❇️Signs of skull fractures

▪︎CSF (clear fluid) leaking from nose or ear

▪︎Raccoon (Panda) eyes: bruising around the eyes (Fracture of the base of the skull)

▪︎Battle sign: bruising behind the ear over the mastoid process (Fracture in the posterior Cranial Fossa)

▪︎Haemotympanum: blood noted behind the tympanic membrane on otoscopy
#clinical  #surgery
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❇️Truma Basics History & Examination 👆👆

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Middle Age Female patients coming complaining of Chronic epigastric pain for 6 months

- What's obvious clinical sign? And What's the clinical suspecting of this case ?"



"مريضة في منتصف العمر تشتكي من ألم مزمن في منتصف البطن (فوق المعدة) منذ 6 أشهر.

ما العلامة السريرية الواضحة؟
وما هو الاشتباه السريري في هذه الحالة؟

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Troisor sign (Enlargment in left supraclavicular Lymph Node) indicating to GIT cancer especially Gastric cancer

#Remember..
♦️ Virchow's node ♦️
Metastatic tumor to left supraclavicular node (usually due to gastric cancer)

–––––––––––––––
#Answer of the case
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📍Patient WITH peptic ulcer, now SUFFER FROM sever abdominal pain.

📝Chest x ray erect position showing bilateral air under diaphragmatic.

🔎 Bilateral perforation peptic ulcer.
Ddx bilateral perforation of hollow organs.

#Radiology
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📌Patient PRESENT WITH headache, fever.
💥P. M. Hx otitis media, diabetes mellitus.

📝In CT scan axial section of the brain showing left side regular border well define mass hypodensity from inside
WITH midline deviation to other side.

✏️Dignosis left side Brain abscess.
#Radiology
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♦️ Parkland formula:
Use for measuring the amount of Fluid replacement in Burns

Children have a relatively larger proportion of body surface area in their head and neck, which is compensated for by a relatively smaller surface area in the lower extremities.

− In infants: Head and neck- 21%Q ; Each leg- 13%

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🪝Double J ;

  🎭 Def ;
It is a thin flexible plastic tube , that is temporarily placed in the ureter to help urine drain from the kidney into the bladder in case of blockage..


           
  🎭Indications =>

            1. Obstructed anuria
            2. Pyonephrosis
            3. Pre _ ESWL
            4. Open surgery
            5. Pelvic trauma
            6. Reconstructive surgery



🎭 How to insert Double J ?
        _  Under general anesthesia,  By using fluorscope & guid wire =>
One J is placed in the renal pelvis & the other one in the bladder



🎭CI =>
         _ Avulsion of ureter


🎭 Complications;
            _ Hematuria
            _ Infection
            _  Encrystation
            _ Vesico_ureteric reflex
            _ Stent fracture
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A Cullen’s sign (near the Umbilicus)
B Gray turner sign (at the flanks)

possibly ▶️ haemorrahgic pancreatitis.

Do Amylase or lipase blood test.

#Surgery_rotation
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‏هكذا هِي الحياة ، إِما أَن تعيشها مهانا أَو أَن تَعيشها هنِيَّة .
دعواتكم لغزة في هذا اليوم الفضيل

❇️Triads
#Surgery_rotation
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