Arterial occlusion
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Arterial occlusion is defined as a condition of acute lack of tissue perfusion due to sudden cessation of circulation. Main axial artery of the limb is blocked presenting within minutes to hour after occlusion.
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Arterial arterial occlusion
Drive:-https://drive.google.com/open?id=1VUORIMNocR7Zrlrig8DT85Vp5zjJVwsN
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Mesenteric ischemia
Mesenteric ischemia is a condition with reduced blood flow to the intestines that can be fatal if not treated. It can be acute or chronic and involve both the arterial and venous circulation. Diagnosis involves imaging tests like CT scans to identify arterial blockages or venous clots. Treatment aims to resuscitate the patient, treat any underlying causes, and restore blood flow surgically or via endovascular methods if possible. Unviable intestines will also be resected. Despite advances, mesenteric ischemia remains challenging to diagnose and treat due to its complexity and non-specific symptoms.
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Mesenteric ischemia is a condition with reduced blood flow to the intestines that can be fatal if not treated. It can be acute or chronic and involve both the arterial and venous circulation. Diagnosis involves imaging tests like CT scans to identify arterial blockages or venous clots. Treatment aims to resuscitate the patient, treat any underlying causes, and restore blood flow surgically or via endovascular methods if possible. Unviable intestines will also be resected. Despite advances, mesenteric ischemia remains challenging to diagnose and treat due to its complexity and non-specific symptoms.
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1) Classification of wounds based on several factors like cleanliness, thickness, and time since injury. The main phases of wound healing are inflammation, proliferation, and remodeling.
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This document discusses cardiac trauma, including traumatic aortic rupture and penetrating cardiac injuries. It provides details on:
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Emergency surgical access methods like left anterolateral thoracotomy or clamshell thoracotomy are described for rapidly addressing life-threatening cardiac injuries.
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A stroke occurs when blood supply to the brain is interrupted, depriving brain cells of oxygen. Strokes can be either ischemic (88%), caused by clot or embolism blocking an artery, or hemorrhagic (12%), caused by bleeding within the brain. Diagnosis involves physical exam, blood tests, CT/MRI scans of the brain, and tests of the heart and arteries. Ischemic strokes result from plaque buildup in arteries leading to clot formation, while hemorrhagic strokes damage brain tissue through blood toxicity. Prompt treatment is needed to minimize brain injury from loss of oxygen and blood toxicity.
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The document provides information on subarachnoid haemorrhage (SAH), including:
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4. Embolism occurs when a detached mass is
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This document discusses embolism, infarction, and their causes and classifications. It defines an embolism as a detached mass carried by the blood to distant sites, which can lodge and block vessels, causing tissue dysfunction. Emboli sources include thrombi, fat, air, debris. Embolisms are classified as pulmonary (95% from DVTs), systemic (sites include legs, brain, intestines, kidneys). Infarctions are areas of ischemic necrosis due to blood flow obstruction. They are classified as hemorrhagic, white, septic based on appearance and presence of infection. Infarcts are eventually replaced by scar tissue.
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Urethritis by Dr.K.AmrithaAnilkumar
URETHRITIS - inflammation of urethra
CAUSES
Gonococcal urethritis.
Nongonococcal urethritis:
Trichomonal urethritis.
Lymphogranuloma venereum (LGV).
Mycoplasma.
Ureaplasma urealyticum.
Candida.
Trauma
Catheters
Cystoscopes
stones.
Chemical urethritis.
Reiter’s disease: Arthritis, conjunctivitis, urethritis.
Allergy.
Stricture urethra by Dr.K.AmrithaAnilkumar
STRICTURE URETHRA
CLASSIICATION -I
I: Aetiologically.
2. Congenital.
3. Inflammatory:
Post-gonococcal
is most common
Gonococcal stricture occurs one year after infection.
Retention develops only 10–15 years later.
Rupture of urethra by Dr.K.AmrithaAnilkumar
Rupture of the anterior urethra is usually caused by a fall astride a projecting object. Clinical features include blood in the urethra, a perineal hematoma, and retention of urine. Treatment involves gentle catheterization in the operating room. If catheterization is not possible, open surgical repair of the tear is performed through a perineal incision. Complications can include infection and stricture formation.
