This document discusses the management and complications of acute pancreatitis. For mild cases, the disease is usually self-limiting and resolves within a week with conservative treatment like analgesics and IV fluids. Severe cases require intensive care monitoring and aggressive rehydration. Systemic complications can affect various organ systems in the first week while local complications like pancreatic necrosis and pseudocysts usually develop after the first week. Infected necrosis has a high mortality rate and requires percutaneous or surgical drainage. Pseudocysts are managed with endoscopic or surgical drainage depending on their size and complications.
ACUTE CHOLECYSTITIS- RUQ ABDOMINAL PAIN
#surgicaleducator #ruqabdominalpain #acutecholecystitis #usmle #babysurgeon #surgicaltutor
• Dear Viewers,
• Greetings from “Surgical Educator”
• Today I have uploaded a video on Acute Cholecystitis
• It is one of the common surgical problems you see in surgical wards.
• I have discussed the various causes for RUQ pain, etiology, pathology, clinical features, investigations, complications and treatment of Acute Cholecystitis.
• I have also included a mind map, a diagnostic and a treatment algorithm for Acute Appendicitis.
• I hope the video will be very useful and you will enjoy it.
• You can watch all my surgical teaching videos in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
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.
ACUTE CHOLECYSTITIS- RUQ ABDOMINAL PAIN
#surgicaleducator #ruqabdominalpain #acutecholecystitis #usmle #babysurgeon #surgicaltutor
• Dear Viewers,
• Greetings from “Surgical Educator”
• Today I have uploaded a video on Acute Cholecystitis
• It is one of the common surgical problems you see in surgical wards.
• I have discussed the various causes for RUQ pain, etiology, pathology, clinical features, investigations, complications and treatment of Acute Cholecystitis.
• I have also included a mind map, a diagnostic and a treatment algorithm for Acute Appendicitis.
• I hope the video will be very useful and you will enjoy it.
• You can watch all my surgical teaching videos in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
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.
Approach to Management of Upper Gastrointestinal (GI) BleedingArun Vasireddy
Upper gastrointestinal bleeding is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Blood may be observed in vomit (hematemesis) or in altered form in the stool (melena). Depending on the severity of the blood loss, there may be symptoms of insufficient circulating blood volume and shock. As a result, upper gastrointestinal bleeding is considered a medical emergency and typically requires hospital care for urgent diagnosis and treatment. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and some rarer causes such as gastric cancer.
The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine hemoglobin concentration. In significant bleeding, fluid replacement is often required, as well as blood transfusion, before the source of bleeding can be determined by endoscopy of the upper digestive tract with an esophagogastroduodenoscopy. Depending on the source, endoscopic therapy can be applied to reduce rebleeding risk. Specific medical treatments (such as proton pump inhibitors for peptic ulcer disease) or procedures (such as TIPS for variceal hemorrhage) may be used. Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment.
PERFORATED PEPTIC ULCER
PERFORATION
DEFINITION
It is the terminology used for perforation of duodenal ulcer or gastric ulcer or stomal ulcer.
Otherwise all clinical features and management are similar.
Perforation is common in duodenal ulcer
Mortality is more in gastric ulcer perforation and perforation in elderly
Approach to Management of Upper Gastrointestinal (GI) BleedingArun Vasireddy
Upper gastrointestinal bleeding is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Blood may be observed in vomit (hematemesis) or in altered form in the stool (melena). Depending on the severity of the blood loss, there may be symptoms of insufficient circulating blood volume and shock. As a result, upper gastrointestinal bleeding is considered a medical emergency and typically requires hospital care for urgent diagnosis and treatment. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and some rarer causes such as gastric cancer.
The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine hemoglobin concentration. In significant bleeding, fluid replacement is often required, as well as blood transfusion, before the source of bleeding can be determined by endoscopy of the upper digestive tract with an esophagogastroduodenoscopy. Depending on the source, endoscopic therapy can be applied to reduce rebleeding risk. Specific medical treatments (such as proton pump inhibitors for peptic ulcer disease) or procedures (such as TIPS for variceal hemorrhage) may be used. Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment.
PERFORATED PEPTIC ULCER
PERFORATION
DEFINITION
It is the terminology used for perforation of duodenal ulcer or gastric ulcer or stomal ulcer.
Otherwise all clinical features and management are similar.
Perforation is common in duodenal ulcer
Mortality is more in gastric ulcer perforation and perforation in elderly
Acute pancreatitis atlanta classification & managementSeneeth Peramuna
Acute Pancreatitis
Definition,
Etialogy and pathogenesis
Atlanta Revised classification
Initial risk assesment
Management of general condition, local and systemic complications
BISAP score
Modified Marshall score
Pancreatitis -a detailed study ( medical information )martinshaji
Pancreatitis is the Inflammation of the pancreatic parenchyma. Acute condition of diffuse pancreatic inflammation & auto digestion, presents with abdominal pain, and is usually associated with raised pancreatic enzyme levels in the blood &urine. this is a detailed study pancreatitis describing factors such as definition , epidemiology , etiology , pathophysiology , treatment , prevention , imaging techniques , diagnosis , lab investigations , images , drugs , control etc
please comment
thank u
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. MANAGEMENT
In most patients (85-90%) with mild acute pancreatitis,
the disease is self-limited and subsides spontaneously,
usually within 3-7 days.
