Double_A

General examination: Deep jaundice. Sign of cirrhosis. Virchow's gland Local Examination: Hepatomegaly irregular nodule. Lump in abdomen. Ascites. Sister marry joseph nodule. Severe pain due to involvment of posterior structure. Involved duodenum: Vomiting, Malena. Severe weight loss. Severe anorexia. Investigation findings: Altered liver function. CT scan 1.Mass more than 4 cm than beyond pancreas. 2.Peripancreatic structure involvment 3.Peri pancreatic lymphnode 4.Portal vein involvment 5.Liver Mets 6.Ascites Per operative: Peritoneal seedling. But can be seen in PET CT scan. Portal vein involvment. #Mass in the head, how we can take tissue from mass USG CT guided FNAC. Endoluminal USG. Difficult part of dissection Uncinate process. Third part of duodenum.

Septic shock: Definition It may be defined as a shock that is associated with sepsis or infection by microbes resulting in release of bacterial endotoxin and the activation of cellular and humeral components of immune system. Causes: 1.      Surgical causes- a.       Bowel preparation and peritonitis b.      Strangulated intestine c.       Soft tissue infection, abscess, gangrene d.      Suppurative biliary condition e.g. empyema of Gall bladder e.       Major trauma, burn etc. f.        Gas gangrene g.      Following operation of large gut 2.      Non-surgical causes a.       Pneumonia b.      Endocarditis c.       Meningitis d.      Hospital infection e. ...

Preoperative preparation of patient with DVT Definition: Blood coagulation and its deposition due to venous stasis is called DVT. Pathogenesis/factors responsible Virchow’s triad: 1.      Stasis 2.      Vascular injury 3.      Hypercoagulability Risk factors: Age more than 60 years Race- white Obesity Trauma or surgery Reduced mobility for more than 3 days Pregnancy/puerperium Varicose vein with phelebitis Drugs estrogen contraceptive, HRT Smoking Known active cancer or on treatment significant medical co morbidities e.g heart failure, critical care admission Family/personal history of thrombosis e.g deficiency in antithrombin Ⅲ, protein C, protein S Polycythemia Pulmonary embolism Uncontrolled DM Arteriopathy Presentation: Asymptomatic upto half of the patient Symptomatic: Dull ache in the calf Swelling Pyrexia Sign: ...