Peritonitis is an inflammation of the peritoneum that can be caused by infections spreading from the gastrointestinal tract or other abdominal organs. There are two main types - primary peritonitis arising from the peritoneum itself, and secondary peritonitis arising from intra-abdominal infections. Symptoms include abdominal pain and tenderness. Diagnosis involves physical exam, imaging, and diagnostic laparoscopy. Treatment focuses on treating the underlying cause, administering antibiotics, and surgically removing infected tissues or foreign bodies to control the infection.
Hemorrhoidectomy is a surgery to remove hemorrhoids. It is done under general or spinal anesthesia. The doctor makes incisions around the hemorrhoid, cuts off its blood supply, and removes it. Surgery is recommended for large or recurring hemorrhoids after other treatments fail. Recovery takes 2-3 weeks with pain being the most common side effect. Changes to diet and lifestyle are needed after surgery to prevent hemorrhoids from returning.
A hernia is an abnormal protrusion of an organ or tissue through the wall of the cavity that normally contains it. There are two main types of hernias - congenital (present at birth) and acquired (develop later in life). The most common types are inguinal, femoral, and umbilical hernias. Hernias are usually caused by increased pressure inside the abdominal cavity from activities like coughing, straining, or obesity. Treatment options include strapping with a plaster or surgery to repair or remove the hernia sac.
This document discusses bowel obstructions, including small bowel obstruction and large bowel obstruction. Small bowel obstructions can be caused by adhesions, hernias, tumors or other conditions. Signs include abdominal pain, nausea and distension. Treatment involves correcting fluid deficits, using tubes to decompress the bowel, and potentially surgery if signs of complete obstruction. Large bowel obstructions are often due to colon cancer, diverticulitis or other colon issues. Treatment involves IV fluids, tubes, and potentially surgery to address the obstruction or perform a ostomy. Pseudo-obstruction can mimic mechanical obstruction but is treated differently.
Diverticulitis is an inflammation and infection of small pouches called diverticula that form in the lining of the intestines, usually in the colon. It is commonly caused by trapped fecal material and bacteria. Symptoms include crampy lower abdominal pain, fever, and changes in bowel habits. Treatment involves rest, clear liquids, antibiotics, and analgesics. A high fiber diet and fluid intake are recommended for prevention and management of diverticulitis. Nursing care focuses on monitoring for complications, managing pain and nutrition, and health education.
The document discusses the anatomy of the esophageal hiatus and types of hiatal hernia. It describes four types of hiatal hernia, with type I being the most common sliding hernia associated with GERD. Surgical options for repair include laparoscopic and open approaches, with the goals being to relieve symptoms and prevent complications by reducing reflux and returning the GE junction below the diaphragm. Post-operative care involves a progressive diet and activity plan, with most patients finding symptom relief but recurrence rates remaining between 20-40% even at large centers.
Anastomosis is the surgical connection of two tubular structures, such as joining sections of intestine or blood vessels. The document discusses techniques for intestinal and vascular anastomoses. For intestinal anastomoses, factors like adequate blood supply, careful suturing technique, and patient health and nutrition are essential for safe healing. Vascular anastomoses require precision to ensure immediate watertight closure without damage to the vessel lining. Suturing skills and practice are fundamental for surgeons to successfully perform anastomoses.
Lt hemicolectomy - Surgical Approach, Complications.Vikas V
This is a detailed Presentation of the surgical procedure - Left Hemicolectomy. It deals with the Surgical anatomy, Indications, Surgical Steps, Complications of the Procedure
Hemorrhoidectomy is a surgery to remove hemorrhoids. It is done under general or spinal anesthesia. The doctor makes incisions around the hemorrhoid, cuts off its blood supply, and removes it. Surgery is recommended for large or recurring hemorrhoids after other treatments fail. Recovery takes 2-3 weeks with pain being the most common side effect. Changes to diet and lifestyle are needed after surgery to prevent hemorrhoids from returning.
A hernia is an abnormal protrusion of an organ or tissue through the wall of the cavity that normally contains it. There are two main types of hernias - congenital (present at birth) and acquired (develop later in life). The most common types are inguinal, femoral, and umbilical hernias. Hernias are usually caused by increased pressure inside the abdominal cavity from activities like coughing, straining, or obesity. Treatment options include strapping with a plaster or surgery to repair or remove the hernia sac.
This document discusses bowel obstructions, including small bowel obstruction and large bowel obstruction. Small bowel obstructions can be caused by adhesions, hernias, tumors or other conditions. Signs include abdominal pain, nausea and distension. Treatment involves correcting fluid deficits, using tubes to decompress the bowel, and potentially surgery if signs of complete obstruction. Large bowel obstructions are often due to colon cancer, diverticulitis or other colon issues. Treatment involves IV fluids, tubes, and potentially surgery to address the obstruction or perform a ostomy. Pseudo-obstruction can mimic mechanical obstruction but is treated differently.
Diverticulitis is an inflammation and infection of small pouches called diverticula that form in the lining of the intestines, usually in the colon. It is commonly caused by trapped fecal material and bacteria. Symptoms include crampy lower abdominal pain, fever, and changes in bowel habits. Treatment involves rest, clear liquids, antibiotics, and analgesics. A high fiber diet and fluid intake are recommended for prevention and management of diverticulitis. Nursing care focuses on monitoring for complications, managing pain and nutrition, and health education.
