medportal CDB | Hernia / Bowel Obstruction

Hernia / Bowel Obstruction

Activity
Round Table Discussion

Definitions. Approach to bowel obstructions (Plain films / Investigations). Small bowel obstructions. Large bowel obstructions. Management of bowel obstructions. Hernias.

Curriculum Block

Clerkship / Surgery Rotation

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Objectives

Clerkship Objectives

Volvulus
Differentiate the signs, symptoms and radiographic patterns of paralytic ileus and small bowel obstruction.
Contrast the presentation and management of partial vs. complete small bowel obstruction.
Outline the initial management of a patient with mechanical small bowel obstruction, including laboratory tests and x-rays.
Discuss the potential complications and management of small bowel obstruction.
Describe the common etiologies of mechanical small bowel obstruction.
Describe the signs and symptoms of small bowel obstruction.
Discuss the diagnosis and management of obstructive ulcer disease.
Describe the clinical presentation and etiologies of gastric outlet obstruction.
Discuss in general, the differential diagnosis for a patient with emesis. Consider timing and character of the emesis and associated abdominal pain. Contrast etiologies in infants, children and adults.
Discuss Barrett’s esophagus and its implications. What are the risks of malignancy? Who needs surgical management?
Fecal Impaction
Characterization of abdominal pain (location, severity, character, pattern).
Large Bowel Obstruction
Small Bowel Obstruction Partial/Complete
Describe the potential sites for abdominal wall hernias. Consider incisional, umbilical, inguinal, femoral, Spigelian, and epigastric. Differentiate diastasis recti from abdominal hernia.
Discuss the clinical conditions that may predispose to development of inguinal hernia.
Discuss the relative frequency of indirect, direct and femoral hernias by age and gender.
Describe the anatomic differences between indirect and direct hernias.
Discuss the differential diagnosis of inguinal pain, mass or bulge. consider hernia, adenopathy, muscular strain.
Pertinent medical history: prior surgery or illness, associated conditions (pregnancy, menstrual cycle, diabetes, atrial fibrillation or cardiovascular disease, immunosuppression). Medications: anticoagulation, steroids etc. (for abdominal pain).
Associated signs and symptoms of abdominal pain (nausea vomiting, fever, chills, anorexia, wt. loss, cough, dysphagia, dysuria/frequency, altered bowel function diarrhea, constipation, obstipation, hematochezia, melena, etc.).
Alleviating and exacerbating factors of abdominal pain (position, food, activity, medications).
Temporal sequence of abdominal pain (onset, frequency, duration, progression).

Curriculum Block

Objectives

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