Gastrostomie percutanee sous scopie
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This document discusses percutaneous gastrostomy, which is a procedure to place a feeding tube directly into the stomach through the abdominal wall. It lists indications such as chronic conditions requiring long-term nutritional support. Contraindications include gastric varices and total gastrectomy. The preparation involves informed consent, NG tube placement, oral contrast, IV access and analgesia. Potential complications are discussed, from major issues like infection and hemorrhage, to minor problems like wound infection or a dislodged tube. The procedure involves using ultrasound and glucagon to mark the stomach location, inflating the stomach with air, attaching a T-fastener for gastroplexy, inserting a guidewire using the Seldinger
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Gastrostomy
This document discusses percutaneous gastrostomy, a procedure to place a feeding tube directly into the stomach through the abdominal wall. It notes several conditions that may require long-term nutritional support via gastrostomy tube, including various cancers, neurological diseases, and swallowing disorders. The document outlines the indications, contraindications, and complications of the percutaneous gastrostomy procedure. It then describes the step-by-step process of performing the procedure, including patient preparation, ultrasound guidance, gastric distension, gastroplexy using T-fasteners, verification of tube placement, and securing the tube.
Esophageal diseases, Gastroesophageal reflux disease (GERD)
This document discusses various esophageal disorders including gastroesophageal reflux disease (GERD), achalasia, esophageal diverticula, and esophageal perforation. It provides details on the etiology, symptoms, diagnosis, and treatment of each condition. For example, it states that GERD is caused by an incompetent lower esophageal sphincter which allows gastric content to reflux, and that treatment involves lifestyle changes and medications like antacids, H2 blockers, or PPIs. Achalasia is defined by a hypertonic LES that does not relax, causing dysphagia and regurgitation. Its treatment includes dilation, botulinum toxin injection, or surgery.
GERD
This document discusses gastroesophageal reflux disease (GERD). GERD occurs when stomach contents backflow into the esophagus past the lower esophageal sphincter. Factors that can contribute to reflux include a low pressure LES, spontaneous LES relaxation, hiatal hernia, and gastric distension. Symptoms range from heartburn and regurgitation to respiratory complications. Diagnosis involves endoscopy, pH monitoring, esophageal manometry, and imaging. Treatment includes lifestyle modifications, proton pump inhibitors, and in some cases surgery such as Nissen fundoplication or other anti-reflux procedures. Complications of surgery include gas bloat and dysphagia.
Git perforation
- Perforation of the gastrointestinal tract can occur due to various causes like perforated ulcers, penetrating injuries, or ischemic bowel. Signs include severe abdominal pain, fever, and tenderness.
- Diagnosis is suggested by imaging showing free air or fluid in the abdomen. Treatment requires emergency surgery to repair any perforations followed by intensive care and broad-spectrum antibiotics to treat peritonitis.
- Surgical management involves thorough irrigation and drainage of the abdominal cavity followed by resection of non-viable bowel and primary anastomosis or stoma formation as needed. Close postoperative monitoring in the ICU is important to support organ function and detect any complications.
Small intestine perforation
Small intestine perforation- Easy ppt for student nurses
definition
causes
clinical manifestations
diagnostic tests
management of small intestine perforation
Perforation
This document describes the case of a 60-year-old female patient presenting with abdominal pain and distension. On examination, she showed signs of peritonitis. Investigations including ultrasound and x-ray revealed free fluid and free gas in the abdomen, suggestive of a hollow viscous perforation. She was diagnosed with a perforated peptic ulcer of the duodenum and underwent exploratory laparotomy and Graham's patch repair. Post-operatively, she improved with treatment and was discharged on the 12th day.
Approach, indications and surgical management of gerd 2
GERD is diagnosed clinically or with endoscopy and pH monitoring. Surgical options include laparoscopic Nissen fundoplication, which is the gold standard for treating failed medical management, complications, or large hiatal hernias. Complications include dysphagia, which can be reduced using a partial fundoplication or short wrap. Newer minimally invasive options include the LINX device and endoscopic fundoplication but long-term data is still emerging. Revisional surgery is an option for failed initial antireflux procedures.
Gastroesophageal reflux disease
This document provides an overview of gastroesophageal reflux disease (GERD). It defines GERD as symptoms or complications resulting from reflux of gastric contents into the esophagus. Approximately 15% of US adults are affected by GERD based on reports of chronic heartburn. The pathophysiology involves transient lower esophageal sphincter relaxations and impaired esophageal clearance allowing gastric acid and other contents to reflux into the esophagus and cause inflammation. Clinical manifestations include heartburn, regurgitation, dysphagia, and chest discomfort. Diagnostics include endoscopy, pH monitoring, and manometry. Differential diagnoses require excluding other causes of esophageal symptoms.
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Gastrostomy
This document discusses percutaneous gastrostomy, a procedure to place a feeding tube directly into the stomach through the abdominal wall. It notes several conditions that may require long-term nutritional support via gastrostomy tube, including various cancers, neurological diseases, and swallowing disorders. The document outlines the indications, contraindications, and complications of the percutaneous gastrostomy procedure. It then describes the step-by-step process of performing the procedure, including patient preparation, ultrasound guidance, gastric distension, gastroplexy using T-fasteners, verification of tube placement, and securing the tube.
Esophageal diseases, Gastroesophageal reflux disease (GERD)
This document discusses various esophageal disorders including gastroesophageal reflux disease (GERD), achalasia, esophageal diverticula, and esophageal perforation. It provides details on the etiology, symptoms, diagnosis, and treatment of each condition. For example, it states that GERD is caused by an incompetent lower esophageal sphincter which allows gastric content to reflux, and that treatment involves lifestyle changes and medications like antacids, H2 blockers, or PPIs. Achalasia is defined by a hypertonic LES that does not relax, causing dysphagia and regurgitation. Its treatment includes dilation, botulinum toxin injection, or surgery.
