Paralytic ileus (adynamic intestinal obstruction)
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This document discusses paralytic ileus, defined as a failure of intestinal peristalsis due to failure of the neuromuscular mechanism. It can be localized or generalized. Causes include postoperative issues, infections, toxins, spinal injuries, and more. Clinical features include no passage of gas or bowel sounds, abdominal distension, vomiting, tachycardia, respiratory distress, abdominal pain, and fluid/electrolyte imbalance. Treatment focuses on treating the underlying cause, IV fluids, electrolyte management, antibiotics, analgesics, and decompression techniques if needed.
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Paralytic ileus
Paralytic ileus is the inability of the intestines to conduct peristalsis, which can lead to obstruction. It most often occurs after surgery but can be caused by inflammation, electrolyte abnormalities, or spinal fractures. If the distension occurs near an obstruction, intestinal contents can build up pressure and cause the bowel to collapse, leading to leakage into the abdominal cavity and potentially shock. Intestinal strangulation is a dangerous complication where blood flow is minimized, resulting in edema, cyanosis, and potential gangrene or rupture. Clinical manifestations include colicky abdominal pain, nausea, vomiting, abdominal distention and tenderness, absent bowel sounds, and temperature over 100°F if strangulation or peritonitis occur.
Intussusception (2)
Intussusception is the telescoping of one part of the intestine into another part and is most common in children under 2 years old. The classic presentation includes intermittent abdominal pain, a sausage-shaped abdominal mass, and currant jelly stools. Ultrasound is the preferred diagnostic method and shows a target or "doughnut" sign. Treatment involves rehydration and antibiotics if infected. Non-operative reduction using hydrostatic or pneumatic pressure is usually attempted first but surgery may be needed if reduction fails or there are signs of perforation or necrosis. With prompt diagnosis and treatment, mortality from intussusception is less than 1%.
Common surgical problems in children
This document summarizes several common surgical problems in children. It discusses conditions like cleft lip and palate, gastroesophageal reflux disease, infantile hypertrophic pyloric stenosis, and Hirschsprung disease. For each condition, it provides information on incidence, clinical features, investigations, and management. The goal is to provide pediatricians with sound knowledge of these common pediatric surgical issues.
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Portal hypertension can be treated with shunt operations to lower portal pressure and reduce variceal bleeding by shunting blood away from the liver. Selective shunts like the distal splenorenal shunt are preferred as they do not divert all blood flow and have a lower risk of hepatic encephalopathy. Non-selective shunts effectively lower pressure but carry higher risks of encephalopathy. Investigation with angiography and ultrasound is needed before surgery to assess anatomy. Complications include bleeding, shunt thrombosis and encephalopathy.
Testicular Torsion
Testicular torsion refers to twisting of the spermatic cord and loss of blood supply to the testicle. It is a urological emergency as early diagnosis and treatment are needed to save the testicle. Ultrasound with Doppler is the primary imaging method and shows absent or decreased blood flow in the affected testicle compared to the normal side. Prompt surgical detorsion and orchioplexy are the definitive treatments.
Neonatal intestinal obstruction
Delayed passage of meconium can be caused by several intestinal obstructions and diseases. It is suspected in full-term infants who do not pass meconium in the first 24 hours and in premature infants who delay passage for over a week. Diagnostic workup includes abdominal x-rays, ultrasound, and contrast studies to locate the obstruction. Management requires gastric decompression, fluid resuscitation to address dehydration, and monitoring of electrolytes and glucose levels which may become imbalanced. The cause is determined based on the presentation and imaging findings, and treatment involves surgery for structural issues or supportive care for medical conditions.
Intestinal obstruction by Dr. Nitin Alapure
This document provides an overview of intestinal obstruction. It defines intestinal obstruction as a partial or complete blockage of the small or large intestine. It then classifies intestinal obstructions based on their nature, cause, severity, and blood supply. The most common causes of small and large intestine obstructions are also outlined. Clinical features, investigations, and treatment approaches for both conservative management and surgery are discussed. Key points include outlining signs of strangulation versus simple obstruction and indications for surgical intervention.
