Dr.laith al-harbauy Tuesday, September 06, 2016
Session 10
1
Causes of I.O
most common
st
1
most
nd
2
common
most
rd
3
common
Ileocecal valve competence
-if the ileocecal valve is incompetent------fecal material vomitus
How to examine for intestine
viability in I.O.?
Types of adhesion –
1. Post op. fibrinous adhesion (easy) bet. 3-6 post op unlikely cause complete
obst. Disappear completely after months
2. Post op. fibrous adhesion (difficult) it’s a strong band occur in area
deficient of blood supply & become adherent to omentum or parietal
peritoneum to gain blood supply cause obst. At any time
Prevention
Prevention of postoperative adhesion:
1- good surgical technique.
2- careful handling of tissue
3- minimal use and exposure of peritoneum to foreign bodies.
4- use of laparoscopy rather than open surgery.
Dr.laith al-harbauy Tuesday, September 06, 2016
Session 10
2
Causes of being sigmoid volvulus is more than other places
Reduction en-masse of inguinal/femoral hernia can be
defined as reduction of the hernial sac together with
its intestinal contents so that the bowel still remains incarcerated
-Round legment of uterus is redumentary and decend through inguinal canal
-30 y.o male w/t chronic obstruction ------------think about volvulus
40 y.o female obese presented with swelling in the right to umbilicus .O/E it's tender &red&
tense =Dx is strangulated paraumbilical hernia
Taxis
مموجودة بالكتب حاليا بس احتمال يسال عليها د.ليث
Dr.laith al-harbauy Tuesday, September 06, 2016
Session 10
3
Types of mesh used in hernioplasty
1.nylon 2-dacrone
Colonic pseudo-obstruction (Ogilvie's syndrome)
Is a disorder characterized by gross dilatation of the colon in the absence of an anatomic
lesion that obstructs the flow of intestinal contents
Associated factors DM, hypothyroidism, burn, drugs → an impairment of the autonomic
nervous system. → Interruption of the parasympathetic fibers
Present as acute large bowel obst.
Caecal perforation is recognized complication
Acute megacolon can also lead to ischemic
necrosis in massively dilated intestinal segments.