The document discusses the anatomy of the esophageal hiatus and types of hiatal hernia. It describes four types of hiatal hernia, with type I being the most common sliding hernia associated with GERD. Surgical options for repair include laparoscopic and open approaches, with the goals being to relieve symptoms and prevent complications by reducing reflux and returning the GE junction below the diaphragm. Post-operative care involves a progressive diet and activity plan, with most patients finding symptom relief but recurrence rates remaining between 20-40% even at large centers.
Anastomosis is the surgical connection of two tubular structures, such as joining sections of intestine or blood vessels. The document discusses techniques for intestinal and vascular anastomoses. For intestinal anastomoses, factors like adequate blood supply, careful suturing technique, and patient health and nutrition are essential for safe healing. Vascular anastomoses require precision to ensure immediate watertight closure without damage to the vessel lining. Suturing skills and practice are fundamental for surgeons to successfully perform anastomoses.
Lt hemicolectomy - Surgical Approach, Complications.Vikas V
This is a detailed Presentation of the surgical procedure - Left Hemicolectomy. It deals with the Surgical anatomy, Indications, Surgical Steps, Complications of the Procedure
Hiatal hernia
Synonyms Hiatus hernia
Hiatalhernia.gif
A drawing of a hiatal hernia
Specialty Gastroenterology, general surgery
Symptoms Taste of acid in the back of the mouth, heartburn, trouble swallowing[1]
Complications Iron deficiency anemia, volvulus, bowel obstruction[1]
Types Sliding, paraesophageal[1]
Risk factors Obesity, older age, major trauma[1]
Diagnostic method Endoscopy, medical imaging, manometry[1]
Treatment Raising the head of the bed, weight loss, medications, surgery[1]
Medication H2 blockers, proton pump inhibitors[1]
Frequency 10–80% (US)[1]
[edit on Wikidata]
A hiatal hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest.
Peritonitis is an inflammation of the peritoneum caused by bacterial or fungal infection. Left untreated, it can lead to sepsis, multiple organ failure and death. There are three main types: primary occurs spontaneously with liver failure; secondary follows a perforation of abdominal organs; tertiary occurs in immuno-compromised people like with AIDS and tuberculosis. Symptoms include severe abdominal pain, fever, nausea and vomiting. Diagnosis involves medical history, exams, blood tests and imaging scans. Treatment requires intravenous fluids, antibiotics, pain relief, and may require surgery to repair damaged organs and drain infections. With proper treatment outcomes are good, but risks include sepsis, adhesions and organ failure if not addressed promptly.
Ventral hernia is protrusion of peritoneal sac through anterior abdominal wall defects except Groin hernias. In this presentation I have discussed Epigastric, Umbilical, Para umbilical, Incisional, Spigelian and Lumbar hernias.
Intussusceptions occur when one segment of the gastrointestinal tract telescopes inside an adjacent segment. While rare in adults, intussusceptions account for 5% of bowel obstructions and have an identifiable underlying disorder in 90% of cases. Symptoms include abdominal pain, nausea, vomiting and bleeding, while diagnostic tools include abdominal CT, x-rays and ultrasound. Treatment involves surgical resection of the involved segment. Prognosis depends on the cause, with mortality rates varying from 8.7% for benign lesions to 52.4% for malignant cases.
Diagnosis and complications of gastric cancerSilah Aysha
Diagnosis of gastric carcinoma involves several steps: an endoscopy to examine the stomach lining, an endoscopic ultrasound to view the stomach wall layers and nearby structures, and a biopsy of any suspicious tissues to examine under a microscope. Additional imaging tests like barium swallow, CT scan, MRI, and PET scan may be used to determine if the cancer has spread from the stomach. Surgical tests like laparoscopy are also used to confirm if the cancer is contained to the stomach or has spread before deciding on treatment.
The document discusses hiatal hernia, which occurs when part of the stomach bulges through an opening in the diaphragm. It outlines the causes, symptoms, diagnosis through imaging and endoscopy, differential diagnosis, and treatment options including medication, surgery to repair the diaphragm and prevent reflux, and post-operative care. The prognosis is generally good if the hernia is repaired and complications like aspiration pneumonia are managed.
1. Colorectal trauma can result from penetrating injuries like gunshots, impalement, or medical procedures. Blunt trauma is rare but can occur from pelvic fractures in car accidents or falls.
2. Treatment depends on factors like injury size, contamination, and time since injury. Small, clean injuries found early may be closed primarily. Larger or delayed injuries usually require resection and colostomy.
3. Rectal injuries require examination to locate them, irrigation, and sometimes drainage or abdominal repair with proximal fecal diversion. Perineal injuries usually cannot be primarily repaired and require diversion.
Intestinal obstruction occurs when the intestine is blocked partially or completely, preventing contents from passing through. It can be classified as dynamic, adynamic, small bowel, or large bowel obstruction.
Clinical presentation depends on the location and severity of the obstruction. Symptoms often include colicky abdominal pain, vomiting, distention, and constipation.
Common causes are adhesions, hernias, volvulus, intussusceptions, gallstones, and tumors. Strangulated obstruction with compromised blood flow is a surgical emergency.