Paralytic ileus
This document discusses different types of intestinal obstruction including dynamic and adynamic obstruction. It specifically focuses on paralytic ileus which is defined as neuromuscular failure leading to failure of peristalsis. Paralytic ileus commonly occurs post-operatively and can be caused by infection, metabolic abnormalities, or reflex inhibition. Management involves decompression with nasogastric suction and maintenance of fluid and electrolyte balance. Pseudo-obstruction is also discussed which describes obstruction without a mechanical cause associated with various neuropathies or myopathies.
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Paralytic ileus
Paralytic ileus is the inability of the intestines to conduct peristalsis, which can lead to obstruction. It most often occurs after surgery but can be caused by inflammation, electrolyte abnormalities, or spinal fractures. If the distension occurs near an obstruction, intestinal contents can build up pressure and cause the bowel to collapse, leading to leakage into the abdominal cavity and potentially shock. Intestinal strangulation is a dangerous complication where blood flow is minimized, resulting in edema, cyanosis, and potential gangrene or rupture. Clinical manifestations include colicky abdominal pain, nausea, vomiting, abdominal distention and tenderness, absent bowel sounds, and temperature over 100°F if strangulation or peritonitis occur.
Intussusception (2)
Intussusception is the telescoping of one part of the intestine into another part and is most common in children under 2 years old. The classic presentation includes intermittent abdominal pain, a sausage-shaped abdominal mass, and currant jelly stools. Ultrasound is the preferred diagnostic method and shows a target or "doughnut" sign. Treatment involves rehydration and antibiotics if infected. Non-operative reduction using hydrostatic or pneumatic pressure is usually attempted first but surgery may be needed if reduction fails or there are signs of perforation or necrosis. With prompt diagnosis and treatment, mortality from intussusception is less than 1%.
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This document summarizes several common surgical problems in children. It discusses conditions like cleft lip and palate, gastroesophageal reflux disease, infantile hypertrophic pyloric stenosis, and Hirschsprung disease. For each condition, it provides information on incidence, clinical features, investigations, and management. The goal is to provide pediatricians with sound knowledge of these common pediatric surgical issues.
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Portal hypertension can be treated with shunt operations to lower portal pressure and reduce variceal bleeding by shunting blood away from the liver. Selective shunts like the distal splenorenal shunt are preferred as they do not divert all blood flow and have a lower risk of hepatic encephalopathy. Non-selective shunts effectively lower pressure but carry higher risks of encephalopathy. Investigation with angiography and ultrasound is needed before surgery to assess anatomy. Complications include bleeding, shunt thrombosis and encephalopathy.
Testicular Torsion
Testicular torsion refers to twisting of the spermatic cord and loss of blood supply to the testicle. It is a urological emergency as early diagnosis and treatment are needed to save the testicle. Ultrasound with Doppler is the primary imaging method and shows absent or decreased blood flow in the affected testicle compared to the normal side. Prompt surgical detorsion and orchioplexy are the definitive treatments.
Neonatal intestinal obstruction
Delayed passage of meconium can be caused by several intestinal obstructions and diseases. It is suspected in full-term infants who do not pass meconium in the first 24 hours and in premature infants who delay passage for over a week. Diagnostic workup includes abdominal x-rays, ultrasound, and contrast studies to locate the obstruction. Management requires gastric decompression, fluid resuscitation to address dehydration, and monitoring of electrolytes and glucose levels which may become imbalanced. The cause is determined based on the presentation and imaging findings, and treatment involves surgery for structural issues or supportive care for medical conditions.
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This document provides an overview of intestinal obstruction. It defines intestinal obstruction as a partial or complete blockage of the small or large intestine. It then classifies intestinal obstructions based on their nature, cause, severity, and blood supply. The most common causes of small and large intestine obstructions are also outlined. Clinical features, investigations, and treatment approaches for both conservative management and surgery are discussed. Key points include outlining signs of strangulation versus simple obstruction and indications for surgical intervention.
