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
- Surgical Procedure
A variety of extensive surgical procedures including small bowel resections and various genitourinary procedures were successfully performed. In 17 patients a functioning epidural catheter was in place postoperatively. [ncbi.nlm.nih.gov]
- Sepsis
AUC-ROC for diagnosis of sepsis was 0.940 and 0.854 for TIMP-1 and 0.924 and 0.788 for MMP-9/TIMP-1 ratio (sepsis versus nonoperated and sepsis versus operated controls, resp.). [ncbi.nlm.nih.gov]
Nonetheless, such patients may be categorized by whether or not they require mechanical ventilation, have an open body cavity, or have severe sepsis or septic shock. [clinicaladvisor.com]
For complete information on this topic, see Peritonitis and Abdominal Sepsis. [emedicine.medscape.com]
- Weakness
If the pressure is enough, they can push though at the weak spot, bulging out in a lump that you may be able to feel under your skin. This is not always painful, and you may be able to push the lump back inside then it is called a reducible hernia. [oregonsurgical.com]
Given the impaired cough resulting from abdominal muscle weakness, patients with Pompe disease who undergo abdominal major surgery are prone to great risks of postoperative pulmonary complications. [ncbi.nlm.nih.gov]
Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time. [healthline.com]
Patients should also expect to feel slightly weak during the first several weeks after the procedure. Patients who have undergone abdominal surgery typically need to return to the doctor to remove the staples used for suturing. [docdoc.com]
Liposuction may also be performed at the same time of a complete tummy tuck Partial or Mini Abdominoplasty The mini abdominoplasty is performed on those patients with mild to moderate tummy contour changes, relatively little skin excess and little weakness [my.clevelandclinic.org]
Respiratoric
- Pneumonia
Secondary outcomes were hospital acquired pneumonia, length of hospital stay, utilisation of intensive care unit services, and hospital costs. [ncbi.nlm.nih.gov]
Surgeons operating on a patient (Image: Keith Brofsky/Photodisc/Getty Images) Pulmonary or lung complications, including atelectasis, pneumonia, respiratory failure, spasm of the breathing tubes or exacerbation of preexisting conditions, may occur after [livestrong.com]
- Cough
Given the impaired cough resulting from abdominal muscle weakness, patients with Pompe disease who undergo abdominal major surgery are prone to great risks of postoperative pulmonary complications. [ncbi.nlm.nih.gov]
[…] or sneezing The factors that increase your risk of developing a hernia include: a personal or family history of hernias being overweight or obese a chronic cough chronic constipation smoking, which can trigger a chronic cough Conditions such as cystic [healthline.com]
Do the coughing and breathing exercises you were taught in the hospital. If you were given an incentive spirometer to help with breathing, use it as directed. This is important and will help prevent lung infections. [saintlukeskc.org]
The patient is turned and is helped to breathe deeply every hour and, if secretions are present, to cough. Medication is given as needed for pain relief. [medical-dictionary.thefreedictionary.com]
- Aspiration
Progressive pulmonary function loss predisposes Pompe disease patients to an increased risk of aspiration pneumonia, atelectasis, and all pulmonary infections. [ncbi.nlm.nih.gov]
Surgeons also commonly believe that the practice reduces the likelihood of vomiting and related aspiration pneumonia. [news-medical.net]
Proficiency in applying NGT in awake patients with or without sedation to reduce the risk of aspiration. Proper positioning of patients for laparoscopic procedures. [ether.stanford.edu]
The laryngeal mask airway (LMA) has been used as an alternative to tracheal intubation but, aspiration of gastric contens may occur. [intechopen.com]
PPC includes postoperative hypoxia, atelectasis, bronchospasm, pulmonary infection, pulmonary infiltrate, aspiration pneumonitis, acute respiratory distress syndrome, pleural effusions and pulmonary oedema (Arozullah et al. 2000 ). [perioperativemedicinejournal.biomedcentral.com]
- Pleural Effusion
Even after abdominal surgery, a persistent pleural effusion should always induce us to suspect a chylothorax. [ncbi.nlm.nih.gov]
PPC includes postoperative hypoxia, atelectasis, bronchospasm, pulmonary infection, pulmonary infiltrate, aspiration pneumonitis, acute respiratory distress syndrome, pleural effusions and pulmonary oedema (Arozullah et al. 2000 ). [perioperativemedicinejournal.biomedcentral.com]
Gastrointestinal
- 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]
- Dysphagia
