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    Gawat Darurat Bedah - DR Munthadar, SP.B, SP - Ba

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    Hayatul AkmaLia
    The document discusses acute gastrointestinal emergencies, classifying them by site in the GI tract. It details common conditions that can present as emergencies for each site, including their typical presentations and treatments. These include conditions of the esophagus, stomach, gallbladder, pancreas, small intestine, large intestine and peritoneal cavity.

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    Gawat Darurat Bedah - DR Munthadar, SP.B, SP - Ba

    Uploaded by

    Hayatul AkmaLia
    20 views25 pages
    The document discusses acute gastrointestinal emergencies, classifying them by site in the GI tract. It details common conditions that can present as emergencies for each site, including their typical presentations and treatments. These include conditions of the esophagus, stomach, gallbladder, pancreas, small intestine, large intestine and peritoneal cavity.

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    Gawat Darurat Bedah - Dr Munthadar, Sp.B, Sp.ba

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    The document discusses acute gastrointestinal emergencies, classifying them by site in the GI tract. It details common conditions that can present as emergencies for each site, including their typical presentations and treatments. These include conditions of the esophagus, stomach, gallbladder, pancreas, small intestine, large intestine and peritoneal cavity.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    20 views25 pages

    Gawat Darurat Bedah - DR Munthadar, SP.B, SP - Ba

    Uploaded by

    Hayatul AkmaLia
    The document discusses acute gastrointestinal emergencies, classifying them by site in the GI tract. It details common conditions that can present as emergencies for each site, including their typical presentations and treatments. These include conditions of the esophagus, stomach, gallbladder, pancreas, small intestine, large intestine and peritoneal cavity.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 25

    Acute Gastrointestinal Emergencies

    F C Campbell
    Dept of Surgery

    Acute GI Emergencies - Objectives


    Know conditions which commonly present as GI
    emergency, according to GI site
    Know typical clinical presentation
    Know underlying pathology
    Know treatment strategy

    Acute GI Emergencies - 1
    Classify by site
    Oesophagus
    Acute
    dysphagia
    Perfusion
    Bleeding
    Stomach/duodenum
    Perfusion
    Bleeding

    Acute GI Emergencies - 2
    Gallbladder/Biliary Tract
    Cholecystitis
    Cholangitis
    Obstructive jaundice

    Pancreas
    Acute pancreatitis

    Acute GI Emergencies - 3
    Small intestine
    Intestinal obstruction
    Mesenteric Infarct
    (Infectious diarrhoea)
    Crohns Disease
    Meckels Diverticulum

    Acute GI Emergencies - 4
    Large Bowel (+ App)
    Acute Appendicitis
    Acute Diverticulitis
    Lower GI bleeding
    Perforation
    Intestinal obstruction
    Uncontrolled ulcerative colitis

    Acute GI Emergencies - 5
    Perintoneal cavity
    Peritonitis
    Intra-abdominal abscess

    Oesophagus - Bleeding
    Oesophagitis, Mallroy Weiss,
    Varices
    Variceal bleeding can be
    catastrophic
    Treatment - varices
    Sengstaken tube
    Somatostatin injection

    Oesophagus Acute Dysphagia


    Presentation cannot swallow
    May have benign stricture or cancer
    Triggered by food bolus or tablet
    Treatment remove bolus
    deal with underlying
    oesophageal disease

    Oesophagus Perforation
    High mortality
    May follow endoscopy
    Presentation acute chest/abdominal pain
    Air in mediastinum and soft tissues
    Treatment surgery - benign
    intubation - malignant

    Stomach/duodenum Perforation
    Presentation
    abdominal pain
    rigidity
    peritonism, shock
    Air under diaphragm on X-ray
    Treatment
    antibiotics, resuscitate
    repair

    Stomach/duodenum Bleeding
    Presentation
    Haematemesis +/Melaena
    Severity
    Increased PR>90
    Fall BP<100
    Causes
    DU, erosions, GU
    Treatment transfusion
    inject DU

    Gall bladder/Biliary Tract


    Obstructive Jaundice
    Yellow skin, sclerae
    Pale stools, dark urine
    +/- Pain
    +/- Courvoisiers sign
    CT dilated bile ducts
    Establish diagnosis
    Gallstones
    Ca Head of Pancreas
    Appropriate treatment

    Gall bladder/Biliary Tract


    Acute Cholecystitis
    Presentation
    Acute RUQ pain
    +/- Pyrexia
    +/- Rigors
    Diagnosis FBC, WBCC, USS
    Treatment Antibiotics,
    analgesics
    Early surgery

    Pancreas
    Acute pancreatitis
    Constant pain, vomiting,
    shock
    Causes
    Gallstones, or
    Alcohol
    Diagnosis
    Serum amylase
    elevation, USS
    complications
    pseudocyst, phlegmon
    abcess

    Small Intestine
    Meckels Diverticulum
    rare
    diverticulum of terminal ileum
    can be lined by gastric epithelium
    can perforate
    can present like appendicitis

    Small Intestine
    Intestinal obstruction
    May arise due to
    adhesions, hernia, tumour
    Presentation
    colicky abdominal pain,
    vomiting, constipation
    Treatment
    resuscitate/operate

    Small Intestine
    Mesenteric infarct
    Sudden occlusion of small
    bowel arterial supply
    Sudden onset of abdominal pain, shock
    Peritonitis
    Treatment
    resuscitate/operate

    Large bowel
    Acute diverticulitis
    Maximal in (L) colon
    Presentation LIF pain,
    fever, tenderness,
    leukocytosis
    Middle aged or elderly
    Treatment conservative
    antibiotics, fluids, bed rest

    Large bowel
    Lower GI bleeding
    Diverticulum, colitis,
    Crohns tumour
    Present with Fresh Red Blood P/R
    Tendency to be more conservative than
    with upper GI
    resuscitate, transfusion

    Large bowel
    Perforation
    Diverticulum, colitis,
    sudden severe abdominal pain,
    rigidity
    Faecal peritonitis
    Pyrexia, shock
    Free gas on X-ray
    Treatment
    resuscitate, operate

    Inflammatory Bowel Disease


    Recurrent regeneration
    Increased risk of tumour formation
    14.8 X

    Large Bowel
    Ulcerative colitis
    Presents bloody
    diarrhoea, pyrexia
    leukocytosis
    may develop toxic megacolon
    Treatment steroids
    Surgery on failure

    Peritoneal cavity
    Acute peritonitis
    any perforation,
    pancreatitis
    abdominal pain, tenderness
    guarding, silent abdomen
    shock
    Treatment underlying condition

    Acute GI Emergencies - Conclusions


    Conditions which commonly present
    GI emergency, according to
    GI site
    Typical clinical presentation
    Underlying pathology
    Treatment strategy

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