Paralytic ileus
This document discusses different types of intestinal obstruction including dynamic and adynamic obstruction. It specifically focuses on paralytic ileus which is defined as neuromuscular failure leading to failure of peristalsis. Paralytic ileus commonly occurs post-operatively and can be caused by infection, metabolic abnormalities, or reflex inhibition. Management involves decompression with nasogastric suction and maintenance of fluid and electrolyte balance. Pseudo-obstruction is also discussed which describes obstruction without a mechanical cause associated with various neuropathies or myopathies.
Intestinal obstruction
This document discusses various causes and types of intestinal obstruction, including their presentation, diagnosis and management. It covers mechanical obstructions caused by adhesions, hernias, volvulus and intussusception. It also discusses paralytic ileus and pseudo-obstruction which are adynamic obstructions without a mechanical cause. The management involves supportive care, surgical correction of the underlying cause, and resection of non-viable intestine. Early diagnosis and treatment are important to prevent complications like strangulation.
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Paralytic ileus
Paralytic ileus is the inability of the intestines to conduct peristalsis, which can lead to obstruction. It is caused by stressful stimuli activating the sympathetic nervous system, decreasing peristalsis. Intraoperative manipulation may also cause nitric oxide release and smooth muscle relaxation, decreasing peristalsis. Common causes include medications, intestinal cancer, Crohn's disease, diverticulitis, and Parkinson's disease. Symptoms include abdominal cramping, appetite loss, constipation, inability to pass gas, stomach swelling, nausea, and vomiting. It is diagnosed using x-ray, CT scan, or ultrasound. Treatment involves putting the patient on a clear liquid diet, inserting a tube for relief, surgery, IV
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This document discusses infantile hypertrophic pyloric stenosis (IHPS), a condition where the pyloric muscle of the stomach becomes thickened, preventing food from passing normally into the small intestine. The key points are:
- IHPS is most common in firstborn males under 6 weeks of age and may be linked to erythromycin use as an infant.
- Symptoms include projectile vomiting, dehydration, and weight loss. Diagnosis involves feeling an olive-sized lump in the stomach and confirming on ultrasound or blood tests.
- Treatment involves rehydration followed by pyloromyotomy surgery to cut the thickened muscle and allow food to pass through. Complications
Pediatric Intussusception - An Overview
This document discusses intussusception, which is the telescoping of one segment of bowel into an adjacent segment. It provides definitions, etiology, types and pathology, signs and symptoms, differential diagnosis, workup, and treatment options for intussusception. The main points are that intussusception is usually idiopathic or caused by respiratory viruses in infants and young children, presenting with abdominal pain, vomiting, and bloody stools. Diagnosis involves imaging like ultrasound or barium enema. Treatment options include non-surgical reduction techniques like hydrostatic or pneumatic reduction or surgical reduction through manual manipulation or resection.
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This document discusses intestinal obstruction, including its classification, etiology, causes, symptoms, diagnosis and management. It classifies obstruction by site (small vs large bowel), presentation (acute, chronic, acute on chronic), and blood flow (simple vs strangulated). Common causes are adhesions, hernias, tumors, strictures and volvulus. Diagnosis involves history, exam, labs, imaging like abdominal X-rays and CT scans. Treatment depends on the severity and includes resuscitation, NG decompression, IV fluids, antibiotics if needed, and surgery for severe cases to remove the obstruction. Surgical procedures vary based on the site and nature of the obstruction.
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1. Choledochal cysts are abnormal dilations of the bile ducts that are more common in Asia and women.
2. They are classified into 5 types based on location and extent of dilation.
3. Presentation varies from jaundice and abdominal mass in children to pain and cholangitis in older patients.
4. Investigation involves ultrasound, CT, MRCP and cholangiography to determine type and rule out complications.
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Hirschsprung's disease
Hirschsprung's disease is a congenital disorder caused by the absence of ganglion cells in parts of the colon, which prevents normal nerve function. It most commonly involves the rectum and sigmoid colon. Affected infants experience constipation or intestinal obstruction after birth. Diagnosis involves rectal biopsy and imaging tests. Treatment involves surgically removing the affected part of the colon and reconnecting the healthy ends, which often cures the condition. Complications can include infection, leakage at the connection site, or ongoing constipation issues.
intestinal obstruction
This document discusses intestinal obstruction, including its definition, classification, causes, examination, investigation, pseudo-obstruction, management, and surgical indications. Intestinal obstruction occurs when the contents of the intestine are blocked from passing through. It can be caused by mechanical, paralytic, or functional factors. Examination involves inspection, palpation, percussion, and auscultation of the abdomen. Investigations include blood tests, radiological imaging like abdominal x-rays and CT scans. Pseudo-obstruction is obstruction without a mechanical cause. Management focuses on resuscitation, decompression, fluid replacement, and surgery if signs of strangulation or perforation are present.