Diagnosis involves blood tests, abdominal exams, imaging studies like abdominal x-rays and CT scans to detect air-
Lecture on abdominal trauma during Basic Life Support 2018 course in Sibu Hospital. Encompasses blunt and penetrating trauma, principles and tips of management
This document discusses fistula in ano and anal fissure. It defines a fistula in ano as an abnormal track connecting two epithelial surfaces, most commonly caused by anorectal abscess. It describes the classification, symptoms, diagnosis and management of fistula in ano, including fistulotomy and setons for simple vs. complex fistulas. It also defines anal fissure as a tear distal to the dentate line, most commonly caused by hard stool or constipation. It notes the pathogenesis is a cycle of pain and spasm that impairs healing. It provides details on the location, symptoms and treatment of acute vs. chronic anal fissure.
This document provides an overview of colorectal trauma and injuries. It discusses relevant anatomy, considerations for colonic and rectal trauma including classification systems, management approaches, and risks factors. It also reviews iatrogenic injuries that can occur from various surgical, endoscopic, and diagnostic procedures. Key points include that nondestructive colon injuries can often be primarily repaired, while destructive injuries require resection. Rectal injuries are classified using the "4Ds" concept of debridement, drainage, washout, and sometimes diversion.
An anal fistula is a small channel that develops between the end of the bowel and the skin near the anus, usually as a result of an infection near the anus causing pus to drain and leave behind a tunnel. It can be caused by an infected anal gland. Diagnosis involves physical examination where the doctor inserts a gloved finger in the anus to feel abnormal areas, and may use sigmoidoscopy, colonoscopy, MRI or dye tests to further examine the fistula. Treatment depends on the fistula's location and complexity but may include laying it open, setting in a plug, or glue to allow it to heal from the inside out.
This document discusses acute peritonitis, including:
- Peritonitis is defined as inflammation of the peritoneum and can be localized or generalized. It is usually caused by bacterial infection entering through the gastrointestinal tract or other sources.
- Symptoms depend on whether it is localized or diffuse. Localized peritonitis causes pain specific to the affected organ, while diffuse peritonitis causes generalized abdominal pain and tenderness.
- Treatment involves antibiotics, fluid resuscitation, and sometimes surgery to address the underlying cause and drain any abscesses. Outcomes depend on several factors but mortality is around 10% with prompt treatment. Complications can include shock, bowel obstruction, and residual infections.
OPEN CHOLECYSTECTOMY- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #opencholecystectomy #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy and Modified Radical Mastectomy.
• In this video today, I have discussed Open Cholecystectomy.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
• Thank you for watching the videos.
Hiatal hernia is a condition where the stomach and other intra-abdominal contents protrude through the esophageal hiatus of the diaphragm. Risk factors include obesity, increased abdominal pressure, and previous hiatal hernia surgery. Symptoms may include heartburn, dysphagia, chest pain, or respiratory issues. Diagnosis is typically made through upper gastrointestinal imaging. Treatment depends on symptoms and hernia type but may involve lifestyle changes, medication, or surgery to repair the diaphragmatic defect and prevent acid reflux. Complications can include obstruction, bleeding, stomach twisting, and Barrett's esophagus.
Diverticulosis and diverticular diseaseDoha Rasheedy
This document discusses diverticular disease, specifically diverticulosis and acute diverticulitis. It covers the epidemiology, pathophysiology, clinical presentation, investigations including CT and barium enema, differential diagnosis, and Hinchey classification of diverticulitis severity. Diverticulosis is asymptomatic protrusions in the colon wall that become symptomatic as diverticulitis in 20% of cases from obstruction, inflammation, or perforation. Risk factors include low fiber diet and increased age. CT is the best imaging method to diagnose and stage diverticulitis.
This document discusses appendicitis, a condition where the appendix becomes inflamed or infected. The appendix is a small, tube-like structure attached to the large intestine. While its function is unknown, appendicitis occurs when the appendix becomes blocked and bacteria grow, causing swelling. Common symptoms include abdominal pain, nausea, and fever. Untreated appendicitis can lead to the appendix rupturing, resulting in a serious infection of the abdominal cavity. Standard treatment is surgical removal of the appendix to prevent rupture and further complications.
This document discusses hernias, including types, causes, risk factors, clinical manifestations, diagnostic measures, management, complications, and nursing management. The main types of hernias are inguinal, femoral, umbilical, diaphragmatic, hiatal, and incisional. Hernias occur when an organ or tissue protrudes through a weakened area in the muscle or surrounding wall. Clinical features depend on whether the hernia is reducible, irreducible, or strangulated. Treatment involves surgical repair or herniorrhaphy, with nursing care focused on monitoring for complications and educating patients.
This document discusses rectal prolapse, including different types (full thickness, internal, mucosal), causes, clinical features, and treatment options. It describes full thickness prolapse as a full-thickness protrusion of the rectum through the anal sphincters. Mucosal prolapse involves protrusion of the rectoanal mucosa only. Treatment includes non-operative options like fiber supplements as well as surgical procedures. Perineal surgeries include resection, reefing, and encirclement techniques while abdominal surgeries include anterior and posterior rectopexy to fixate the rectum. Laparoscopic rectopexy is now commonly used with lower morbidity than open abdominal procedures. Surgery aims to correct the
Peritonitis is inflammation of the peritoneum lining the abdominal cavity. It can be caused by infection, injury, or chemical irritation. Acute peritonitis requires prompt treatment to eliminate the infectious source and reduce bacterial load. Treatment involves intravenous antibiotics, surgery to resolve the underlying cause, and intensive care as needed. Prognosis depends on the severity and cause of peritonitis. More severe or generalized cases with organ dysfunction carry a high risk of complications and mortality.
