsatile abdominal mass.
CLINICAL
FEATURES
SIGNS:
Presence of pulsatile mass on deep
palpation—larger than 5-cm aneurysm
palpable in up to 75% of patients
In larger patients, it may be impossible to
detect AAAs regardless of diameter.
Other pulses: It is important to evaluate
peripheral arteries for associated occlusive
disease (pulses and bruits) or additional
aneurysmal disease.
In ruptured AAA features of shock
9. Abdominal Aortic Aneurysm
Plain AXR:
Calcific rim (“eggshell”) or large soft-tissue
shadow is often visible projecting anterior to
the spine.
INVESTIGATIONS
B-MODE ULTRASOUND:
Screening imaging test of choice because of ease of
use and most cost effective
Can evaluate blood flow in renal and visceral arteries
Because of presence of gas couldn’t pick up
suprarenal AAA.
10. Abdominal Aortic Aneurysm
CECT SCAN:
Can provide accurate characterization of entire
aorta—gold standard for preoperative planning
and diagnosis of a ruptured AAA
Permits assessment of diameter, length, wall
thickness, and thrombus
3D reconstruction used for endograft evaluation
and planning
INVESTIGATIONS
MRI SCAN:
May have a role in patients in whom intravenous
contrast is contraindicated
No role in ruptured patients, given the length of
time needed to complete the examination
11. Abdominal Aortic Aneurysm
AORTOGRAPHY:
Poor study for diagnosis or assessment of size,
because mural thrombus within AAA can obscure
actual aneurysm sac size
Expensive and invasive
Being replaced by CT and MRI angiograms that
provide noninvasive three-dimensional images
Provides information regarding associated
vascular lesions for renal arteries and distal runoff
Indications for aortography—evidence of accessory
renal arteries, horseshoe kidneys, mesenteric
ischemia, and peripheral arterial occlusive disease
INVESTIGATIONS
DSA: CT Angiogram
12. Abdominal Aortic Aneurysm
OPEN REPAIR:
Uses a synthetic (Dacron) graft to
repair aneurysm.
Long midline incision
(laparotomy).
Aorta clamped below renal
arteries where possible to prevent
renal ischaemia.
Graft can be straight if iliac
arteries not involved or bifurcated
if iliac arteries involved.
3-7% mortality
TREATMEN
T
13. Abdominal Aortic Aneurysm
Endovascular aneurysm repair (EVAR):
Insertion of a stent over aneurysmal
segment
Small groin incisions (may be vertical or
transverse)
Does not require cross clamping of aorta
Procedure carried out under direct
radiological guidance.
Uses high doses of nephrotoxic contrast.
Reduced early mortality.
High early re-intervention rate if
endoleak occurs.
Requires lifelong surveillance post-op for
endoleak.
TREATMEN
T
14. Abdominal Aortic Aneurysm
EARLY:
Death
Haemorrhage- uncontrolled vessels or anastomotic
breakdown
Myocardial ischaemia- 20% of patients
Cardiac arrhythmias.
Cardiac failure
Bowel ischaemia- characterized by abdominal
pain, and bloody diarrhoea. Urgent laparotomy if
evidence of peritonitis
Abdominal compartment syndrome
Atelectasis, ARDS, RTI
Endoleak (EVAR)
Renal dysfunction- pre-existing renal disease,
nephrotoxic contrast/antibiotics, prolonged
hypotension/ dehydration, use of NSAIDs
Limb ischemia
COMPLICATIONS
LATE:
Graft infection- usually needs to be removed.
Graft limb occlusion- within 30 days, may present
with acute ischaemic limb.
Aortoenteric fistula
Endoleak (EVAR)
Impaired sexual function
Endoleak: An endoleak is persistent blood flow
into an aneurysmal sac after EVAR is performed.
Type I Leak at attachment sites of graft
Type II Filling of aneurysmal sac by collateral vessels (IMA,
Lumbar)
Type III Leak through defect in graft
Type IV Leak through fabric of graft due to porosity
Type V Expansion of aneurysm sac without evidence of leak
on imaging
15. Abdominal Aortic Aneurysm
Clinical Features:
Presentation may be delayed if rupture is
contained within retroperitoneal space.
A contained leak may initially be
haemodynamically stable but can proceed rapidly
to rupture.
Longstanding leak causing aortoenteric fistula can
present with high output cardiac failure and GI
bleed.
Sudden onset abdominal/back/flank pain.
Sudden collapse with hypotension.
May have a history of AAA under surveillance.
Pulsatile abdominal mass is not always palpable
Triad of severe abdominal pain, hypotension and
pulsatile abdominal mass
RUPTURED
Management:
Airway
Breathing (give 15L 100% O2 via non-rebreather
mask)
Circulation (Wide bore IV Access X2, give IV
Fluids)
Do not aggressively hydrate: Allow permissive
hypotension to avoid worsening a rupture
Analgesia
Alert vascular surgeon, anaesthetist, theatre, ICU
Gain consent for surgery
If not a candidate for surgery: analgesia &
palliative care
If a candidate for open/endovascular repair:
Urgent transfer to theatre
ICU care post-op