However, a conservative (non-invasive) approach is
indicated(1) analgesics for pain, (2) IV fluids and
colloids to maintain normal intravascular volume, and
(3) no oral alimentation.
A brief period of fasting may be sensible mainly in
patients who are nauseated or in pain.
3.
4. SEVERE ATTACK
Markers of severity within 24 hours are
-SIRS, Hct>44%,BUN>22mg%
Admit the patient to ICU, Give Analgesic drugs and Aggressive
fluid rehydration.
Oxygen masks may be applied and Invasive monitoring of vital
signs, central venous pressure, urine output and blood gases
should be carried out.
Frequent monitoring of haematological and biochemical
parameters
Nasogastric drainage, it is not essential but may be of value in
patients with vomiting.
5. Antibiotic prophylaxis can be considered (imipenem,
cefuroxime). The overall rate of infected necrosis is
20%.
CT scan(contrast enhanced) essential if organ failure,
clinical deterioration or signs of sepsis develop. Its
severity can be judged by Balthazar scoring system.
6. ERCP within 36-72 hours for severe gallstone
pancreatitis or signs of cholangitis.
Supportive therapy for organ failure if it develops
(inotropes, ventilatory support, haemofiltration, etc.)
If nutritional support is required, consider enteral
(nasogastric) feeding instead of TPN.
9. LOCAL COMPLICATIONS
Usually develops after the first week.
A CT scan should be performed where clinical resolution
does not take place and signs of of sepsis develop.
These complications carry a significant burden of
mortality.
10. Pancreatic necrosis is a Diffuse or focal area of non-viable
parenchyma in the pancreas and can be identified by an
absence of contrast enhancement on CT.
These are sterile to begin with, but can become subsequently
infected, probably due to translocation of gut bacteria.
Infected necrosis is associated with a mortality rate of up to
50%.
If the pancreatic fluid aspirate is purulent, percutaneous
drainage of the infected fluid should be carried out. The tube
drain inserted should have the widest bore possible.
11. If the area involved is the head of pancreas midline laprotomy
should be carried out. The duodenocolic and gastrocolic
ligaments should be divided and the lesser sac opened.
Thorough debridement of the dead tissue around the
pancreas should be carried out.
If the body and tail of the gland are primarily involved, a
retroperitoneal approach though a left flank incision may be
more appropriate.
Laproscopy- A rigid laparoscope is inserted into the
peripancreatic area through a retroperitoneal approach, and
vigorous irrigation and suction is combined with a gradual
nibbling away of the necrotic debris.
12. This is a circumscribed collection of pus, and may be an
acute fluid collection or a pseudocyst that has become
infected. Percutaneous drainage with the widest
possible drains should be done
Pancreatic Ascites is a chronic, generalised, peritoneal,
enzyme-rich effusion usually associated with pancreatic
duct disruption. Paracentesis will reveal turbid fluid with
a high amylase level.
Pancreatic effusion is an encapsulated collection of fluid
in the pleural cavity. Concomitant pancreatic ascites may
be present, or there may be a communication with an
intra-abdominal collection.
13. Bleeding may occur into the gut, into the
retroperitoneum or into the peritoneal cavity. Possible
causes include bleeding into a pseudocyst cavity, or
diffuse bleeding from a large raw surface.
14. A pseudocyst is a extra pancreatic collection of amylase-rich
fluid enclosed in a wall of fibrous or granulation tissue.
Disruption of Pancreatic ductal system is common, however
the course may vary from spontaneous healing to tense
ascites.
Cause – 90% pancreatitis
10% trauma
They are often single but, occasionally, patients will develop
multiple pseudocysts.
A pseudocyst is usually identified on ultrasound or a CT scan.
It is important to differentiate a pseudocyst from an acute
fluid collection or an abscess and a cystic neoplasm.
15.
16. Distinguishing a pseudocyst from a cystic
neoplasm
History
Appearance on CT and ultrasound
FNA of fluid, preferably under EUS guidance and
Cytology typically reveals inflammatory cells in
pseudocyst fluid.
CEA (high level in mucinous tumours .400ng/ml)
Amylase (level usually high in pseudocysts, but
occasionally in tumours)
17. Complications
Process Outcomes
Infection Abscess
Systemic sepsis
Rupture(prime cause of death)
into the gut
into the peritoneum
GI bleeding
peritonitis
Enlargement
Pressure effects
Obstructive jaundice from
biliary compression
Bowel obstruction
Erosion into a vessel Haemorrhage into the cyst
Haemoperitoneum ( A triad of
findings-inc size of mass,
localized bruise over mass and
a sudden dec in Hb and
Hematocrit without external
blood loss)
18. Management
Pseudocysts that are thick-walled or large (over 6 cm in
diameter), have lasted for a long time (over 12 weeks) are
less likely to resolve spontaneously.
1. Percutaneous drainage to the exterior under radiological
guidance should be avoided. It carries a very high likelihood
of recurrence.
2. Endoscopic drainage usually involves puncture of the cyst
through the stomach or duodenal wall under EUS guidance,
and placement of a tube drain with one end in the cyst
cavity and the other end in the gastric lumen.
3. Surgical drainage involves internally draining the cyst into
the gastric or jejunal lumen. Pseudocysts that have
developed complications are best managed surgically.