Peritonitis is among the most common surgical cases. getting familiarized with it for early proper diagnostic and management is the key to reduce morbidity and mortality. In this power point i have analysed important anatomy, causes, investigation and how to manage it as medical personal covers all the necessary things you will require to know about peritonitis
Kindly like, save and share if you find the material useful
Hiatal hernia
Synonyms Hiatus hernia
Hiatalhernia.gif
A drawing of a hiatal hernia
Specialty Gastroenterology, general surgery
Symptoms Taste of acid in the back of the mouth, heartburn, trouble swallowing[1]
Complications Iron deficiency anemia, volvulus, bowel obstruction[1]
Types Sliding, paraesophageal[1]
Risk factors Obesity, older age, major trauma[1]
Diagnostic method Endoscopy, medical imaging, manometry[1]
Treatment Raising the head of the bed, weight loss, medications, surgery[1]
Medication H2 blockers, proton pump inhibitors[1]
Frequency 10–80% (US)[1]
[edit on Wikidata]
A hiatal hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest.
Peritonitis is an inflammation of the peritoneum caused by bacterial or fungal infection. Left untreated, it can lead to sepsis, multiple organ failure and death. There are three main types: primary occurs spontaneously with liver failure; secondary follows a perforation of abdominal organs; tertiary occurs in immuno-compromised people like with AIDS and tuberculosis. Symptoms include severe abdominal pain, fever, nausea and vomiting. Diagnosis involves medical history, exams, blood tests and imaging scans. Treatment requires intravenous fluids, antibiotics, pain relief, and may require surgery to repair damaged organs and drain infections. With proper treatment outcomes are good, but risks include sepsis, adhesions and organ failure if not addressed promptly.
Ventral hernia is protrusion of peritoneal sac through anterior abdominal wall defects except Groin hernias. In this presentation I have discussed Epigastric, Umbilical, Para umbilical, Incisional, Spigelian and Lumbar hernias.
Intussusceptions occur when one segment of the gastrointestinal tract telescopes inside an adjacent segment. While rare in adults, intussusceptions account for 5% of bowel obstructions and have an identifiable underlying disorder in 90% of cases. Symptoms include abdominal pain, nausea, vomiting and bleeding, while diagnostic tools include abdominal CT, x-rays and ultrasound. Treatment involves surgical resection of the involved segment. Prognosis depends on the cause, with mortality rates varying from 8.7% for benign lesions to 52.4% for malignant cases.
Diagnosis and complications of gastric cancerSilah Aysha
Diagnosis of gastric carcinoma involves several steps: an endoscopy to examine the stomach lining, an endoscopic ultrasound to view the stomach wall layers and nearby structures, and a biopsy of any suspicious tissues to examine under a microscope. Additional imaging tests like barium swallow, CT scan, MRI, and PET scan may be used to determine if the cancer has spread from the stomach. Surgical tests like laparoscopy are also used to confirm if the cancer is contained to the stomach or has spread before deciding on treatment.
The document discusses hiatal hernia, which occurs when part of the stomach bulges through an opening in the diaphragm. It outlines the causes, symptoms, diagnosis through imaging and endoscopy, differential diagnosis, and treatment options including medication, surgery to repair the diaphragm and prevent reflux, and post-operative care. The prognosis is generally good if the hernia is repaired and complications like aspiration pneumonia are managed.
1. Colorectal trauma can result from penetrating injuries like gunshots, impalement, or medical procedures. Blunt trauma is rare but can occur from pelvic fractures in car accidents or falls.
2. Treatment depends on factors like injury size, contamination, and time since injury. Small, clean injuries found early may be closed primarily. Larger or delayed injuries usually require resection and colostomy.
3. Rectal injuries require examination to locate them, irrigation, and sometimes drainage or abdominal repair with proximal fecal diversion. Perineal injuries usually cannot be primarily repaired and require diversion.
Intestinal obstruction occurs when the intestine is blocked partially or completely, preventing contents from passing through. It can be classified as dynamic, adynamic, small bowel, or large bowel obstruction.
Clinical presentation depends on the location and severity of the obstruction. Symptoms often include colicky abdominal pain, vomiting, distention, and constipation.
Common causes are adhesions, hernias, volvulus, intussusceptions, gallstones, and tumors. Strangulated obstruction with compromised blood flow is a surgical emergency.
Diagnosis involves blood tests, abdominal exams, imaging studies like abdominal x-rays and CT scans to detect air-
Lecture on abdominal trauma during Basic Life Support 2018 course in Sibu Hospital. Encompasses blunt and penetrating trauma, principles and tips of management
This document discusses fistula in ano and anal fissure. It defines a fistula in ano as an abnormal track connecting two epithelial surfaces, most commonly caused by anorectal abscess. It describes the classification, symptoms, diagnosis and management of fistula in ano, including fistulotomy and setons for simple vs. complex fistulas. It also defines anal fissure as a tear distal to the dentate line, most commonly caused by hard stool or constipation. It notes the pathogenesis is a cycle of pain and spasm that impairs healing. It provides details on the location, symptoms and treatment of acute vs. chronic anal fissure.