Renal calculus by Dr.K.AmrithaAnilkumar
RENAL CALCULUS AETIOLOGY
Males- radio-opaque gall stones
Females - Radiolucent gall stones
Diet:Vitamin A deficiency
it causes desquamation of epithelium
which acts as a nidus for stone formation.
Climate:
In hot climate urinary solutes will increase with decrease in colloids,
Paraphimosis by Dr.K.AmrithaAnilkumar
PARAPHIMOSIS
DEFINITION
Inability to place back (cover) the retracted prepucial skin over the glans is called as paraphimosis.
It causes ring like constriction proximal to the corona and prepuceal skin.
Hypospadias by Dr.K.AmrithaAnilkumar
HYPOSPADIAS
DEFINITION
It is the most common congenital malformation of urethra wherein external meatus is situated proximal than normal, over the ventral (under) aspect of the penis.
Hydronephrosis by Dr.K.AmrithaAnilkumar
HYDRONEPHROSIS (HN)
DEFINITION
It is an aseptic dilatation of pelvicalyceal system due to partial or intermittent obstruction to the outflow of urine.
AETIOLOGY
unilateral
bilateral.
Epispadias by Dr.K.AmrithaAnilkumar
EPISPADIAS
Here the urethra opens on the dorsum of the penis, proximal to the glans.
COMMON SITES
abdominopenile junction.
It is associated with a dorsal chordee, ectopia vesicae, urinary incontinence, separated pubic bones.
It is uncommon in females.
Beningn prostrate Hypertrophy (BPH) by Dr.K.AmrithaAnilkumar
This document discusses benign prostate hyperplasia (BPH), including its etiology, pathology, clinical features, diagnosis, and treatment. BPH is a non-cancerous enlargement of the prostate that occurs in older men due to an imbalance of hormones. It causes obstruction of the urethra and symptoms like frequent urination, weak urine stream, and retention. Diagnosis involves exams, urine and blood tests, and imaging of the prostate, kidneys, and bladder. Treatment depends on symptoms and complications but may include catheterization, surgery to remove part of the prostate like TURP, or other procedures to relieve blockage.
Bladder tumor by Dr.K.AmrithaAnilkumar
BLADDER TUMOURS
They are urothelial tumours.
They are commonly malignant.
Transitional cell carcinoma (TCC) is the most common.
Varicocele by Dr.K.AmrithaAnilkumar
Varicocele is dilatation and tortuosity of the veins within the scrotum that drain blood from the testicles. It is more common on the left side where the left testicular vein drains directly into the left renal vein. Varicocele can cause increased temperature in the scrotum and impair sperm production. Treatment involves surgical ligation of the affected veins to repair blood flow and potentially improve fertility.
Testicular tumors
TESTICULAR TUMOURS
PREVALANCE
99% of testicular tumours are malignant.
Life time prevalence of getting testicular tumour is 0.2%.
Very common in Scandinavia; least common inAfrica andAsia.
4 times common in whites than blacks.
Orchitis by Dr.K.AmrithaAnilkumar
ORCHITIS
AETIOLOGY
It is an inflammation of the testis.
It is commonly associated with inflammation ofthe epididymis. Hence, called as epididymo-orchitis.
Orchitis is due to infection through blood, lymphatics or epididymis.
Hydrocele by Dr.K.AmrithaAnilkumar
HYDROCELE
DEFINITION
It is the collection of fluid between the two layers of tunica vaginalis of testis.
Epididymitis by Dr.K.AmrithaAnilkumar
EPIDIDYMITIS,
CAUSES
Inflammation of epididymis is commonly associated with orchitis— epididymo-orchitis.
Nonspecific
viral like mumps.
Bacterial.
Filarial.
Tuberculosis
Perforated peptic ulcer by Dr.K.AmrithaAnilkumar
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
Gastric ulcer by Dr.K.AmrithaAnilkumar
GASTRIC ULCER
AETIOLOGY
It occurs due to imbalance between protective and damaging factors of gastric mucosa.
Atrophic gastritis
duodenogastric bile reflux
gastric stasis
abnormalities in acid and pepsin secretion.
Acid becomes ulcerogenic even to normal gastric mucosa.
