[ROUNDS WITH DR.

BORDON]

 (+) Colicky pain – think of hollow viscus organs

 Risk of post-op adhesions – 30%; up to 80% of post op adhesions resolve w/ medical
mgt
 Description of pain d/t ischemia: Severe intractable pain (pain out of proportion)
 Management for intestinal obstruction:
1. NPO
2. Decompression – NGT
3. Hydrate – LR not D5 (risk of hyperglycemia)
4. Foley catheter
5. Antibiotic
6. Electrolytes
 Most common electrolyte imbalance in intestinal obstruction – Hypokalemia
 Diagnostics
o XRAY
 (supine) – dilated bowels
 (upright) – air fluid levels
o UTZ – not done kay wala makita kay aira ang unod so indi ma reflect back and
sound waves.
 Pancreatitis vs Cholecystitis
 Pancreatitis – boring pain, radiation at midline lower back
 Cholecystitis – colicky pain with radiation to shoulder
 Mgt for hydrops gallbladder – emergency cholecystectomy
 Cutoff dilated CBD – 0.8cm
 Cefoxitin – 2nd gen cephalosporin w/ anaerobic coverage
 Sphincter is located 2-4 cm from the anal verge
 Why is it important to measure the distance of the tumor from the anal verge? For
sphincter saving procedures
 Source control of infection in sepsis should be within 6 hours
 Reasons for recurrent gallstones: hyperuricemia, infection (Proteus mirabilis), hemolytic
disease