This document provides an overview of colorectal trauma and injuries. It discusses relevant anatomy, considerations for colonic and rectal trauma including classification systems, management approaches, and risks factors. It also reviews iatrogenic injuries that can occur from various surgical, endoscopic, and diagnostic procedures. Key points include that nondestructive colon injuries can often be primarily repaired, while destructive injuries require resection. Rectal injuries are classified using the "4Ds" concept of debridement, drainage, washout, and sometimes diversion.
An anal fistula is a small channel that develops between the end of the bowel and the skin near the anus, usually as a result of an infection near the anus causing pus to drain and leave behind a tunnel. It can be caused by an infected anal gland. Diagnosis involves physical examination where the doctor inserts a gloved finger in the anus to feel abnormal areas, and may use sigmoidoscopy, colonoscopy, MRI or dye tests to further examine the fistula. Treatment depends on the fistula's location and complexity but may include laying it open, setting in a plug, or glue to allow it to heal from the inside out.
This document discusses acute peritonitis, including:
- Peritonitis is defined as inflammation of the peritoneum and can be localized or generalized. It is usually caused by bacterial infection entering through the gastrointestinal tract or other sources.
- Symptoms depend on whether it is localized or diffuse. Localized peritonitis causes pain specific to the affected organ, while diffuse peritonitis causes generalized abdominal pain and tenderness.
- Treatment involves antibiotics, fluid resuscitation, and sometimes surgery to address the underlying cause and drain any abscesses. Outcomes depend on several factors but mortality is around 10% with prompt treatment. Complications can include shock, bowel obstruction, and residual infections.
OPEN CHOLECYSTECTOMY- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #opencholecystectomy #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy and Modified Radical Mastectomy.
• In this video today, I have discussed Open Cholecystectomy.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
• Thank you for watching the videos.
Hiatal hernia is a condition where the stomach and other intra-abdominal contents protrude through the esophageal hiatus of the diaphragm. Risk factors include obesity, increased abdominal pressure, and previous hiatal hernia surgery. Symptoms may include heartburn, dysphagia, chest pain, or respiratory issues. Diagnosis is typically made through upper gastrointestinal imaging. Treatment depends on symptoms and hernia type but may involve lifestyle changes, medication, or surgery to repair the diaphragmatic defect and prevent acid reflux. Complications can include obstruction, bleeding, stomach twisting, and Barrett's esophagus.
Diverticulosis and diverticular diseaseDoha Rasheedy
This document discusses diverticular disease, specifically diverticulosis and acute diverticulitis. It covers the epidemiology, pathophysiology, clinical presentation, investigations including CT and barium enema, differential diagnosis, and Hinchey classification of diverticulitis severity. Diverticulosis is asymptomatic protrusions in the colon wall that become symptomatic as diverticulitis in 20% of cases from obstruction, inflammation, or perforation. Risk factors include low fiber diet and increased age. CT is the best imaging method to diagnose and stage diverticulitis.
This document discusses appendicitis, a condition where the appendix becomes inflamed or infected. The appendix is a small, tube-like structure attached to the large intestine. While its function is unknown, appendicitis occurs when the appendix becomes blocked and bacteria grow, causing swelling. Common symptoms include abdominal pain, nausea, and fever. Untreated appendicitis can lead to the appendix rupturing, resulting in a serious infection of the abdominal cavity. Standard treatment is surgical removal of the appendix to prevent rupture and further complications.
This document discusses hernias, including types, causes, risk factors, clinical manifestations, diagnostic measures, management, complications, and nursing management. The main types of hernias are inguinal, femoral, umbilical, diaphragmatic, hiatal, and incisional. Hernias occur when an organ or tissue protrudes through a weakened area in the muscle or surrounding wall. Clinical features depend on whether the hernia is reducible, irreducible, or strangulated. Treatment involves surgical repair or herniorrhaphy, with nursing care focused on monitoring for complications and educating patients.
This document discusses rectal prolapse, including different types (full thickness, internal, mucosal), causes, clinical features, and treatment options. It describes full thickness prolapse as a full-thickness protrusion of the rectum through the anal sphincters. Mucosal prolapse involves protrusion of the rectoanal mucosa only. Treatment includes non-operative options like fiber supplements as well as surgical procedures. Perineal surgeries include resection, reefing, and encirclement techniques while abdominal surgeries include anterior and posterior rectopexy to fixate the rectum. Laparoscopic rectopexy is now commonly used with lower morbidity than open abdominal procedures. Surgery aims to correct the
Peritonitis is inflammation of the peritoneum lining the abdominal cavity. It can be caused by infection, injury, or chemical irritation. Acute peritonitis requires prompt treatment to eliminate the infectious source and reduce bacterial load. Treatment involves intravenous antibiotics, surgery to resolve the underlying cause, and intensive care as needed. Prognosis depends on the severity and cause of peritonitis. More severe or generalized cases with organ dysfunction carry a high risk of complications and mortality.
Peritonitis is among the most common surgical cases. getting familiarized with it for early proper diagnostic and management is the key to reduce morbidity and mortality. In this power point i have analysed important anatomy, causes, investigation and how to manage it as medical personal covers all the necessary things you will require to know about peritonitis
Kindly like, save and share if you find the material useful
The peritoneal membrane lines the abdominal cavity and divides it into two parts. It has several functions including pain perception, lubrication, and immune responses. Peritonitis is inflammation of the peritoneum which can be caused by infection, chemicals, ischemia or other factors. It can be localized or diffuse. Tuberculosis is a common cause of chronic peritonitis. Cancer can also spread to the peritoneum causing carcinomatosis. Mesenteric cysts occur in the mesentery and have several classifications including chylolymphatic and enterogenous cysts. Clinical features of mesenteric cysts include a painless abdominal swelling or acute symptoms from torsion or rupture.