The patient is currently well and is free from dysphagia symptoms. Treatment with combination thoracoscopic and abdominal open surgery was effective. [ncbi.nlm.nih.gov]
- Abdominal Bruising
Physical examination findings, such as the seat belt sign, abdominal bruising, abdominal wound, and abdominal tenderness, were present significantly more frequently in those requiring abdominal surgery (p CONCLUSION: Data from this study solidify the [ncbi.nlm.nih.gov]
Cardiovascular
- Thrombosis
Chronic portal, splenic, and mesenteric vein thrombosis with portal hypertension was caused by a hypercoagulable state due to the abdominal infection and abdominal surgery. [ncbi.nlm.nih.gov]
Hypercoagulability after a simple procedure such as an appendectomy may lead to mesenteric venous thrombosis. ICU care should address the enhanced clotting while awaiting the second-look laparotomy. Figure 6. [clinicaladvisor.com]
Musculoskeletal
- Muscle Weakness
Given the impaired cough resulting from abdominal muscle weakness, patients with Pompe disease who undergo abdominal major surgery are prone to great risks of postoperative pulmonary complications. [ncbi.nlm.nih.gov]
Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time. [healthline.com]
Skin
- Ulcer
Ileal stenoses with mucosal ulcers in dilated prestenotic loops were observed in both cases. The capsule was retained at the stenosis site, requiring ileal resection and anastomosis. Pathology reports showed mucosal ulcers. [ncbi.nlm.nih.gov]
Surgery can be used to stop bleeding caused by the ulcer. Read more about peptic ulcers by clicking here. Cholecystectomy A cholecystectomy is the surgical removal of the gallbladder. [nhsurgicalassociates.org]
A Case Report and Literature Review Closure of the Perforated Gastric Ulcer Using the Round Ligament of Liver, Pathologically Changed Due to Ulcer Penetration: Report of a Case Retroperitoneal Bronchogenic Cyst Masquerading as an Adrenal Mass, Successfully [abdominalsurg.org]
Workup
X-Ray
- Atelectasis
‡ No atelectasis 13 (87%) 15 (75%) 0.51 Plate atelectasis 0 0 Segmental atelectasis 1 (7%) 0 Partial lobar atelectasis 0 0 Complete atelectasis of one lung lobe 0 2 (10%) Complete atelectasis of one lung lobe in addition to any of the above 1 (7%) 3 [bmcresnotes.biomedcentral.com]
Progressive pulmonary function loss predisposes Pompe disease patients to an increased risk of aspiration pneumonia, atelectasis, and all pulmonary infections. [ncbi.nlm.nih.gov]
Anesthesiology 73:890–895 PubMed Google Scholar 12. van Kaam AH, Lachmann RA, Herting E, et al (2004) Reducing atelectasis attenuates bacterial growth and translocation in experimental pneumonia. [link.springer.com]
Surgeons operating on a patient (Image: Keith Brofsky/Photodisc/Getty Images) Pulmonary or lung complications, including atelectasis, pneumonia, respiratory failure, spasm of the breathing tubes or exacerbation of preexisting conditions, may occur after [livestrong.com]
- 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]
- Esophageal Motility Disorder
Manometric studies showed hypotensive pressure in the lower esophageal sphincter (LES) and relaxation failure of the LES during swallowing. We diagnosed a combination of sliding hiatal hernia with nonspecific esophageal motility disorder (NEMD). [ncbi.nlm.nih.gov]
Pleura
- Pleural Effusion
Even after abdominal surgery, a persistent pleural effusion should always induce us to suspect a chylothorax. [ncbi.nlm.nih.gov]
PPC includes postoperative hypoxia, atelectasis, bronchospasm, pulmonary infection, pulmonary infiltrate, aspiration pneumonitis, acute respiratory distress syndrome, pleural effusions and pulmonary oedema (Arozullah et al. 2000 ). [perioperativemedicinejournal.biomedcentral.com]
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]
[…] other, non-surgical treatments fail. [floridamedicalclinic.com]
We also specialise in selected surgical treatments of the thorax and vessels. [ukb.de]
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]
The prognosis for abdominal pain depends on the cause and the promptness of medical care and diagnosis. Type and Location of the Abdominal Pain The type and location of pain may help the doctor find the cause. [emedicinehealth.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]
Certain findings raise suspicion of a more serious etiology: Severe pain Signs of shock (eg, tachycardia, hypotension, diaphoresis, confusion) Signs of peritonitis Abdominal distention Distention, especially when surgical scars, tympany to percussion, [merckmanuals.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]
Bartlett RH, Gazzaniga AB, Geraghty T (1973) Respiratory maneuvers to prevent postoperative pulmonary complications: a critical review. JAMA 224:1017–1021 CrossRef PubMed Google Scholar 28. [link.springer.com]