ملخص ضخم لأغلب مواضيع الجراحة
يساعدك للمراجعه السريعة خلال فترة الراوند 😻

#Surgery
https://t.me/Surgery_Practice

🔴Compartment Syndrome

▪︎Increase In The Interstitial Pressure Within Closed OsteoFasical Compartment To The Level That Compromise Tissue Perfusion Which Leads Then To Ischaemia & Gangrene

▪︎More in Lower Limb Injuries (Calf Muscles)

🔷Causes Of Compartment Syndrome
1. Bone Fractures (Most Common 70%)

2. Soft Tissue Contusions Or Trauma (23%)

3. Bleeding Tendency & Anti-Coagulant Drugs

4. Burns (3rd Degree Circumferential)

5. Reperfusion Injury (Tissue Perfusion After Prolonged Shock & Ischaemia)

6. Tight Dressings Or Casts Or Tourniquets

7. ExtraVasation Of IV Infusion (Contrast Injection)

8. Arterial Injury (Iatrogenic Or Trauma)


🔷Clinical Features & Dx Of Compartment Syndrome
📍1. Pain On The Affected Limb
▪︎Out Of Proportion
▪︎Increasing Gradually
▪︎Aggravated By Limb Stretching

📍2. Paraesthesia & Numbness
📍3. Paralysis Of Affected Limb
📍4. Pallor Of The Affected Limb's Skin
📍5. Pulselessness (Loss Of Pulse)
📍6. Swelling Of The Affected Limb

📍7. Intra-Compartmental Pressure ≥30 mmHg اكثر من

📍8. Pressure Difference (Diastolic P - Compartment P) ≤30 mmHg اقل من


🔷Complications Of Compartment Syndrome
1. Limb Amputation

2. Limb Infection

3. Rhabdomyolysis & Renal Failure & Death

4. Volkmann's Ischemic Contracture (Muscle Fibrosis & Shortening)



🔷Mx Of Compartment Syndrome
🔸A. Removal Of All Limb Compressions (Casts Or Dressings)


🔸B. Limb Elevation


🔸C. Emergent FascioTomy Of The Skin & Deep Fascia
📍1. One Long Axial Incision ➡️ For Upper Limbs

📍2. Two Incisions ➡️ For Lower Limb
▪︎Media Longitudinal Incision (Decompress Superficial & Deep Posterior Compartment) ➡️ Done 1-2cm Posterior To Medial Border Of Tibia

▪︎Lateral Longitudinal Incision (Decompress Peroneal & Anterior Compartments) ➡️ Done 2cm Lateral To Anterior Tibial Border


🔰Abdominal Compartment Syndrome
▪︎Increase in The Intra-Abdominal Pressure To The Level That Reduces Perfusion (Blood Supply) To Abdominal Organs Then Results in Multiple Organs Failure

▪︎Seen More in Critically-ill Patients

▪︎Intra-Abdominal Pressure >20 mmHg ➡️ Confirm Dx

🔷Causes Of Abdominal Compartment Syndrome
1. Severe Intra-Abdominal Sepsis
2. Severe Ascites (Liver Cirrhosis)
3. Pancreatitis
4. Ruptured Aortic Aneurysm
5. Tight Wound Closure After Abdominal Surgery


🔷Mx Of Abdominal Compartment Syndrome
1. Stomach & Bladder Decompression
2. Peritoneal Fluid Aspiration
3. Open Laparotomy

#compartment_syndrome
#surgery
https://t.me/Surgery_Practice

#compartment_syndrome
#surgery
https://t.me/Surgery_Practice

⚠️ Analgesics is contraindicated  if appendicitis is suspected  to avoid mask of diagnosis.

🔵 The main symptom of appendicitis is "abdominal pain" but the first symptom to appear is  "  Anorexia ".

⚠️ How We can differentiate between acute appendicitis and gastroenteritis clinically ❗️

Simply If abdominal  pain precedes  vomiting it indicates acute appendicitis, but if vomiting precedes abdominal  pain  it indicates AGE.


⚠️ يمنع استخدام المسكنات في حالة الاشتباه بالتهاب الزائدة الدودية لتجنب إخفاء التشخيص.

🔵 العرض الرئيسي لالتهاب الزائدة الدودية هو "آلم في البطن" لكن أول الأعراض ظهوراً هو "فقدان الشهية ".

⚠️ كيف يمكننا  التفريق بين التهاب الزائدة الدودية الحاد والتهاب المعدة والأمعاء سريريا❗️

ببساطة إذا سبق ألم البطن القيء فهذا يدل على التهاب الزائدة الدودية الحاد، أما إذا سبق القيء ألم البطن فهو يشير إلى التهاب المعدة والأمعاء.


#appendicitis
#surgery
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✅Abnormal findings in Diabetic Patients

▪︎Dehydration and Kussmaul respiration (hyperventilation) are common in ketoacidosis.

▪︎Bacterial skin infections, e.g. cellulitis, boils, abscesses and fungal infections

▪︎Acanthosis nigricans in patients with insulin-resistant type 2 diabetes.

▪︎Necrobiosis lipoidica (a yellow indurated or ulcerated area surrounded by a red margin) due to collagen degeneration

▪︎Xanthelasmata and xanthomata indicate significant hyperlipidaemia

▪︎Glycosuria suggests hyperglycaemia and, if accompanied by ketonuria and Kussmaul respiration indicates ketoacidosis.

▪︎Proteinuria occurs in diabetic
nephropathy.

▪︎Detection of nitrite ± haematuria suggests urinary infection

#Diabetic
#surgery
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❇️Abnormal Findings in Diabetic Foot

▪︎Hair loss and nail dystrophy occur with ischaemia,

▪︎skin fissures or tinea infection (‘athlete’s foot’).

▪︎The foot arch may be excessive in neuropathy or collapsed (rocker-bottom sole) cause abnormal pressures and increase risk of plantar ulceration.

▪︎Warm feet occur in neuropathy

▪︎cold feet in ischaemia.

▪︎Sensory neuropathy is present if the patient cannot feel the monofilament in any site

▪︎Charcot’s arthropathy is disorganised foot architecture,

#Diabetic_Foot
#surgery
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النسب الطبيعية للعلامات الحيوية وأغلب الفحوصات
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