🔪Surgery Stuff

Question 1

In colorectal cancer presenting with acute large bowel obstruction, what is the safest immediate surgical option?

Answer 1

Defunctioning loop colostomy to decompress bowel before definitive surgery.

Question 2

What is a Hartmann’s procedure?

Answer 2

Resection of diseased colon with closure of distal stump and end colostomy, no anastomosis done.

Question 3

When is an abdominoperineal (AP) resection indicated in rectal cancer?

Answer 3

When tumour involves the anal sphincter making sphincter preservation impossible.

Question 4

A 10 year old boy is shot in the abdomen with an airgun pellet. He is concerned that he will get into trouble and the injury remains concealed for 10 days. Imaging using CT scanning shows it to be lodged in the left lobe of the liver. On examination, his abdomen is soft and non tender and he seems well. What is the best course of action?
In other words…
What is the management of a stable patient with a retained hepatic foreign body and no symptoms?

Answer 4

A: Do not operate, and review the patient several weeks later … In other words:
Conservative management and review.

Stable trauma patient → Non-operative management unless complications.

Question 5

What are clinical features of an anastomotic leak?

Answer 5

Post-op fever, ileus, abdominal pain, raised inflammatory markers.