GERD
This document discusses gastroesophageal reflux disease (GERD). GERD occurs when stomach contents backflow into the esophagus past the lower esophageal sphincter. Factors that can contribute to reflux include a low pressure LES, spontaneous LES relaxation, hiatal hernia, and gastric distension. Symptoms range from heartburn and regurgitation to respiratory complications. Diagnosis involves endoscopy, pH monitoring, esophageal manometry, and imaging. Treatment includes lifestyle modifications, proton pump inhibitors, and in some cases surgery such as Nissen fundoplication or other anti-reflux procedures. Complications of surgery include gas bloat and dysphagia.
Git perforation
- Perforation of the gastrointestinal tract can occur due to various causes like perforated ulcers, penetrating injuries, or ischemic bowel. Signs include severe abdominal pain, fever, and tenderness.
- Diagnosis is suggested by imaging showing free air or fluid in the abdomen. Treatment requires emergency surgery to repair any perforations followed by intensive care and broad-spectrum antibiotics to treat peritonitis.
- Surgical management involves thorough irrigation and drainage of the abdominal cavity followed by resection of non-viable bowel and primary anastomosis or stoma formation as needed. Close postoperative monitoring in the ICU is important to support organ function and detect any complications.
Small intestine perforation
Small intestine perforation- Easy ppt for student nurses
definition
causes
clinical manifestations
diagnostic tests
management of small intestine perforation
Perforation
This document describes the case of a 60-year-old female patient presenting with abdominal pain and distension. On examination, she showed signs of peritonitis. Investigations including ultrasound and x-ray revealed free fluid and free gas in the abdomen, suggestive of a hollow viscous perforation. She was diagnosed with a perforated peptic ulcer of the duodenum and underwent exploratory laparotomy and Graham's patch repair. Post-operatively, she improved with treatment and was discharged on the 12th day.
Approach, indications and surgical management of gerd 2
GERD is diagnosed clinically or with endoscopy and pH monitoring. Surgical options include laparoscopic Nissen fundoplication, which is the gold standard for treating failed medical management, complications, or large hiatal hernias. Complications include dysphagia, which can be reduced using a partial fundoplication or short wrap. Newer minimally invasive options include the LINX device and endoscopic fundoplication but long-term data is still emerging. Revisional surgery is an option for failed initial antireflux procedures.
Gastroesophageal reflux disease
This document provides an overview of gastroesophageal reflux disease (GERD). It defines GERD as symptoms or complications resulting from reflux of gastric contents into the esophagus. Approximately 15% of US adults are affected by GERD based on reports of chronic heartburn. The pathophysiology involves transient lower esophageal sphincter relaxations and impaired esophageal clearance allowing gastric acid and other contents to reflux into the esophagus and cause inflammation. Clinical manifestations include heartburn, regurgitation, dysphagia, and chest discomfort. Diagnostics include endoscopy, pH monitoring, and manometry. Differential diagnoses require excluding other causes of esophageal symptoms.
Rectal bleeding, colon cancer
A 59-year-old female presented with severe rectal bleeding for 3 days. She has a history of hypertension, diabetes, and hemorrhoid surgery. On examination, she was dehydrated and in pain. Investigation showed possible colorectal cancer. She received IV fluids, pain medication, and antibiotics for acute management and may require surgery, chemotherapy, or radiotherapy. Colorectal cancer can be several types and screening is recommended for those with risk factors or family history. Staging helps determine treatment and prognosis.
Ge Rd
This document discusses gastroesophageal reflux disease (GERD), including its symptoms, complications, diagnosis, and treatment options. It notes that GERD affects 44% of Americans monthly and outlines lifestyle modifications, medications like antacids, H2 blockers, and proton pump inhibitors, as well as surgical treatments including Nissen fundoplication. Newer endoscopic therapies beyond medications are also mentioned for treatment of refractory GERD cases.
Esophageal disease
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GERD,UNDERSTANDING
GERD IS A COMMON CLINICAL PRESENTATION. SOME DETAILS ABOUT BASIC UNDERSTANDING OF GERD AND ITS MANAGEMENT
GERD
Mr. Sankappa
Definition
Gastro esophageal reflux disease is a chronic and relapsing condition in which prolonged reflux of hydrochloric acid, pepsin and bile salts in the esophagus, oral cavity and respiratory system occurs that leads to esophagitis
Excessive intake of junk foods, coffee, chocolate
Excessive intake of onion, tomato, and beverages
Heavy exercise
Alcoholic and smoking
Medications
Heartburn
Discomfort
Chest pain
Difficulty in respiration
Aspiration pneumonia
After endoscopy the lesions are graded for severity using the Savary Miller grading system;
Grade 1: single or multiple erosions on a single fold.
Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.
Grade 3: multiple circumferential or rounded erosions.
Grade 4: ulcer, stenosis or esophageal shortening.
Grade 5: Barrett's epithelium. Columnar metaplasia (cellular changes on the microscopic level) in the form of circular or non-circular (islands or tongues) extensions.
Pathophysiology
Management
Antacids: An antacid is a substance which neutralizes stomach acidity, used to relieve heartburn, indigestion or an upset stomach (ex: Rantac, Zantac)
H2receptor antagonist: H2 antagonists block histamine-induced gastric acid secretion from the parietal cells of the gastric mucosa. They include cimetidine, famotidine, nizatidine
Proton Pump Inhibitors: Proton pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid (Omeprazole, Rabeprazole, pantoprazole)
Cholinergic drugs:Cholinergic drug, any of various drugs that inhibit, enhance, or mimic the action of the neurotransmitter (acetylcholine, carbachol, methacholine)
Cytoprotective drugs: is a process by which chemical compounds provide protection to cells against harmful agents (carbenoxolone, sucralfate, misoprostol)
Prokinetic drugs: prokinetic, is a type of drug which enhances gastrointestinal motility by increasing the frequency of contractions in the small intestine or making them stronger, but without disrupting their rhythm. (Benzamide, Cisapride, Domperidone).
Endoscopic intraluminal valvuloplasty
Gastric tissue is utilised to increase the integrity of LES By creating a valve like structure.