Peptic ulcers form in the stomach or duodenum due to an imbalance between acid secretions and mucosal defenses. Risk factors include H. pylori infection in 90% of cases, NSAID use, and stress. Complications include hemorrhage, perforation, and obstruction. H. pylori survives stomach acid through urease production. Diagnosis involves symptoms and imaging. Treatment depends on complications but usually involves antibiotics to eradicate H. pylori along with acid suppression. Surgery may be needed for perforation or obstruction.
Acute cholecystitis is an inflammation of the gallbladder that is usually caused by gallstones blocking the cystic duct. The main symptoms are severe pain in the upper right abdomen that may radiate to the back or shoulder, along with nausea and vomiting. On examination, tenderness is found over the gallbladder and symptoms are worsened by pressure. Laboratory tests show elevated white blood cell count and ultrasound reveals abnormalities of the gallbladder. Treatment involves antibiotics and supportive care, with surgical removal of the gallbladder (cholecystectomy) as definitive treatment once the acute inflammation subsides.
The document provides information on acute abdomen and intestinal obstruction. It discusses the common causes of acute abdomen including acute appendicitis and intestinal obstruction. For intestinal obstruction, it describes the different mechanisms including mechanical (dynamic) and non-mechanical (adynamic) obstruction. It also discusses the clinical features, investigations, management and complications of acute appendicitis and intestinal obstruction.
Peritonitis is an inflammation of the peritoneum lining the abdominal cavity that can be caused by infection or non-infectious processes. There are two main types - primary peritonitis caused by infection spreading from the blood or lymph nodes, and secondary peritonitis caused by infection entering through the GI or biliary tract. Symptoms include abdominal pain and tenderness, fever, nausea, and vomiting. Treatment involves antibiotics, intravenous fluids, and sometimes surgery to drain and cleanse the peritoneum if infection is present. Complications can include electrolyte imbalances, organ dysfunction, sepsis, and formation of scar tissue.
An acute abdomen is severe abdominal pain lasting less than 24 hours with signs of tenderness. It requires rapid diagnosis and treatment as some causes like perforation require urgent surgery. Common causes are hemorrhage, infection, perforation, blockage, and ischemia. Physical exam, lab tests, imaging like CT scans, and diagnostic tools help determine the cause. Indications for urgent surgery include signs of peritonitis, shock, deterioration on conservative care, and radiologic findings suggestive of a condition like perforation requiring operation. Preoperative preparation focuses on IV access, fluid resuscitation, antibiotics, and correcting electrolyte abnormalities.
Diverticular disease is common in Western populations, where diverticula form as outpouchings in the colonic wall. Diverticulosis refers to the presence of diverticula without inflammation, while diverticulitis occurs when diverticula become inflamed. Common symptoms of diverticulitis include severe left lower quadrant pain, fever, and leukocytosis. Complications can include abscess, fistula formation, perforation, hemorrhage, or obstruction. Diagnosis involves imaging such as CT scan or contrast enema to evaluate for complications. Treatment depends on severity but may involve antibiotics, drainage, or surgical resection.
11. Other Problems in Inflammatory Response.pptxJRRolfNeuqelet
This document discusses several inflammatory conditions that can affect different body systems. It provides details on the causes, symptoms, diagnostic tests and treatments for appendicitis, peritonitis, pancreatitis, cholecystitis, and cystitis. Appendicitis is caused by obstruction of the appendix, usually by a fecalith, and requires appendectomy to prevent rupture. Peritonitis is inflammation of the abdominal lining that can result from a perforated appendix or other infections. Pancreatitis may be due to gallstones or alcohol and causes abdominal pain. Cholecystitis is gallbladder inflammation often from gallstones blocking the cystic duct. Cystitis is a urinary tract infection.
This document provides an overview of small intestinal obstruction. It begins by defining small intestinal obstruction as a blockage of the small intestine. It then discusses the epidemiology, pathophysiology, signs and symptoms, causes, complications, diagnosis and treatment of small intestinal obstruction. The main points are that adhesion and hernia are the most common causes, and treatment involves correcting fluid and electrolyte imbalances, nasogastric decompression, antibiotics and potentially surgery for cases of strangulation or complete blockage. Both non-operative and surgical treatments are discussed.
This document provides an overview of small intestinal obstruction. It begins by defining small intestinal obstruction as a blockage of the small intestine. It then discusses the epidemiology, pathophysiology, signs and symptoms, causes, complications, diagnosis and treatment of small intestinal obstruction. The main points are that adhesion and hernia are the most common causes, and treatment involves correcting fluid and electrolyte imbalances, nasogastric decompression, antibiotics and potentially surgery for cases of strangulation or complete blockage. The document provides details on evaluating and managing both mechanical and paralytic forms of small intestinal obstruction.
Non tubercular infections of GUT- Dr Niranjan Patil.pptxdypradio
This document summarizes various non-tuberculous infections of the urinary tract, including bacterial infections like acute pyelonephritis. It describes common pathogens, symptoms, diagnoses, and treatments for conditions such as renal and perinephric abscesses, pyonephrosis, emphysematous and xanthogranulomatous pyelonephritis, and renal fistulas. Imaging modalities like CT, ultrasound, and excretory urography are discussed for evaluating infections and complications involving the kidneys and urinary tract.
