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007 Non Acute Abdominal Conditions - Introduction to Clinical Surgery Lectures

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Information about 007 Non Acute Abdominal Conditions - Introduction to Clinical Surgery...

Published on July 1, 2008

Author: memorablemedicine

Source: slideshare.net

Description

Lecture on non-acute abdominal conditions from a series of lectures on an introduction to clinical surgery. It has been devised with medical students in mind.
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Non-acute Abdominal Conditions Nick Harvey

Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Gastric Ulcer Duodenal Ulcer/Ca Stomach Biliary Gallstones Retrosternal Pain Burning Increased on lying down Relieved by antacids NSAIDS Haematemesis Melaena Weight loss RUQ pain Colicky Radiates to back Referred to shoulder Vomiting Jaundice OGD + Biopsy 24 hours pH monitoring Manometry OGD + Biopsy CT USS

Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Gastric Ulcer Duodenal Ulcer/Ca Stomach Biliary Gallstones Retrosternal Pain Burning Increased on lying down Relieved by antacids NSAIDS Haematemesis Melaena Weight loss RUQ pain Colicky Radiates to back Referred to shoulder Vomiting Jaundice OGD + Biopsy 24 hours pH monitoring Manometry OGD + Biopsy CT USS

Non-acute Abdominal Conditions: Dyspepsia Indigestion Oesophageal Gastroesophageal Reflux Gastrodudenal Acute Gastritis/Gastric Ulcer Duodenal Ulcer/Ca Stomach Biliary Gallstones Retrosternal Pain Burning Increased on lying down Relieved by antacids NSAIDS Haematemesis Melaena Weight loss RUQ pain Colicky Radiates to back Referred to shoulder Vomiting Jaundice OGD + Biopsy 24 hours pH monitoring Manometry OGD + Biopsy CT USS

Non-acute Abdominal Conditions: Jaundice Jaundice Pre-hepatic Haemolytic Hepatocellular Post-hepatic Obstructive Pale stools Dark urine ?pale stools ?dark urine Urine & stools Normal colour

Non-acute Abdominal Conditions: Obstructive Jaundice Causes Benign CBD stones Female Biliary colic Fluctuating jaundice No weight loss Benign biliary stricture Malignant Ca pancreas Male Painless Progressive jaundice Weight loss Cholangiocarcinoma

Benign

CBD stones

Female

Biliary colic

Fluctuating jaundice

No weight loss

Benign biliary stricture

Malignant

Ca pancreas

Male

Painless

Progressive jaundice

Weight loss

Cholangiocarcinoma

Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dilated Biliary Tree Normal Biliary Tree MRCP ERCP CT PTC

Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dilated Biliary Tree Normal Biliary Tree MRCP ERCP CT PTC

Non-acute Abdominal Conditions: Obstructive Jaundice Investigations History & Examination FBC / U&Es / LFTs / INR USS Dilated Biliary Tree Normal Biliary Tree MRCP ERCP CT PTC

Non-acute Abdominal Conditions: Suspected Bowel Cancer Clinical Presentation Right Colon Anaemia RIF Mass Acute Appendicitis! Left Colon Change in bowel habit PR bleeding Mass Rectum PR bleeding Tenesmus ‘ Morning diarrhoea’

Right Colon

Anaemia

RIF Mass

Acute Appendicitis!

Left Colon

Change in bowel habit

PR bleeding

Mass

Rectum

PR bleeding

Tenesmus

‘ Morning diarrhoea’

Non-acute Abdominal Conditions: Suspected Bowel Cancer Other Features PR Bleeding Change in Bowel Habit Mucous Weight loss Sense of incomplete evacuation History of IBD FH of bowel cancer

PR Bleeding

Change in Bowel Habit

Mucous

Weight loss

Sense of incomplete evacuation

History of IBD

FH of bowel cancer

Non-acute Abdominal Conditions: Suspected Bowel Cancer PR Bleeding Colour? Mixed? Pan? Paper? Mucous?

Colour?

Mixed?

Pan?

Paper?

Mucous?

Non-acute Abdominal Conditions: Suspected Bowel Cancer Change in Bowel Habit Constipation Diarrhoea Morning diarrhoea 6 weeks

Constipation

Diarrhoea

Morning diarrhoea

6 weeks

Non-acute Abdominal Conditions: Suspected Bowel Cancer Investigations FBC / U&Es / LFTs ?CEA Rigid sigmoidoscopy Flexible sigmoidoscopy Barium enema Colonoscopy CT colonography Pre-op staging: Bx, CXR, U/S, CT, MRI

FBC / U&Es / LFTs ?CEA

Rigid sigmoidoscopy

Flexible sigmoidoscopy

Barium enema

Colonoscopy

CT colonography

Pre-op staging: Bx, CXR, U/S, CT, MRI

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