Peritonitis NCM 103
Peritonitis is inflammation of the peritoneum lining the abdominal cavity. It is usually caused by a rupture or perforation of the stomach, intestine, appendix, or gallbladder. Clinical manifestations include diffuse abdominal pain, tenderness, fever, nausea, and vomiting. Diagnosis involves blood tests, imaging tests like ultrasound or CT scan, and diagnostic paracentesis. Treatment consists of intravenous antibiotics, fluid resuscitation, pain management, and sometimes surgery to repair damaged organs. Nursing focuses on monitoring vital signs and fluid balance, administering medications, providing comfort, and assessing for resolution of symptoms.
Surgeries of thorax
This document discusses various thoracic surgeries including those of the bony cage, esophagus, thymus, lungs, pleura, pericardium, heart, and aorta. It covers topics like chest wall deformities and hernias, thoracic outlet syndrome, chest wall tumors, reconstruction after chest wall defects, congenital diaphragmatic hernia repair, surgeries for esophageal disorders like achalasia and GERD, esophagectomy, and thymectomy. The various procedures are described along with their indications, techniques, and potential complications.
GERD 8-16
This document discusses gastroesophageal reflux disease (GERD). It summarizes that GERD is caused by disruption of the gastroesophageal junction barrier that allows abnormal reflux. Symptoms include heartburn and regurgitation but can also include other atypical symptoms. Treatment involves lifestyle modifications, medications like PPIs, and possibly surgery for refractory cases. The standard is to start with minimal treatment and increase as needed or start with high dose PPI and titrate down to find the effective maintenance level. The goal is to control symptoms, heal damage, prevent recurrence and complications like esophageal cancer from long term reflux damage.
Gastro-oesophageal reflux (GORD)
This document discusses gastroesophageal reflux disease (GORD). It defines key terms like hiatal hernia and Barrett's esophagus. It covers the epidemiology, pathophysiology, risk factors, diagnosis and treatment of GORD. Regarding treatment, it discusses lifestyle modifications, medical options like PPIs, and surgical interventions. It emphasizes that PPIs are the most effective medical treatment for healing esophagitis and relieving symptoms of GORD. Investigation with endoscopy, pH monitoring, and manometry is recommended for patients who fail to respond to initial treatment or have concerning symptoms.
Surgery for GERD
The document discusses surgical treatments for gastroesophageal reflux disease (GERD) and achalasia performed by surgeons at Beth Israel Medical Center, including minimally invasive procedures like laparoscopic fundoplication and myotomy which provide relief for patients with these conditions. It also provides an overview of the general surgery division and some of the conditions they treat ranging from hernias and gallbladder disease to obesity and trauma.
Gerd
Gastroesophageal reflux disease (GERD) affects over 60 million Americans and is commonly diagnosed and treated by family physicians. GERD is defined as reflux of stomach contents into the esophagus, causing symptoms like heartburn and acid regurgitation. Proton pump inhibitors (PPIs) are highly effective at relieving GERD symptoms and different PPIs provide similar relief. Long-term PPI use may be associated with complications like hypomagnesemia, hip fractures, and pneumonia. Endoscopy is useful for diagnosing GERD complications but not sensitive for diagnosing GERD itself. Surgery should be reserved for severe cases that are poorly controlled by lifestyle changes and high doses
Neutropenic colitis, Typhlitis
Neutropenic colitis, also known as typhlitis, is characterized by ileocolonic inflammation in immunosuppressed patients with neutropenia, fever, and abdominal pain. It is most commonly seen in patients with hematologic malignancies or following chemotherapy and is caused by bacterial translocation during neutropenia. Clinical presentation includes gastrointestinal symptoms like abdominal pain in addition to fever. Diagnosis involves imaging showing bowel wall thickening as well as ruling out other causes. Management is usually conservative involving antibiotics, bowel rest, and correction of neutropenia, though surgery may be needed for complications like perforation.
GASTROINTESTINAL REFLUX DISEASE (GERD)
This document discusses Gastroesophageal Reflux Disease (GERD). It defines GERD as refluxed stomach contents entering the esophagus or beyond, causing symptoms or complications. The document discusses the epidemiology, anatomy, mechanisms of reflux, etiology, pathophysiology, clinical manifestations, diagnostic evaluation and treatment approaches for GERD, including lifestyle modifications, medications like PPIs, and surgical procedures. The goals of treatment are to alleviate symptoms, decrease reflux frequency and promote healing of injured mucosa.
46 gas in the bowel wall (pneumatosis
Pneumatosis intestinalis is a condition where gas forms in the wall of the intestines. The document discusses four cases - an asymptomatic man with primary pneumatosis intestinalis, a premature infant with necrotizing enterocolitis where gas appears in the diseased colon, a case due to mesenteric arterial thrombosis, and a patient with severe pyloric stenosis where pneumatosis involved the colon. The figures show x-ray and CT scan images of the different cases of pneumatosis intestinalis.
A.P.D. presentation by Prof.JaAkram
This document discusses new perspectives on the management of peptic ulcer disease. It defines a peptic ulcer and common misconceptions. It also discusses the diagnosis of H. pylori infection, complications of peptic ulcers such as bleeding, and treatment approaches including eradicating H. pylori and using sucralfate or proton pump inhibitors. Sucralfate is highlighted as a non-systemic, cytoprotective drug for acid-related disorders that has fewer side effects and is more effective for healing chronic erosive gastritis compared to cimetidine.
Gastroesophageal reflux disease
This document provides an overview of gastroesophageal reflux disease (GERD). It begins with phenotypic classifications of GERD and discusses the Montreal definition. It then covers the pathogenesis of GERD including antireflux mechanisms, gastric factors, esophageal clearance mechanisms, and esophageal epithelial resistance. The document discusses the clinical presentation of GERD and diagnostic tests including endoscopic examination, pH monitoring, and testing. It concludes with an overview of treatment approaches including pharmacologic therapy, antireflux surgery, and endoscopic antireflux procedures.