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Neonatal intestinal obstruction
This document discusses various types of intestinal obstructions in neonates. It describes high intestinal obstructions, which occur proximal to the ileum such as gastric, duodenal or jejunal obstructions. It also describes low intestinal obstructions, which occur distal to the ileum and in the colon. Specific causes of obstruction discussed include duodenal atresia, intestinal malrotation, necrotizing enterocolitis, meconium ileus and Hirschsprung's disease. Diagnosis involves abdominal x-rays and contrast studies to identify the location and cause of obstruction.
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• 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.
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This document discusses rectal prolapse, including partial (mucosal) and complete (full-thickness) prolapse. It describes the types, causes, diagnosis and treatment options for each. For partial prolapse in infants and children, treatment includes digital repositioning, injections or surgery like Thiersch's operation. In adults, options are injections, excision or ligature. Complete prolapse involves all rectal wall layers and has abdominal or perineal surgical treatments like mesh rectopexy, resection rectopexy or Delorme's operation to reposition or remove the prolapsed tissue.
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Intestinal obstruction occurs when the downward movement of intestinal contents is arrested. It can be classified based on its pathological cause, level of obstruction, onset and course. Common causes include adhesions, hernias, tumors and strictures. Symptoms depend on the level and type of obstruction and may include pain, distension, vomiting and constipation. Examination findings can provide clues to whether the obstruction is simple, strangulated or closed loop. Further testing is needed to determine the specific cause and appropriate management.
Congenital hypertrophic pyloric stenosis
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1. Choledochal cysts are abnormal dilations of the bile ducts that are more common in Asia and women.
2. They are classified into 5 types based on location and extent of dilation.
3. Presentation varies from jaundice and abdominal mass in children to pain and cholangitis in older patients.
4. Investigation involves ultrasound, CT, MRCP and cholangiography to determine type and rule out complications.
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This document provides an overview of acute scrotum in children, including its causes, evaluation, and management. It begins with an anatomical review of the scrotum. The main causes of acute scrotum are testicular torsion, trauma, infection, inflammation, and hernia. Evaluation involves history, physical exam, urine analysis, ultrasound, and in some cases blood tests or isotope scan. Treatment depends on the underlying condition, and may involve conservative management with rest, antibiotics, and anti-inflammatories or surgical intervention like manual detorsion for torsion, herniotomy for hernia, and orchiectomy for non-viable testes. The goal of treatment is to preserve testicular function whenever possible
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Hirschsprung's disease
Hirschsprung's disease is a congenital disorder caused by the absence of ganglion cells in parts of the colon, which prevents normal nerve function. It most commonly involves the rectum and sigmoid colon. Affected infants experience constipation or intestinal obstruction after birth. Diagnosis involves rectal biopsy and imaging tests. Treatment involves surgically removing the affected part of the colon and reconnecting the healthy ends, which often cures the condition. Complications can include infection, leakage at the connection site, or ongoing constipation issues.
intestinal obstruction
This document discusses intestinal obstruction, including its definition, classification, causes, examination, investigation, pseudo-obstruction, management, and surgical indications. Intestinal obstruction occurs when the contents of the intestine are blocked from passing through. It can be caused by mechanical, paralytic, or functional factors. Examination involves inspection, palpation, percussion, and auscultation of the abdomen. Investigations include blood tests, radiological imaging like abdominal x-rays and CT scans. Pseudo-obstruction is obstruction without a mechanical cause. Management focuses on resuscitation, decompression, fluid replacement, and surgery if signs of strangulation or perforation are present.