This document discusses acute peritonitis, including:
- Peritonitis is defined as inflammation of the peritoneum and can be localized or generalized. It is usually caused by bacterial infection entering through the gastrointestinal tract or other sources.
- Symptoms depend on whether it is localized or diffuse. Localized peritonitis causes pain specific to the affected organ, while diffuse peritonitis causes generalized abdominal pain and tenderness.
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Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
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10. Describe the Cheyne-Stokes breathing
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1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
2. Peritonitis
Intra-abdominal infections
Two major clinical manifestations
Early or diffuse infection results
in localised or generalised
peritonitis
Bacterial peritonitis is classified as
primary or secondary
Late and localised infections
produces an intra-abdominal
abscess
Pathophysiology depend on
competing factors of bacterial
virulence and host defences
3. Primary peritonitis
Diffuse bacterial infection without loss of integrity of GI tract
Often occurs in adolescent girls
Streptococcus pneumonia commonest organism involved
Ascites, secondary to cirrhosis of the liver, may become
infected spontaneously.
Secondary peritonitis
Acute peritoneal infection
Often involves multiple organisms - both aerobes and anaerobes
Commonest organisms are E. coli and Bacteroides fragilis
5. Etiology (secondary peritonitis )
• Perforation of a viscus into the
peritoneal cavity
• Trauma
• Infected intraperitoneal blood from any
source (eg, trauma, surgery, ectopic pregnancy)
can become infected and lead to peritonitis.
• Foreign bodies
• Pancreatitis
6. Etiology (secondary peritonitis )
• Strangulating intestinal obstruction
• Pelvic inflammatory disease (PID)
• Vascular catastrophes (mesenteric
thrombosis or embolism).
• In sexually active women: gonococcus and
chlamydia are most common.
• IUD long-lasting
• Anastomotic dehiscence
7. Etiology (secondary peritonitis )
• Peritoneo-systemic shunts, in common with other long-lasting
• peritoneal drains, tend to become infected and lead to peritonitis.
• Drains of any type may furnish an entry for bacteria into the
peritoneal cavity.
• Barium introduced into the peritoneal cavity via an enema through a
perforated diverticulum can lead to acute and later to chronic
peritonitis because of the combination of barium and infection.
• Meconium peritonitis can occur from perforation of the bowel in
utero.
• Peritoneal dialysis
8. Peritonitis, symptoms
• Abdominal pain
• Abdominal tenderness
• Fluid in the abdomen
• Inability to pass feces or gas („ silent „ abdomen )
• Distended abdomen
• Fever
• Low urine output
• Nausea and vomiting
• Point tenderness
• Thirst
10. Symptoms, Signs, and
Complications
The symptoms of peritonitis depend on the virulence
and extent of the infection.
In severe cases of generalized peritonitis, tenderness occurs over
the entire abdomen with vomiting and high fever.
Peristalsis is absent. (An old clinical rule: A silent abdomen demands
a laparotomy.)
Note: a stone in the urether can also causes strong pain and absence of
intestinal movements and sounds!
A postoperative paralysis does not need operation !
11. Symptoms, Signs, and
Complications
• The loss of fluids into the peritoneal
cavity and bowel leads to severe
dehydration and electrolyte
disturbances
• Adult respiratory distress syndrome
also develops rapidly.
• Kidney failure, liver failure, and
disseminated intravascular coagulation
follow.
16. Iatrogenic perforations (eg, from an esophagoscope, balloon
dilator, or bougie) above or below the diaphragm.
Forceful vomiting with a full stomach may cause esophageal rupture
(Boerhaave's syndrome), which is the most serious type of emetic
injury. Pain in the left upper quadrant, left chest, or shoulder after any of
these occurrences should alert the physician to order an immediate
meglumine diatrizoate (Gastrografin) swallow.
If a perforation is noted, immediate operation is necessary
because the mortality from peritonitis or empyema increases rapidly with
delay.
Perforated abdominal esophagus
17. Perforated gastric or duodenal ulcer
tends to cause the one of most serious cases of peritonitis; the mortality
rate is nearly 20%. There may be a history of peptic ulcer disease, but in
about 33% of cases, the first symptom is a sudden attack of severe
epigastric pain.
A patient examined shortly after onset may be relatively free of pain and
show only mild tenderness and diminished or absent peristalsis.
However, within a few hours, vomiting, tenderness, and spasm, either in
the epigastrium or over the whole abdomen, develop.
18. Perforated Appendix
It can occur at any age but is
the most common cause of
peritonitis in children and
young adults.
In children, because of a poorly
developed omentum,
peritonitis is likely to be
generalized;
in adults, local peritonitis and
abscess formation are more
common.
Tenderness in the right lower
quadrant or over the entire
abdomen indicates the
extent of inflammation.
19. Perforated colon
caused by obstruction, diverticulitis, inflammatory diseases, and
toxic megacolon.
Perforated diverticulitis of the sigmoid or right colon is the most
common cause of peritonitis from a perforated colon.
Patients receiving prednisone or immunosuppressive drugs can also
increase the danger of perforation.
Crohn’s disease, ulcerative colitis
Acute necrotizing enterocolitis
Ulcerative colitis
22. Vascular lesions of the intestine or colon
Usually, the superior mesenteric distribution is involved, but the area
supplied by the inferior mesenteric artery can be devitalized by division
of this artery during resection of an aortic aneurysm.