Gastroesophageal Reflux Disease (GERD)
GERD is caused by backflow of gastric contents into the esophagus due to lower esophageal sphincter dysfunction. It commonly causes heartburn and can lead to complications like esophagitis and Barrett's esophagus. Treatment involves lifestyle modifications, medications like antacids, H2 blockers, and PPIs. Surgery to reinforce the LES may be needed in severe cases. Nursing focuses on pain management, dietary changes, medication administration, and education on GERD and its treatment.
GERD & Asthma
GERD, or gastroesophageal reflux disease, is a common condition where stomach contents flow back up into the esophagus. It is the most common disease seen by gastroenterologists. While occasional reflux is normal, GERD is characterized by troublesome symptoms or complications that negatively impact quality of life. The primary symptom is heartburn, though some patients experience atypical symptoms. Diagnosis is usually made based on symptoms, though testing can be used to confirm the diagnosis or assess for complications. Treatment involves lifestyle modifications, medications like PPIs, and possibly surgery for severe cases.
benign esophagus disorder
This document discusses benign disorders of the esophagus, focusing on GERD (gastroesophageal reflux disease). It covers the epidemiology, pathophysiology, symptoms, diagnostic tests and treatment options for GERD. Regarding treatment, lifestyle modifications and medications like antacids, H2 blockers, and proton pump inhibitors are discussed as first-line options. Endoscopic treatments and anti-reflux surgery are also mentioned.
Complications of-peptic-ulcer
Perforated peptic ulcers commonly occur in middle-aged patients, often due to smoking and NSAID use. Symptoms include sudden severe abdominal pain. Diagnosis involves chest X-ray showing free air or CT scan. Treatment is surgical closure of the perforation along with antibiotics. Upper GI bleeding treatment involves resuscitation, diagnosis via endoscopy, and treatment of the bleeding source, such as ulcers. Gastric outlet obstruction is usually due to peptic ulcer disease or gastric cancer, causing non-bilious vomiting, weight loss, and metabolic abnormalities like hypochloremic alkalosis. Treatment involves rehydration, gastric decompression, investigation of the cause, and sometimes surgical gastroenterostomy.
Peg Feeding
PEG is a surgical procedure where a feeding tube is placed through the abdomen into the stomach using an endoscope, avoiding open abdominal surgery. It is used for patients unable to eat for a prolonged period. A gastrostomy is created through the skin and stomach using the endoscope to guide placement of the feeding tube. PEG is performed to provide nutrition to patients who cannot swallow food and is done by physicians like surgeons, ENT specialists, radiologists or gastroenterologists, often in outpatient settings. It has advantages over surgical gastrostomy in taking less time, carrying less risk and costing less.
Peg Feeding
This document provides information on caring for and potential complications of a PEG tube. It describes routinely cleaning and rotating the tube to prevent adherence. Potential immediate complications within 72 hours include hemorrhage, perforation, aspiration or oversedation from the endoscopy, as well as ileus, pneumoperitoneum or wound issues. Delayed complications can include gastric outlet obstruction, buried bumper syndrome, dislodged or blocked tubes, or infections. PEG tubes should be removed if no longer needed, for persistent infections, or failure/deterioration, and the method depends on the tube type.
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A 59-year-old female presented with severe rectal bleeding for 3 days. She has a history of hypertension, diabetes, and hemorrhoid surgery. On examination, she was dehydrated and in pain. Investigation showed possible colorectal cancer. She received IV fluids, pain medication, and antibiotics for acute management and may require surgery, chemotherapy, or radiotherapy. Colorectal cancer can be several types and screening is recommended for those with risk factors or family history. Staging helps determine treatment and prognosis.
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This document discusses gastroesophageal reflux disease (GERD), including its symptoms, complications, diagnosis, and treatment options. It notes that GERD affects 44% of Americans monthly and outlines lifestyle modifications, medications like antacids, H2 blockers, and proton pump inhibitors, as well as surgical treatments including Nissen fundoplication. Newer endoscopic therapies beyond medications are also mentioned for treatment of refractory GERD cases.
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esophagitis,sclerederma,achalsia,plummer vinxon,hiatal hernia, diffuse esophageal spasm, esophageal cancer,boaerhave,perforation...
GERD,UNDERSTANDING
GERD IS A COMMON CLINICAL PRESENTATION. SOME DETAILS ABOUT BASIC UNDERSTANDING OF GERD AND ITS MANAGEMENT
GERD
Mr. Sankappa
Definition
Gastro esophageal reflux disease is a chronic and relapsing condition in which prolonged reflux of hydrochloric acid, pepsin and bile salts in the esophagus, oral cavity and respiratory system occurs that leads to esophagitis
Excessive intake of junk foods, coffee, chocolate
Excessive intake of onion, tomato, and beverages
Heavy exercise
Alcoholic and smoking
Medications
Heartburn
Discomfort
Chest pain
Difficulty in respiration
Aspiration pneumonia
After endoscopy the lesions are graded for severity using the Savary Miller grading system;
Grade 1: single or multiple erosions on a single fold.
Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.
Grade 3: multiple circumferential or rounded erosions.
Grade 4: ulcer, stenosis or esophageal shortening.
Grade 5: Barrett's epithelium. Columnar metaplasia (cellular changes on the microscopic level) in the form of circular or non-circular (islands or tongues) extensions.
Pathophysiology
Management
Antacids: An antacid is a substance which neutralizes stomach acidity, used to relieve heartburn, indigestion or an upset stomach (ex: Rantac, Zantac)
H2receptor antagonist: H2 antagonists block histamine-induced gastric acid secretion from the parietal cells of the gastric mucosa. They include cimetidine, famotidine, nizatidine
Proton Pump Inhibitors: Proton pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid (Omeprazole, Rabeprazole, pantoprazole)
Cholinergic drugs:Cholinergic drug, any of various drugs that inhibit, enhance, or mimic the action of the neurotransmitter (acetylcholine, carbachol, methacholine)
Cytoprotective drugs: is a process by which chemical compounds provide protection to cells against harmful agents (carbenoxolone, sucralfate, misoprostol)
Prokinetic drugs: prokinetic, is a type of drug which enhances gastrointestinal motility by increasing the frequency of contractions in the small intestine or making them stronger, but without disrupting their rhythm. (Benzamide, Cisapride, Domperidone).