Acute and chronic urinary retention
This document discusses urinary retention, including its types, causes, clinical features, investigations, management, and prognosis. Urinary retention is defined as the inability to void despite bladder distention. It can be acute, chronic, or acute-on-chronic. Common causes in males include benign prostatic hyperplasia and urethral stricture. Clinical features depend on whether retention is acute or chronic. Initial management involves relieving the obstruction through catheterization. Long-term management depends on identifying and treating the underlying cause. Complications can include bladder and kidney damage if not properly treated.
Neonatal intestinal obstruction
This document discusses various types of intestinal obstructions in neonates. It describes high intestinal obstructions, which occur proximal to the ileum such as gastric, duodenal or jejunal obstructions. It also describes low intestinal obstructions, which occur distal to the ileum and in the colon. Specific causes of obstruction discussed include duodenal atresia, intestinal malrotation, necrotizing enterocolitis, meconium ileus and Hirschsprung's disease. Diagnosis involves abdominal x-rays and contrast studies to identify the location and cause of obstruction.
Acute cholecystitis/ RUQ Pain
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.
Prolapsse of Rectum
This document discusses rectal prolapse, including partial (mucosal) and complete (full-thickness) prolapse. It describes the types, causes, diagnosis and treatment options for each. For partial prolapse in infants and children, treatment includes digital repositioning, injections or surgery like Thiersch's operation. In adults, options are injections, excision or ligature. Complete prolapse involves all rectal wall layers and has abdominal or perineal surgical treatments like mesh rectopexy, resection rectopexy or Delorme's operation to reposition or remove the prolapsed tissue.
Hypospadias
Hypospadias is a congenital anomaly where the opening of the urethra is on the ventral side of the penis rather than at the tip. It occurs in about 1 in 250 male newborns. The document discusses the definition, causes, classification, diagnosis, and surgical techniques for repairing hypospadias. Surgical repair aims to correct penile curvature if present and create a functional urethra in a cosmetically normal position. Complications can include bleeding, meatal stenosis, and impaired healing but early repair from ages 6-12 months has better outcomes.
Intestinal obstruction
Intestinal obstruction occurs when the downward movement of intestinal contents is arrested. It can be classified based on its pathological cause, level of obstruction, onset and course. Common causes include adhesions, hernias, tumors and strictures. Symptoms depend on the level and type of obstruction and may include pain, distension, vomiting and constipation. Examination findings can provide clues to whether the obstruction is simple, strangulated or closed loop. Further testing is needed to determine the specific cause and appropriate management.
Congenital hypertrophic pyloric stenosis
This document discusses congenital hypertrophic pyloric stenosis (CHPS), a condition where the pyloric muscle thickens, obstructing food passage from stomach to small intestine. It affects young infants, more commonly males. Presentation includes projectile vomiting after feeding. Diagnosis involves abdominal ultrasound and upper GI study. Treatment is pyloromyotomy surgery to cut the thickened pyloric muscle. The document covers epidemiology, clinical features, diagnosis, treatment including surgical procedure and postoperative care of CHPS.
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Describes the concept of a surgical abdomen, acute abdominal pain, emergency intervention and approach to management, including the controversial use of analgesic and antibiotics in emergency room.
17 gi
This document provides an overview of the gastrointestinal system, with a focus on the esophagus and stomach. It discusses the anatomy, blood supply, congenital anomalies, motor disorders like achalasia and hiatal hernia, and common pathologies for each organ. For the esophagus, it covers topics like esophagitis, Barrett's esophagus, varices, and cancers. For the stomach, it discusses gastritis, peptic ulcers, hypertrophic gastropathy, gastric varices, benign and malignant tumors, and adenocarcinoma.
Paralytic ileus
Paralytic ileus is the inability of the intestines to conduct peristalsis, which can lead to obstruction. It most often occurs after surgery but can be caused by inflammation, electrolyte abnormalities, or spinal fractures. Symptoms include colicky abdominal pain, nausea, vomiting, abdominal distension, and constipation. Diagnostic tests like CT scans and x-rays are used, and treatment focuses on resting the bowel with NPO, IV fluids for hydration, and sometimes NG tube placement. Patient education emphasizes reporting changes in symptoms and the importance of treatment compliance.
