SURGERY U WORLD
SUPPLEMENTS
PAROTID TUMORS
• Commonest tumor: pleomorphic adenoma
• Usually contain multiple tissues
• Recurrent after surgery
• Surgery involves deep lobe excision
• Facial drop due to facial palsy is a common post operative
complication because facial nerve pass through parotid
AMPUTATION INJURY
• Occur when accidental amputation happens
• Amputated part should be placed in:
# Saline soaked gauze in a plastic bag
# put the bag in ice
# Bring to the emergency
• Management: Plastic surgical consultation
DUMPING SYNDROME
• Common post gastrectomy complication
• Occurs in 50% of patients with bariatric partial gastrectomy
• Due to rapid emptying of hypertonic gastric contents into the
duodenum and S.I. leading to osmotic diarrhea and dehydration
• Management:
1- Dietary modification (symptoms self resolute over time)
2- Octereotide (somatostatin)
3- Reconstruction surgery (resistant cases)
Appendicitis
Appendicitis
Appendicitis
Appendicitis
GASTRIC OUTLET OBSTRUCTION
• Causes: Gastric maliganancy, PUDx, Crohn’s dx, congenital pyloric
stenosis, caustic agents
• C/P: Early satiety, postprandial pain/vomiting, early satiety
• P/E: Succusion splash
• Management:
1- upper GI endoscopy
2- Surgical correction
POSTOPERATIVE PAROTITIS
• Cause: Staph aureus
• Precipitated by dehydration postoperatively
• C/P: Fever, leucocytosis, swollen gland, pain
• P/E: Enlarged tender parotid gland
• Prevention: Adequate fluid intake and oral hygiene
• Treatment: Anti staph antibiotics
DUODENAL HEMATOMA
• Most commonly occur following direct blunt abdominal trauma and
are more commonly seen in children
• Cause: blood collects between the submucosal and muscular layers of
the duodenum causing obstruction
• C/P: Epigastric pain and vomiting due to the failure to pass gastric
secretions past the obstructing hematoma
• Management:
1- Mostly will resolve spontaneously in 1-2 weeks, and the
intervention of choice is nasogastric suction and parenteral nutrition
2- Surgery = if conservative fail
PULMONARY CONTUSION
• Parenchymal bruising of the lung, which may or may not be
associated with rib fractures
• C/P: develop usually in the first 24 hours (often with in few minutes)
- Tachypnea, tachycardia, and hypoxia
- chest wall bruising and decreased breath sounds on the side (P/E)
• Investigations:
- Chest x-ray reveals patchy irregular alveolar infiltrate
- CT may confirm dx
- ABG = Hypoxia
• Management: Admission and follow up with supportive care
CATHETERIZATION COMPLICATIONS
• Local vascular complications at the catheter insertion site = bleeding,
hematoma (localized or with retroperitoneal extension in case of
femoral access)
• Vascular complications = arterial dissection, acute thrombosis,
pseudoaneurysm, or arteriovenous fistula formation
• H&H = occurs within 12 hours of catheterization
• Patients with hematoma present with localized discomfort and/or
swelling of the soft tissue
• Retroperitoneal extension occur if the access site was above the
inguinal ligament
CATHETERIZATION COMPLICATIONS
• Retroperitoneal extension = present with sudden hemodynamic
instability and ipsilateral flank or back pain
• Diagnosis is confirmed by non-contrast CT scan of abdomen and
pelvis or abdominal ultrasound
• Treatment is usually supportive, with intensive monitoring, bed rest,
and intravenous fluids or blood transfusion. Surgical repair of
hematomas or retroperitoneal hemorrhage is rarely required.
• Vascular complications are minimized by radial approach
PILONIDAL DISEASE
• Pilonidal cysts are most prevalent in young males, particularly those
with larger amounts of body hair.
• Etiology of pilonidal cysts and sinuses is not clearly described, but
they are believed to develop following chronic activity involving
sweating and friction of the skin overlying the coccyx within the
superior gluteal cleft
• Infection may spread subcutaneously forming an abscess that then
ruptures forming a pilonidal sinus tract.
PILONIDAL DISEASE
• Chronic sinus tract may then collect hair and debris resulting in
recurrent infections and foreign-body reactions
• Acute inflammation = pain, swelling, and purulent discharge occur in
the midline postsacral intergluteal region.
• Management: Drainage of abscesses and excision of sinus tracts
TORUS PALATINUS
• Benign bony growth (i.e., exostosis) located on the midline suture of
the hard palate.
• Cause = genetic and environmental factors and is more common in
younger patients, women, and Asians.
• <2 cm in size, it can increase in size throughout a person's life.
• The thin epithelium overlying the bony growth tends to ulcerate with
normal trauma of the oral cavity and heal slowly due to a poor
vascular supply.
• Treatment = surgery only if symptomatic
RETROPHARYNGEAL ABSCESS
• Infection in the retropharyngeal deep neck space which carries the
highest risk of spread to the mediastinum, particularly the anterior
and posterior portions of the superior mediastinum as well as to the
entire length of the posterior mediastinum.
• Abscess form in the "danger space", which lies between the alar and
prevertebral fasciae, and drain by gravity into the posterior
mediastinum, resulting in acute necrotizing mediastinitis.
• Excessive salivation and difficulty opening mouth with fever usually
following bacterial infection in the throat
• Surgical drainage is very important and emergent +/- mediastinal
debridment
MASSIVE
HEMOPTYSIS
MASSIVE
HEMOPTYSIS