Endoscopic intraluminal valvuloplasty
Gastric tissue is utilised to increase the integrity of LES By creating a valve like structure.
Peritonitis NCM 103
Peritonitis is inflammation of the peritoneum lining the abdominal cavity. It is usually caused by a rupture or perforation of the stomach, intestine, appendix, or gallbladder. Clinical manifestations include diffuse abdominal pain, tenderness, fever, nausea, and vomiting. Diagnosis involves blood tests, imaging tests like ultrasound or CT scan, and diagnostic paracentesis. Treatment consists of intravenous antibiotics, fluid resuscitation, pain management, and sometimes surgery to repair damaged organs. Nursing focuses on monitoring vital signs and fluid balance, administering medications, providing comfort, and assessing for resolution of symptoms.
Surgeries of thorax
This document discusses various thoracic surgeries including those of the bony cage, esophagus, thymus, lungs, pleura, pericardium, heart, and aorta. It covers topics like chest wall deformities and hernias, thoracic outlet syndrome, chest wall tumors, reconstruction after chest wall defects, congenital diaphragmatic hernia repair, surgeries for esophageal disorders like achalasia and GERD, esophagectomy, and thymectomy. The various procedures are described along with their indications, techniques, and potential complications.
GERD 8-16
This document discusses gastroesophageal reflux disease (GERD). It summarizes that GERD is caused by disruption of the gastroesophageal junction barrier that allows abnormal reflux. Symptoms include heartburn and regurgitation but can also include other atypical symptoms. Treatment involves lifestyle modifications, medications like PPIs, and possibly surgery for refractory cases. The standard is to start with minimal treatment and increase as needed or start with high dose PPI and titrate down to find the effective maintenance level. The goal is to control symptoms, heal damage, prevent recurrence and complications like esophageal cancer from long term reflux damage.
Gastro-oesophageal reflux (GORD)
This document discusses gastroesophageal reflux disease (GORD). It defines key terms like hiatal hernia and Barrett's esophagus. It covers the epidemiology, pathophysiology, risk factors, diagnosis and treatment of GORD. Regarding treatment, it discusses lifestyle modifications, medical options like PPIs, and surgical interventions. It emphasizes that PPIs are the most effective medical treatment for healing esophagitis and relieving symptoms of GORD. Investigation with endoscopy, pH monitoring, and manometry is recommended for patients who fail to respond to initial treatment or have concerning symptoms.
Surgery for GERD
The document discusses surgical treatments for gastroesophageal reflux disease (GERD) and achalasia performed by surgeons at Beth Israel Medical Center, including minimally invasive procedures like laparoscopic fundoplication and myotomy which provide relief for patients with these conditions. It also provides an overview of the general surgery division and some of the conditions they treat ranging from hernias and gallbladder disease to obesity and trauma.
Gerd
Gastroesophageal reflux disease (GERD) affects over 60 million Americans and is commonly diagnosed and treated by family physicians. GERD is defined as reflux of stomach contents into the esophagus, causing symptoms like heartburn and acid regurgitation. Proton pump inhibitors (PPIs) are highly effective at relieving GERD symptoms and different PPIs provide similar relief. Long-term PPI use may be associated with complications like hypomagnesemia, hip fractures, and pneumonia. Endoscopy is useful for diagnosing GERD complications but not sensitive for diagnosing GERD itself. Surgery should be reserved for severe cases that are poorly controlled by lifestyle changes and high doses
Neutropenic colitis, Typhlitis
Neutropenic colitis, also known as typhlitis, is characterized by ileocolonic inflammation in immunosuppressed patients with neutropenia, fever, and abdominal pain. It is most commonly seen in patients with hematologic malignancies or following chemotherapy and is caused by bacterial translocation during neutropenia. Clinical presentation includes gastrointestinal symptoms like abdominal pain in addition to fever. Diagnosis involves imaging showing bowel wall thickening as well as ruling out other causes. Management is usually conservative involving antibiotics, bowel rest, and correction of neutropenia, though surgery may be needed for complications like perforation.
GASTROINTESTINAL REFLUX DISEASE (GERD)
This document discusses Gastroesophageal Reflux Disease (GERD). It defines GERD as refluxed stomach contents entering the esophagus or beyond, causing symptoms or complications. The document discusses the epidemiology, anatomy, mechanisms of reflux, etiology, pathophysiology, clinical manifestations, diagnostic evaluation and treatment approaches for GERD, including lifestyle modifications, medications like PPIs, and surgical procedures. The goals of treatment are to alleviate symptoms, decrease reflux frequency and promote healing of injured mucosa.
46 gas in the bowel wall (pneumatosis
Pneumatosis intestinalis is a condition where gas forms in the wall of the intestines. The document discusses four cases - an asymptomatic man with primary pneumatosis intestinalis, a premature infant with necrotizing enterocolitis where gas appears in the diseased colon, a case due to mesenteric arterial thrombosis, and a patient with severe pyloric stenosis where pneumatosis involved the colon. The figures show x-ray and CT scan images of the different cases of pneumatosis intestinalis.
A.P.D. presentation by Prof.JaAkram
This document discusses new perspectives on the management of peptic ulcer disease. It defines a peptic ulcer and common misconceptions. It also discusses the diagnosis of H. pylori infection, complications of peptic ulcers such as bleeding, and treatment approaches including eradicating H. pylori and using sucralfate or proton pump inhibitors. Sucralfate is highlighted as a non-systemic, cytoprotective drug for acid-related disorders that has fewer side effects and is more effective for healing chronic erosive gastritis compared to cimetidine.