Curling ulcer by Dr.K.AmrithaAnilkumar
CURLING ULCER
DEFINITION
They are acute ulcers which develop after major burns, presenting as pain in epigastric region, vomiting or haematemesis.
Curling’s ulcer occurs when burn injury is more than 35%.
It is observed in the body and fundus not in antrum and duodenum
Congenital (infantile) hypertrophic pyloric stenosis by Dr.K.AmrithaAnilkumar
CONGENITAL (INFANTILE) HYPERTROPHIC PYLORIC STENOSIS
DEFINITION
It is hypertrophy of musculature of pyloric antrum, especially the circular muscle fibres, causing primary failure of pylorus to relax.
Duodenum is normal.
Carcinoma stomach by Dr.K.AmrithaAnilkumar
CARCINOMA STOMACH
INCIDENCE
‘It is the captain of men of death’.
It is more common in Japan—70 per 1,00,000 population.
It is more common in males 2:1.
Decrease incidence in western world
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Arterial occlusion
- 1. en love da Homoeopathy ARTERIAL OCCLUSION
- 3. ARTERIAL OCCLUSION DEFINITION • It is a condition of acutelack of tissue perfusion due to sudden cessation of circulation. • Mainaxial artery of thelimb is blockedpresenting within minutes to hour after occlusion. COMMONSITES • It is common in lower limb • upper limb • Also occur in mesenteric, cerebral, coronaryarteries.
- 4. CAUSES • Embolismis the most commoncausein developing country. • Trauma. • Thrombosis of an artery • polycythaemia rubra vera • thrombocytosis. • It is commonly observedin external iliac artery, profunda femoris arteryand popliteal artery.
- 5. PATHOPHYSIOLOGY • Distal ischaemia ↓ begins immediatelyafteracute obstruction. ↓ Most sensitive peripheral nerves are first involved ↓ and thenmuscles, subcutaneous tissue and skin are affected in order. ↓ Irreversible ischaemiaoccurs in 6 hours. ↓ Golden period is 1–6 hours. ↓ Ischaemia may get aggravatedby ↓ propagationof thrombus below and abovethe block ↓ occluding the orifices of collaterals ↓
- 6. fragmentationof embolus, associatedthrombosis, acute compartment syndrome. • Acute ischaemia causes endothelial injuryof ↓ capillaries, arterioles and venules with luminal obliteration. ↓ Raisedcapillarypermeability causes fluid leakageinto extravascular space ↓ forming massive tissue oedema deepto deepfascia ↓ whichby raising the intracompartmental pressure ↓ further reduces the perfusionleading intoacute compartment syndrome.
- 7. CLINICALFEATURES • Painwhich is continuous, severe, steady, bursting. • Pallor of the distal part withextreme coldlimb. • Pulselessness—sudden loss of earlier palpable pulse. • Paraesthesia—sensory disturbances liketingling, numbness or complete loss of sensation. PATHOLOGY
- 8. • Paresis—damage to motor nerve and muscle leading into paralysis as a late grave feature. • Poikilothermia—changein thetemperature (cold). • Pain, paraesthesia, paresis are due to ischaemia of peripheral nerves which are sensitive to hypoxia.
- 9. DUETO TRAUMA/TRAUMATIC ACUTEARTERIAL OCCLUSION CAUSES • Thrombus due to trauma. • Subintimal haematoma. • Acute compartment syndrome. • During femoral or brachial arterial catheterisationfor either diagnosticor therapeutic procedures.
- 10. CLINICALFEATURES • Historyof trauma • Pain • Swelling at the site • Pallor • Pulselessness • Cold limb. INVESTIGATION • Duplex scan • Angiogram TREATMENT • Wound is exploredand tear in the artery is identified. • Proper antibiotics and heparin are required to prevent thrombosis of the vesseL ASSOCIAEDFEATURES • Immediate decompression by longitudinal fasciotomy • Haematoma • Vessel tear has to be managed accordingly
- 11. REFERENCE 1. SRB's Manual of Surgery by SriramBhat M 2. A Manual on Clinical Surgeryby Das 3. A Concise textbookof Surgeryby Das
- 12. A Special Thanks To A Very Special Doctor