A history of abdominal angina for weeks or months preceding an acute
onset of peritonitis suggests thrombotic occlusion of the superior
mesenteric artery or its branches in association with atherosclerotic
disease of these vessels.
Alternatively, a history of recent atrial arrhythmia, MI, or endocarditis
strongly suggests embolization to the superior mesenteric artery and
its resultant intestinal ischemia
Mesenteric venous thrombosis
23. Perforated gallbladder or biliary tree
Acute cholecystitis can lead to perforation of the gallbladder, which
usually leads to a local abscess but occasionally to generalized peritonitis.
Operation should include cholecystectomy. The common cause of bile
peritonitis arising from the bile ducts is iatrogenic damage during
cholecystectomy or EST.
Cholecystitis acalculosa, poor blood supply of gallbladder
24. Nonocclusive intestinal ischemia
is the partial- or full-thickness necrosis of intestine in the absence of
obvious organic vascular occlusion.
It may be caused by prolonged shock or cardiopulmonary
bypass, during which mesenteric blood flow decreases.
In cases in which this diagnosis is considered, arteriography must be
performed.
Demonstration of an organic vascular lesion will lead to operation,
whereas diffuse spasm may respond to vasodilator therapy.
Transmural bowel necrosis and peritonitis must be treated by bowel
resection.
25. Pancreatitis
can cause an exudate that at first is retroperitoneal but soon involves the
peritoneal cavity.
It is a chemical peritonitis, initially with a high level of amylase in the
exudate; later, contamination with organisms from the GI tract may
occur. Infected pancreatitis.
If the diagnosis seems certain and trauma was not a factor, laparotomy
usually is avoided and reserved for the complications of pancreatic
necrosis, abscess, or pseudocyst.
However, failure to improve may be an indication for earlier operation.
26. Fungal peritonitis
usually with Candida, can occur, especially in postoperative patients
who have had persistent peritonitis treated with antibiotics. Candidal
peritonitis can be treated with IV amphotericin B, but the prognosis is
grave.
Peritoneal dialysis frequently is complicated by peritonitis;
cloudy effluent may indicate its presence.
Inlying catheters or shunts used for ascites can lead to bacterial invasion,
notably by Staphylococcus epidermidis and Staphylococcus aureus.
Treatment is with antibiotics, as determined by culture and sensitivity;
removal of shunts, if necessary; or hemodialysis, as a last resort.
27. Tubo-ovarian abscess
develops in about 15% of women with salpingitis.
It can accompany acute or chronic infection and may require prolonged
hospitalization, sometimes with surgical percutaneous drainage.
Rupture of the abscess is a surgical emergency, rapidly
progressing from severe lower abdominal pain to nausea, vomiting,
generalized peritonitis, and septic shock.
Pyosalpinx, in which one or both fallopian tubes are filled with pus,
may also be present.
The fluid may be sterile, but WBCs predominate in it.
28. Postoperative peritonitis
Operative injury to a viscus (biliary tree, ureter, bladder, GI tract)
requires surgical correction.
Anastomotic dehiscence is a serious problem that also requires early
reoperation.
Retained foreign bodies (eg, a sponge) may cause severe abscess or
inflammatory adhesions and fibrosis that persist until the sponge is
removed surgically or, rarely, discharged spontaneously.
29. Diagnosis
ANAMNESIS, PHYSICAL EXAMINATION
Chest x-rays: diff.dg ( pneumonia )
Plain abdominal x-rays should be taken in both supine and upright
positions.
The presence of gas beneath the diaphragm points to a perforation of
the GI tract. If the diagnosis is in doubt, (Gastrografin) passed into the
stomach through an inlying nasogastric tube will demonstrate the
perforation. (Meglumine diatrizoate does not irritate the peritoneum as
does standard barium.)
Ultrasound: can help in differential diagnosis.( gallstone, measurement
of gallbladder wall, localisation and amount of intraabdominal fluid
collection, sign of tumors, kidney stone )
Laparotomy or laparoscopy is the most important diagnostic
measure.
30. Treatment of peritonitis
Primarily involves treatment of the underlying disease.
General therapy includes antibiotics, nasogastric intubation and suction,
respiratory care, and fluid and electrolyte replacement.
The most effective antibiotic regimen to give before results of cultures are
available is debatable.
Third-generation cephalosporins are effective and probably safest. A
combination of gentamicin and clindamycin is effective but dangerous if
renal function is diminished.
31. Surgical management
The management of secondary peritonitis involves :
Elimination of the source of infection
Reduction of bacterial contamination of the peritoneal cavity
Prevention of persistent or recurrent intra-abdominal
infections
Could be combined with fluid resuscitation, antibiotics and ICU
management
Source control achieved by closure or exteriorisation of perforation
Bacterial contamination reduced by aspiration of faecal matter and
pus
Recurrent infection prevented by the used of:
Drains
Planned re-operations
Leaving the wound open / in case of serious pancreatitis
32.
33. Peritoneal lavage
Peritoneal lavage often used but benefit is unproven
Simple swabbing of pus from peritoneal cavity may be of same
value
Has been suggested that lavage may spread infection or damage
peritoneal surface
No benefit of adding antibiotics to lavage fluid
No benefit of adding Chlorhexidine or Betadine to lavage fluid
If used, lavage with large volume of crystalloid solution probably
has best outcome