Gastroesophageal reflux disease
This document provides an overview of gastroesophageal reflux disease (GERD). It begins with phenotypic classifications of GERD and discusses the Montreal definition. It then covers the pathogenesis of GERD including antireflux mechanisms, gastric factors, esophageal clearance mechanisms, and esophageal epithelial resistance. The document discusses the clinical presentation of GERD and diagnostic tests including endoscopic examination, pH monitoring, and testing. It concludes with an overview of treatment approaches including pharmacologic therapy, antireflux surgery, and endoscopic antireflux procedures.
Gastroesophageal Reflux Disease (GERD)
GERD is caused by backflow of gastric contents into the esophagus due to lower esophageal sphincter dysfunction. It commonly causes heartburn and can lead to complications like esophagitis and Barrett's esophagus. Treatment involves lifestyle modifications, medications like antacids, H2 blockers, and PPIs. Surgery to reinforce the LES may be needed in severe cases. Nursing focuses on pain management, dietary changes, medication administration, and education on GERD and its treatment.
GERD & Asthma
GERD, or gastroesophageal reflux disease, is a common condition where stomach contents flow back up into the esophagus. It is the most common disease seen by gastroenterologists. While occasional reflux is normal, GERD is characterized by troublesome symptoms or complications that negatively impact quality of life. The primary symptom is heartburn, though some patients experience atypical symptoms. Diagnosis is usually made based on symptoms, though testing can be used to confirm the diagnosis or assess for complications. Treatment involves lifestyle modifications, medications like PPIs, and possibly surgery for severe cases.
benign esophagus disorder
This document discusses benign disorders of the esophagus, focusing on GERD (gastroesophageal reflux disease). It covers the epidemiology, pathophysiology, symptoms, diagnostic tests and treatment options for GERD. Regarding treatment, lifestyle modifications and medications like antacids, H2 blockers, and proton pump inhibitors are discussed as first-line options. Endoscopic treatments and anti-reflux surgery are also mentioned.
Complications of-peptic-ulcer
Perforated peptic ulcers commonly occur in middle-aged patients, often due to smoking and NSAID use. Symptoms include sudden severe abdominal pain. Diagnosis involves chest X-ray showing free air or CT scan. Treatment is surgical closure of the perforation along with antibiotics. Upper GI bleeding treatment involves resuscitation, diagnosis via endoscopy, and treatment of the bleeding source, such as ulcers. Gastric outlet obstruction is usually due to peptic ulcer disease or gastric cancer, causing non-bilious vomiting, weight loss, and metabolic abnormalities like hypochloremic alkalosis. Treatment involves rehydration, gastric decompression, investigation of the cause, and sometimes surgical gastroenterostomy.
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Peg Feeding
PEG is a surgical procedure where a feeding tube is placed through the abdomen into the stomach using an endoscope, avoiding open abdominal surgery. It is used for patients unable to eat for a prolonged period. A gastrostomy is created through the skin and stomach using the endoscope to guide placement of the feeding tube. PEG is performed to provide nutrition to patients who cannot swallow food and is done by physicians like surgeons, ENT specialists, radiologists or gastroenterologists, often in outpatient settings. It has advantages over surgical gastrostomy in taking less time, carrying less risk and costing less.
Peg Feeding
This document provides information on caring for and potential complications of a PEG tube. It describes routinely cleaning and rotating the tube to prevent adherence. Potential immediate complications within 72 hours include hemorrhage, perforation, aspiration or oversedation from the endoscopy, as well as ileus, pneumoperitoneum or wound issues. Delayed complications can include gastric outlet obstruction, buried bumper syndrome, dislodged or blocked tubes, or infections. PEG tubes should be removed if no longer needed, for persistent infections, or failure/deterioration, and the method depends on the tube type.
Intraosseous
1. Intraosseous (IO) access involves inserting a needle into the bone marrow cavity to provide vascular access for fluid or drug administration when intravenous access is not possible.
2. IO access was first reported in 1922 and is now widely accepted for use in both children and adults with difficult venous access. It provides a reliable route for drug delivery similar to intravenous administration.
3. IO access has several advantages over other emergency vascular access methods in that it is quick to perform, effective, can be used at multiple insertion sites, and has fewer complications than a central venous catheter.
Newborn Resuscitation Program
This document summarizes newborn resuscitation procedures. It outlines that most newborns do not require assistance, while about 10% need some help and 1% need major resuscitative measures. It describes evaluating the newborn after birth to determine if resuscitation is needed. Steps include providing warmth, clearing the airway, and tactile stimulation. Positive-pressure ventilation is indicated if the heart rate is low or cyanosis is present. Chest compressions are performed if the heart rate remains low despite ventilation. Epinephrine may be given via the umbilical vein if the heart rate does not improve after 60 seconds of coordinated compressions and ventilation.
Usg guided FNA biopsy
A step by step approach to one of the most important interventional procedure with pictorial depictions.
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This document provides information on percutaneous endoscopic gastrostomy (PEG) and jejunostomy procedures. It describes how PEG involves passing a feeding tube through the abdominal wall and into the stomach, and the indications for its use including when oral feeding is not adequate. Complications of PEG are outlined. Jejunostomy involves creating an opening from the abdomen directly into the jejunum, part of the small intestine, and its techniques and uses are discussed.
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This document provides guidance on oropharyngeal, nasopharyngeal, and tracheal suctioning. It discusses the purposes of suctioning, including removing secretions to clear the airway and facilitate ventilation. Assessment factors like respiratory sounds and oxygen saturation are outlined. Proper planning includes delegation considerations and sterile technique for some procedures. Equipment needs and step-by-step implementation instructions are detailed for oral/oropharyngeal and nasopharyngeal/nasotracheal suctioning. Positioning, catheter insertion depth, and suction pressure levels are addressed.