Abdominal Pain
- Abdominal pain has many potential causes and determining the origin requires a detailed history, physical exam, and sometimes diagnostic tests.
- The location, character, timing and associated symptoms of the pain provide clues to its underlying mechanism, such as inflammation, obstruction, vascular or nerve issues.
- A thorough physical exam including inspection, abdominal palpation, and assessment of vital signs can help identify conditions like peritonitis but may not reveal the specific cause.
Diverticular diseases of colon by Dr.AmrithaAnilkumar
DIVERTICULAR DISEASE OF THE COLON
DEFINITION
They are acquired herniations of colonic mucosa through circular muscles at the points where blood vessels penetrate (points of least resistance).
Vomiting
Basic presentation for undergraduates, this ppt covers definition, causes, medical management of vomiting
DISORDERS OF ESOPHAGUS
The document discusses various disorders of the esophagus including esophagitis, gastroesophageal reflux disease (GERD), and esophageal strictures and obstructions. Esophagitis is inflammation of the esophagus which can be caused by infection, irritation or acid reflux. GERD occurs when stomach acid backs up into the esophagus. Esophageal strictures are abnormal narrowing caused by scar tissue buildup from conditions like GERD or injuries. Esophageal obstructions completely or partially block the esophagus, preventing swallowing.
Diagnosis of Acute Pancreatitis
This document provides information on the history, examination, and investigations for acute pancreatitis.
The history section outlines common symptoms including upper abdominal pain that intensifies and radiates to the back. Examination may reveal signs of dehydration as well as abdominal tenderness and guarding.
Laboratory investigations for acute pancreatitis include pancreatic enzymes, liver enzymes, electrolytes, blood glucose, and C-reactive protein. Imaging options are abdominal ultrasound, CT scan, and MRI, with CT being the standard choice to assess severity and complications using the CT severity index. Ultrasound can identify gallstones as a common cause.
intestinal obstruction in the Intestine.pptx
Intestinal obstruction occurs when something blocks the intestines, preventing food and liquid from passing through. It can be caused by adhesions, hernias, tumors, or other conditions. Symptoms include pain, vomiting, constipation, and abdominal distension. Treatment involves fluid resuscitation, nasogastric decompression, pain management, and sometimes surgery to remove the blockage. Nursing care focuses on pain control, maintaining fluid and nutrition, and reducing patient anxiety. Complications can include renal impairment, electrolyte imbalances, infection, and intestinal perforation if not properly treated.
Gi emergenceis.pptx
Based on the limited information provided, additional history, physical exam findings, labs, and imaging are needed to determine the diagnosis. Features that would help differentiate some common acute abdominal conditions in a 15 year old male include:
- Location and radiation of pain (pancreatitis vs appendicitis)
- Fever, leukocytosis (appendicitis)
- Bilirubin, lipase/amylase (pancreatitis)
- Abdominal xray (pneumatosis intestinalis - malrotation)
- Rectal exam, CBC, imaging (intussusception)
- Scrotal exam (testicular torsion)
- Urinalysis (renal calculi)
- Blood
ACUTE ABDOMEN.pptx
The document defines acute abdomen as severe abdominal pain developing over 6-8 hours in a previously well patient requiring surgical management. Common causes include appendicitis, cholecystitis, bowel obstruction, and perforated viscus. A thorough history, physical exam, and diagnostic workup including blood tests, imaging, and possible surgical exploration are needed for rapid diagnosis and treatment. Proper management involves resuscitation, monitoring for signs of worsening, and timely surgery if indicated to prevent morbidity and mortality.
Appendicitis, diverticulitis, peptic ulcer disease, chron's disease
The document discusses appendicitis including its positions, definition, causes, clinical manifestations, investigations, differential diagnosis, treatment and CT scan findings. It provides information on the Alvarado score for diagnosing appendicitis. It also discusses Crohn's disease including its pathogenesis, pathology, clinical features, investigations, medical and surgical management. Finally, it covers diverticulitis including its pathogenesis, presentations of diverticulitis and bleeding, diagnostic tests and primary bowel resection treatment.
