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)

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#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%

https://t.me/M_Information11

🪝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
#clinical  #surgery
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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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لما أفكر أؤلف مرجع في الجراحة 😁

❗️ The Most common hernia in female is indirect inguinal hernia

❗️ Inguinal hernia is the most common hernia in male and female However Femoral hernia  is more common in female

❗️Hernia is more common in multiple pregnancies is Femoral hernia then Umbilical hernia

❗️ Hernia is more common in elderly is Direct inguinal hernia

❗️ Most common site of morgagni hernia ( congenital diaphragmatic hernia ) is in Rt. Anterior

❗️Femoral hernia which is more liable to be  strangulated 👍
But the most common hernia to be strangulated is inguinal hernia

❗️ Most common site of Richter's hernia is femoral canal

✅ Classic Timing for the different Causes of post operative Fever [ 5 W ]
#Surgery
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