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Gastrostomy is a surgical opening made in the stomach to allow for placement of a feeding tube. It is indicated for patients who require prolonged tube feeding for over 4 weeks due to conditions such as neurological swallowing disorders, esophageal cancer, or gastric outlet obstruction. There are two main types - open gastrostomy involving surgical incision and percutaneous endoscopic gastrostomy (PEG) which is performed endoscopically. Complications can include infection, hemorrhage, leakage or displacement of the tube. Gastrostomy allows for safe enteral feeding in patients with poor oral intake who have a functional gastrointestinal system.
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NGT handouts
Nasogastric tubes are inserted through the nose to deliver nutrition or medication to the stomach. Proper measurement and placement is important to prevent injury. Feeding is administered slowly through a syringe or pump. Special care is needed for infants, children, and elders. Complications include vomiting, aspiration, and tube displacement. Proper documentation is required.
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Bone marrow class
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Bonne marrow aspiration and intra osseous injection
Bone marrow aspiration is a medical procedure where bone marrow is removed to examine for diseases like leukemia or infections. It can be used diagnostically to detect conditions or therapeutically to administer medications. It should not be done if the patient has a skin infection, bone disorder, or bleeding disorder. Intra-osseous injection provides intravenous access by directly injecting into the bone marrow when standard IV access is not possible. It is indicated for conditions like collapse or when IV cannot be established, especially in young children or burns patients. Contraindications include osteoporosis, vascular injuries, infections or fractures near the injection site.
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Oropharyngeal , nasopharyngeal and naso tracheal suctioning
Oropharyngeal , nasopharyngeal and naso tracheal suctioning
Medication Administration and Calculation for Nurses Returning to Practice
Medication Administration and Calculation for Nurses Returning to Practice
Bonne marrow aspiration and intra osseous injection
Bonne marrow aspiration and intra osseous injection
Similar to Gastrostomie percutanee sous scopie
Gastrostomiepercutaneesousscopie
This document discusses percutaneous gastrostomy, a procedure to place a feeding tube directly into the stomach through the abdominal wall. It notes several conditions that may require long-term nutritional support via gastrostomy tube, including various cancers, neurological diseases, and swallowing disorders. The document outlines the indications, contraindications, and complications of the percutaneous gastrostomy procedure. It then describes the step-by-step process of performing the procedure, including patient preparation, ultrasound guidance, gastric distension, gastroplexy using T-fasteners, verification of tube placement, and securing the tube.
Ng tube insertion
This document discusses nasogastric tube insertion. It provides indications for NG tube insertion including for diagnostic evaluation of upper GI bleeding and administration of medications or feeding. Therapeutic uses include gastric decompression and relief of small bowel obstruction symptoms. Contraindications include severe midface trauma, recent nasal surgery, and esophageal varices. The document outlines the equipment, patient preparation, insertion technique, complications, and confirmation of proper placement.
Enteral nutrition method
1. The document discusses various enteral feeding methods including nasogastric tubes, nasojejunal tubes, percutaneous endoscopic gastrostomy (PEG) tubes, radiologically placed gastrostomy tubes, and jejunostomy tubes.
2. It describes the indications, contraindications, techniques, advantages, and complications of each method. PEG tubes are the most common method for long-term enteral access beyond 4-6 weeks while NG and NJ tubes are used for short-term feedings.
3. Access methods are chosen based on factors like the patient's condition, prognosis, ability to tolerate different sites of feeding, and risk of complications. Overall the document provides an overview
My presentation1
A 77-year-old female presented with progressive dysphagia and chest pain and was found to have a large paraesophageal hernia; she underwent a laparoscopic paraesophageal hernial repair with gastropexy and had an uneventful postoperative course with resolution of her symptoms. Paraesophageal hernias are rare types of hiatal hernias that can cause symptoms from GERD to obstruction and require surgical repair to prevent complications like strangulation.
TOPICS TPN (Total Parenteral Nutrition)I Nasogastric Tube Insertion Nasogastr...
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TPN (Total Parenteral Nutrition)I Nasogastric Tube Insertion Nasogastric Tube Feeding Nasogastric Tube Removal Gastrostomy Care
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This document provides an overview of dysphagia (difficulty swallowing) including the anatomy, physiology of swallowing, types, causes, and approach to dysphagia. It discusses the physiology of deglutition controlled by the parasympathetic and sympathetic nervous systems. It describes the different phases of swallowing. There are two main types of dysphagia - oropharyngeal and esophageal. Oropharyngeal dysphagia can be caused by structural issues, problems with propulsion, or neurogenic/myogenic issues. Esophageal dysphagia can be caused by extra luminal issues, problems in the esophageal wall, or issues in the esophageal lumen. The document outlines the approach
dysphagia.pptx
Dysphagia refers to difficulty swallowing and can affect any part of the swallowing pathway. There are two main types - oropharyngeal dysphagia where food gets stuck in the mouth or throat, and esophageal dysphagia where food gets stuck in the lower throat or chest. Dysphagia has many potential causes including neurological issues, infections, inflammation, tumors, and motility disorders of the esophagus. Evaluation involves a thorough history and physical exam as well as tests like barium swallow, endoscopy, and manometry. Zenker's diverticulum is a common esophageal diverticulum that can cause dysphagia, and treatment options include an external surgical approach
management of gastro-esophageal reflux disease
1) Gastroesophageal reflux disease (GERD) occurs when stomach contents back up into the esophagus or beyond, causing troublesome symptoms or complications.
2) Diagnosis is confirmed by endoscopic findings of erosive esophagitis or positive pH monitoring, showing abnormal acid exposure in the esophagus.
3) Treatment involves lifestyle changes and medication. Surgery is considered for patients with severe, refractory GERD or complications like strictures. The most common anti-reflux surgery is laparoscopic Nissen fundoplication, which has high success rates but risks dysphagia.
Esophageal injury
This document discusses esophageal injury, including its anatomy, causes, symptoms, diagnosis and management. The esophagus extends from the pharynx to the stomach. Injuries are often caused by medical procedures but can also result from trauma or spontaneous rupture. Symptoms vary depending on the location but may include chest pain, vomiting and subcutaneous emphysema. Diagnosis involves imaging and endoscopy. Treatment depends on factors like timing and location but typically involves antibiotics, nil by mouth, drainage and sometimes stents or surgery to repair the injury. Outcomes are best when treatment begins quickly but morbidity and mortality remain high if sepsis develops.
