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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…
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Appendicitis
epidemiology pathogenesis clinical presentation diagnosis differential diagnosis treatment
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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)
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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…
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Bowel polyps
Hereditary non-polyposis colorectal cancer (Lynch syndrome)
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Cholecystectomy short and Long-Term Effects
Cholecystectomy Short-Term Effects Cholecystectomy Long-Term Effects Additional Considerations
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Cholecystitis
mechanism signs and symptoms differential diagnosis diagnostic investigation complications treatment post cholecystectomy advice
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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…
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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:…
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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…
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Hiatal hernia
predisposing factor = intraabdominal pressure = is a result of Types Can be asymptomatic or have symptoms Diagnosis Management Complications:
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Intussusception
Key points Background Assessment Examination Investigations Management
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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,…
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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: □ Preferred to GTN less headaches Perianal haematoma Strangulated hemorrhoid Anorectal abscess and fistula Perianal abscess Ischiorectal abscess Anorectal fistula…
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Mesenteric adenitis
Pathophysiology Etiology Epidemiology Prognosis Morbidity/mortality Complications Clinical features Physical Examination
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Pancreatic cancer
epidemiology risk factors clinical presentation is related to location of tumour Signs diagnosis pathology treatment prognosis
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Pancreatitis
Prognostic criteria Ranson’s (valid for ETOH-induced pancreatitis only) Mx
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PR bleeding
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Splenectomy