• SURGICAL

    Abdominal Pain and Abdominal Exam

    Four Examination Components of the Abdomen 1) Inspection of the Abdomen 2) Percussion of the Abdomen General Technique Assessing Specific Areas Pathological Findings 3) Auscultation of the Abdomen General Technique Bowel Sounds Bruits Other Sounds Special Maneuver 4) Palpation of the Abdomen General Technique Light Palpation Deep Palpation Specific Areas…

  • CANCER,  COLORECTAL,  SURGICAL

    Colorectal Cancer

    Risk Factors Age >45 years (accounts for 90% of Colon Cancer)Inflammatory Bowel Disease Ulcerative Colitis – Risk increases with duration since diagnosis (2% at 10 years of disease, 18% at 30 years of disease)Crohns Disease – Lifetime risk of Colorectal Cancer: 4-5% Adenomatous polyps >5mm (Confers RR of 2-3 times)Hamartomatous…

  • COLORECTAL,  SURGICAL

    Local anal conditions 

    Anal fissure Haemorrhoids (piles) Grading External/internal + degrees if external. Internal: Dilation of superior haemorrhoidal plexus. External: Dilation of inferior haemorrhoidal plexus – below dentate line.  🡪 Graded by degrees: â–ˇ  Preferred to GTN less headaches Perianal haematoma Strangulated hemorrhoid Anorectal abscess and fistula Perianal abscess Ischiorectal abscess Anorectal fistula…

  • SURGICAL

    Hernias 

    Definition – a hernia is an abnormal protrusion from one anatomical space to another. Abdominal wall hernias are among the most common of all surgical problems in humans. They are a leading cause of work loss and disability and are sometimes lethal. Types of Hernias Indirect and Direct Inguinal Hernias…

  • SURGICAL

    Hiatal hernia

    predisposing factor = intraabdominal pressure = is a result of Types Can be asymptomatic or have symptoms  Diagnosis Management Complications:

  • GASTROENTEROLOGY,  SURGICAL

    Diverticulitis 

    Acute Diverticulitis: Inflammation of a diverticulum, a sac-like protrusion from the colon wall, due to micro-perforation.Diverticular Disease: Encompasses the spectrum of presentations and complications of diverticulosis. Etiology Pathophysiology: Epidemiology Presentation: Can be DIVIDED TO History and Physical Symptoms: Physical Examination: Differential Diagnosis Investigations Clinical Diagnosis: Laboratory Tests: Radiological Tests: Radiographs:…

  • SURGICAL

    Cholecystitis 

    mechanism signs and symptoms differential diagnosis  diagnostic investigation complications treatment post cholecystectomy advice

  • SURGICAL

    Ascending cholangitis 

    Acute cholangitis Courvoisier’s Law: Palpable gallbladder + obstructive jaundice 🡪 NOT STONE  because thickened GB wall cannot dilate to become palpable Cholangitis (inflammation of bile duct)

  • SURGICAL

    Bowel Obstruction 

    Partial vs Complete bowel obstruction Partial Bowel Obstruction Complete Bowel Obstruction Partial passage of flatus or stool Failure to pass flatus or stool Not usually associated with peritonitis Generally associated with peritonitis Simple vs Complicated bowel obstruction Simple Bowel Obstruction Complicated Bowel Obstruction Absence of peritonitis Associated with perionitis Generally…

  • SURGICAL

    Ischemic colitis 

    Risk Factors Acute mesenteric ischaemia Colonic ischaemia Most patients over 50 years 90% of patients over 60 years Acute precipitating cause is usual (e.g.,myocardial infarction, congestive heart failure, cardiac arrhythmias, hypotensive episodes) Acute precipitating cause is rare Predisposing lesion is uncommon (excluding atherosclerosis) Associated predisposing lesion (e.g., colon carcinoma, stricture,…