Intestinal obstruction
This document discusses various causes and classifications of intestinal obstruction, including intraluminal causes like impaction or foreign bodies, intramural causes like strictures or malignancy, and extramural causes like bands, adhesions or hernias. It describes the pathophysiology of obstruction including proximal bowel dilation and changes in motility and absorption. It also covers specific types like strangulation, closed-loop obstruction, internal hernias, enteric strictures, and bolus obstructions. Clinical features of different types of intestinal obstruction and specific causes like gallstones, bezoars, worms, adhesions, intussusception and volvulus are outlined.
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
peptic ulcer mohammad abu sad 1.pptx
Peptic ulcer disease is caused by an imbalance between aggressive factors like H. pylori infection, NSAIDs, and acid that damage the stomach or duodenal lining, and defensive mucosal mechanisms. Common symptoms include abdominal pain and bleeding. Diagnosis involves endoscopy to visualize ulcers and test for H. pylori. Treatment includes lifestyle modifications, medications to reduce acid production like PPIs, eradicating H. pylori with antibiotic therapy, and sometimes surgery for complications. Managing risk factors can help prevent ulcers from recurring.
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clinicalapproachtoapatientwithabdominalpain-120815095722-phpapp02.pptx
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The oesophagus - Congenital anomalies of the oesophagus.
The oesophagus - Congenital anomalies of the oesophagus.
Diverticular diseases of colon by Dr.AmrithaAnilkumar
Diverticular diseases of colon by Dr.AmrithaAnilkumar
Appendicitis, diverticulitis, peptic ulcer disease, chron's disease
Appendicitis, diverticulitis, peptic ulcer disease, chron's disease
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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
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
Pilonidal sinus diseases by Dr.K.AmrithaAnilkumar
PILONIDAL SINUS/DISEASE (Jeep Bottom; Driver’s Bottom)
Pilus—hair; Nidus—nest
It is epithelium lined tract, situated short distance behind the anus, containing hairs and unhealthy diseased granulation tissue.
It is due to penetration of hairs through the skin into subcutaneous tissue.
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Paralytic ileus (adynamic intestinal obstruction)
- 1. en love da Homoeopathy PARALYTIC ILEUS (Adynamic Intestinal Obstruction)
- 3. PARALYTICILEUS (Adynamic Intestinal Obstruction) DEFINITION • It is a state in which intestines fail to transmit peristalsis due to failure of neuromuscular mechanism, • i.e. Auerbach’s and Meissner’s plexus. • It may be localisedor generalised
- 4. CAUSES • Postoperative ™ Infective • Pus • Blood • Bile • Toxins • enteritis ™ • Uraemia ™ • Hypokalaemia ™ • Spinal injury • Retroperitoneal haemorrhage ™ • Spinal surgery ™ • Plaster jacket CLINICALFEATURES • No passageof flatus. • No bowel sounds. • Marked abdominal distension. • Vomiting of large volume of fluid. • Tachycardia.
- 5. • Respiratorydistressdue to pressure over the diaphragm. • High-pitched tinkling note ‘like bells at evening pealing’. • Dull abdominal pain(not colicky). • Features of fluid/protein/electrolyte imbalance . INVESTIGATION • Serumelectrolyte estimation- Especially serumpotassium. • ECG. • X-rayabdomen. • Ultrasound abdomen to findout the possible cause of ileus, e.g. sepsis. • Nasogastricaspiration.
- 6. • The primarycauseis treated. • IV fluids. • Electrolyte management. • Catheterisationand urine output measurement. TREATMENT • Antibiotics and analgesics. • Do not stimulate the peristalsis (“Don’t flog a tired horse”). • Measurement of abdominal girth is necessaryto see whether patient is recovering or not.
- 7. • Decompressionof the large bowel can be triedby inserting a flatus tube per anally intothe rectumand keeping in place for few hours. • Drainage of terminal pulp space by an oblique deep incision. • If there is osteomyelitis of the terminal phalanx, it has to be amputated. REFERENCE 1. SRB's Manual of Surgery by SriramBhat M 2. A Manual on Clinical Surgeryby Das 3. A Concise textbookof Surgeryby Das
- 8. A Special Thanks To A Very Special Doctor