Presentation
On postoperative day 14, the woman presented with a deep wound infection, then 1 week later with MRSA superinfection. [ncbi.nlm.nih.gov]
Entire Body System
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Painter
Myles PS 1, Bellomo R 1, Corcoran T 1, Forbes A 1, Peyton P 1, Story D 1, Christophi C 1, Leslie K 1, McGuinness S 1, Parke R 1, Serpell J 1, Chan MTV 1, Painter T 1, McCluskey S 1, Minto G 1, Wallace S 1 ; Australian and New Zealand College of Anaesthetists [ncbi.nlm.nih.gov]
Gastrointestinal
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Hiccup
This emergency situation may be caused by excessive stress on the wound from coughing, hiccups, vomiting or distention; inadequate or tight sutures; wound infection; diabetes; poor nutrition or hematoma. [livestrong.com]
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Abdominal Bruising
In addition, these data suggest that a lack of the seat belt sign, abdominal bruising, abdominal wounds, or abdominal tenderness are individually predictive of patients who will not require surgical intervention. Copyright 2017 Elsevier Inc. [ncbi.nlm.nih.gov]
Neurologic
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Hyperalgesia
Pain and wound hyperalgesia were consistently greater on the "unblocked" side for the 3-wk period of observation. Thus, even imperfect intraoperative attenuation of noxious stimuli can lead to persistent reductions in postoperative pain. [ncbi.nlm.nih.gov]
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Unable to Walk
Before hospitalization, 79% of patients were completely independent in walking at home, 12% needed assistive devices or direct assistance from the caregiver, and 9% were unable to walk. [ncbi.nlm.nih.gov]
Workup
X-Ray
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Pneumoperitoneum
The effects of nitrous oxide and helium pneumoperitoneum compared with carbon dioxide pneumoperitoneum are uncertain. [ncbi.nlm.nih.gov]
During pneumoperitoneum pulmonary resistance increases. [intechopen.com]
We also offer the latest treatments for complex ventral hernias (a condition in which tissues are pushing through the abdominal wall), such as the preoperative progressive pneumoperitoneum technique for particularly large ventral hernias. [ucsfhealth.org]
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Multiple Renal Cysts
Abstract On abdominal computed tomography scan for evaluation of hematuria, the index patient, a 23-year-old male, was found to have multiple renal cysts bilaterally. [ncbi.nlm.nih.gov]
Treatment
With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group. [ncbi.nlm.nih.gov]
Prognosis
PURPOSE: To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients. [ncbi.nlm.nih.gov]
“We will continue to monitor her closely, but all the signs suggest we should be optimistic about her long-term prognosis. This is credit to Abiageal, her family, as well as the surgical, medical and nursing teams involved in looking after her.” [express.co.uk]
Bagshaw, SM, Wald, R. " Acute kidney injury in 2010: Advances in diagnosis and estimating disease prognosis". Nature Reviews Nephrology. vol. 7. 2011. pp. 70-1. Kaplan, LJ, Kellum, JA. "Fluids, pH, ions and electrolytes". [clinicaladvisor.com]
Etiology
Various etiological aspects of chronic extraheptic venous thrombosis have not been documented due to the low incidence of these events. We discuss these aspects in the context of our patient. [ncbi.nlm.nih.gov]
Liakakos T et al. (2001) Peritoneal adhesions: etiology, pathophysiology, and clinical significance: recent advances in prevention and management. Dig Surg 18 : 260–273 2. [nature.com]
"Microbial etiologies of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia". Clinical Infectious Diseases. vol. 51. 2010. pp. S81-7. Marik, PE, Zaloga, GP. [clinicaladvisor.com]
Epidemiology
Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients. Hum Reprod 2004 ; 19 : 1877 -85. Higgins J, Green S. [doi.org]
Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806–8. [perioperativemedicinejournal.biomedcentral.com]
Epidemiology Patients with abdominal surgery and its complications generally represent 50% of the patient population in a tertiary or quaternary care hospital's surgical ICU. [clinicaladvisor.com]
Pathophysiology
Pathophysiology of each abdominal organ and the consequences for anesthesia. Consequences of bowel and biliary obstruction. Pathophysiology of chronic inflammatory bowel disease and consequences for anesthesia. Diabetes mellitus and the GI-tract. [ether.stanford.edu]
Liakakos T et al. (2001) Peritoneal adhesions: etiology, pathophysiology, and clinical significance: recent advances in prevention and management. Dig Surg 18 : 260–273 2. [nature.com]
Pathophysiology The pathophysiology of abdominal surgery is complex yet straightforward unless there are complications. [clinicaladvisor.com]
REFERENCES Kehlet H: Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 1997; 78:606-17 Aitkenhead AR: Cardiac morbidity after non-cardiac surgery. Lancet 1993; 341:731-2. [anesthesiology.pubs.asahq.org]
Prevention
Therefore, improving the intestinal microenvironment and intestinal barrier function before surgery is crucial to prevent POICs following highly invasive abdominal surgeries. [ncbi.nlm.nih.gov]
Can abdominal adhesions be prevented? Abdominal adhesions are difficult to prevent. However, careful, gentle, surgical techniques can minimize the formation of adhesions. Laparoscopic surgery avoids opening up the abdomen with a large incision. [medicinenet.com]