Duodenal atresia
Duodenal atresia is a common cause of intestinal obstruction in neonates, occurring in about 1 in 5,000-10,000 live births. It results from a failure of recanalization of the fetal duodenum, leading to a complete obstruction. Clinically, it presents with bilious vomiting within the first few hours of life. Diagnosis involves finding the classic "double bubble" sign on abdominal x-ray. Surgical treatment involves reconstructing bowel continuity, usually via a diamond-shaped duodenoduodenostomy. With proper management, over 95% of patients will recover successfully from duodenal atresia.
Nasogastric Tube.pptx
Document removal in chart including:
- Date and time of removal
- Condition of nares on removal
- Patient tolerance and comfort level
- Instructions provided to patient
Veterinary Gastrointestinal surgery Part-II
This document discusses gastric dilatation-volvulus (GDV), also known as gastric torsion, in dogs. It covers the pathophysiology of GDV, clinical signs, diagnosis using radiography, preoperative care including decompression, and surgical correction procedures such as derotating the stomach and gastropexy to prevent future episodes. GDV is a life-threatening condition where the stomach dilates and rotates on its axis, causing shock and gastric necrosis if not promptly treated.
Pancreatitis
Pancreatitis is an inflammation of the pancreas that can be acute or chronic. Acute pancreatitis involves reversible injury to the pancreas and can range from mild to severe, with severe cases involving organ failure. Chronic pancreatitis is characterized by irreversible damage to the pancreas that typically causes pain and loss of pancreatic function over time. Treatment for acute pancreatitis depends on severity and may involve hospitalization, IV fluids, monitoring for organ failure, and antibiotics for severe cases. Treatment for chronic pancreatitis focuses on pain management, treating complications, and sometimes surgical interventions.
Gastrostomy
gastrostomy, enteral feeding, stamm's, janeway, PEG, indications and contraindications of gastrostomy.
DYSPHAGIA (1).ppt
Dysphagia is difficulty swallowing that can affect any part of the swallowing pathway from the mouth to the stomach. It is commonly seen in ENT clinics and may have oropharyngeal or esophageal causes. Common oropharyngeal causes include neurological disorders, while common esophageal causes include GERD, motility disorders like achalasia, and malignancies. Evaluation involves history, examination, barium swallow, endoscopy, and manometry. Treatment depends on the underlying cause but may include dilation, myotomy, stenting, chemotherapy, or radiation. Palliative measures are often needed for advanced or incurable esophageal cancer.
Dysphagia
Dysphagia is difficulty swallowing that can affect any part of the swallowing pathway from the mouth to the stomach. It is commonly seen in ENT clinics. There are two main types - oropharyngeal dysphagia involving preparation and transport of food in the mouth and throat, and esophageal dysphagia with food sticking in the lower throat or chest. Causes vary by age from foreign bodies in children to malignancy in the elderly. Evaluation involves history, examination, barium swallow, endoscopy and manometry. Treatment depends on the underlying cause but may include dilation, stenting or surgery.
Nasogastric intubation
The document discusses nasogastric intubation, which involves inserting a plastic tube through the nose and down into the stomach. It describes the gastrointestinal tract and its functions. Nasogastric intubation is used to treat conditions like intestinal obstruction, vomiting, and drug/chemical poisoning. Placement of the tube requires lubrication and inserting it while the patient swallows. Confirmation is done by injecting air and listening with a stethoscope or getting an x-ray. Removal involves having the patient take a deep breath while quickly pulling out the tube. Potential complications include nose bleeds, sinusitis, and esophageal perforation.
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Gastrostomie percutanee sous scopie
- 1. PERCUTANEOUS GASTROSTOMY Dr. H. Negila Paris
- 2. PERCUTANEOUS GASTROSTOMY INDICATIONS -Patients who need prolonged *Chronic conditions such as nutritional support include: cystic fibrosis and *Head, Neck and esophageal congenital heart disease carcinoma *Bowel decompression *Some neurologic disease *Swallowing disorders and esophageal strictures
- 3. PERCUTANEOUS GASTROSTOMY CONTRE INDICATIONS ABSOLUTE: RELATIVE: Gastric varices Ascites Total gastrectomy Partial gastrectomy Uncorrectable coagulopathy Coagulopathy Overlying colon Inability to pass a nasogastric tube
- 4. PERCUTANEOUS GASTROSTOMY PREPARATION • Informed consent • NG tube placement • 300 ml oral barium in the evening • Intravenous access • Analgesia • Glucagon
- 5. PERCUTANEOUS GASTROSTOMY COMPLICATIONS •Major: -Major infection and septicemia -Perforation -Hemorrhage -Aspiration -Dislodgement of the tube .Minor: -Wound infection -Dislodged or leaking tube
- 6. PERCUTANEOUS GASTROSTOMY T-fasteners • T-fasteners
- 7. PERCUTANEOUS GASTROSTOMY FIRST STEP • Mark the position of left hepatic lobe by ultrasound and injection of 1 mg of glucagon
- 8. PERCUTANEOUS GASTROSTOMY SECOND STEP • Gastric distension by injection of air in the NG tube
- 9. PERCUTANEOUS GASTROSTOMY THIRD STEP • Gastroplexy using the T- fastener
- 10. PERCUTANEOUS GASTROSTOMY VERIFICATION • Injection of contrast to ensure the right position of the needle inside the stomach
- 11. PERCUTANEOUS GASTROSTOMY Seldinger Technique • Using a guidewire to introduce inside the needle
- 12. PERCUTANEOUS GASTROSTOMY DILATATION • Of the orifice by guide( 9F, 14F, 16F ) or using of Baloon
- 13. PERCUTANEOUS GASTROSTOMY AT THE END • Control the position of umbrella