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Common Surgical Problems Lau Cheong Chi. Common Surgical Problems Abdominal pain Foreign bodies ingestion Perineum Lumps & bumps AROU Changed bowel habits.

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Presentation on theme: "Common Surgical Problems Lau Cheong Chi. Common Surgical Problems Abdominal pain Foreign bodies ingestion Perineum Lumps & bumps AROU Changed bowel habits."— Presentation transcript:

1 Common Surgical Problems Lau Cheong Chi

2 Common Surgical Problems Abdominal pain Foreign bodies ingestion Perineum Lumps & bumps AROU Changed bowel habits Haematemesis, Haematuria, Haematochezia, Haemoptysis VV, PVD, Buerger s disease Tumors

3 Abdominal pain HBP – cholecystitis, cholangitis, Upper GI – PPU, gastritis, duodenitis Lower GI – I/O, appendicitis Genital – epididymitis +/- orchitis

4 Perineal concerns Haemorrhoids Fresh PR bleeding / mass / pain Active inflammation? Degree of prolapse Manual reduction Drugs: annusol, faktu; cream vs supp. Banding vs surgery Colonoscopy?

5 Foreign bodies ingestion Most commonly caused by fish bones, followed by chicken bone Odynophagia Direct largynoscope OGD CXR / XR neck: surgical emphysema or retrophargneal abscess

6 Lumps & Bumps Site, pain, texture, duration, size changes, Lipoma, sebaceous cyst, neuroma Lymphadenopathy (1ry vs 2ry) Benign vs malignant Referral to surgical – malignant potential: fixation, painless, induration, rapid growing, ulceration, texture changes; cosmetic reasons

7 AROU Painful retention, palpable bladder Risk of vasovagal syncope BPH, drug (cough, TCA, antipsychotics, etc), UTI, stone, urethral trauma Catheterization, chart RU, save urine x C/ST, AFB, cytology ? Clamp & declamping of Foley s Uses of minipress/hytrin/cardura; ditropan, pyridium, antibiotic (quinolones)

8 Changed bowel habit Definition of constipation what is change in bowel habit Blood / mucus / anaemia / evidence of malignancy colonoscopy

9 Haematemesis, haematuria, haematochezia, haemoptysis Haematemesis vs haemoptysis – amount, taste, cough/vomit, CHF/APO; UGIB – varices, PU, Mallory-Weiss Lungs – tumor, bronchiectasis, TB, etc. Pharynx – tumor Haematuria – early signs, medical vs surgical, macroscopic vs microscopic: TB, UTI, tumor, stone; IgA nephropathy, glomerulonephritis Haematochezia – piles, tumor, infection

10 Tumors Alert Lumps & bumps; moles; skin (BCC vs SCC) H&N(NPC, Ca pharygolarynx), GI (stomach, esophageus, colon, sigmoid & rectum), HBP (HCC, CC, Ca GB), Lymphoma, haematological malignancy

11 VV, PVD, Buergers Disease VV – when to refer, need surgery? Complications, avoid topical medications PVD – risk factors, limit daily activities? Asso. coronary & cerebral vessels, indications for surgery Buerger s disease – sympathetic blockage, autoamputation; education

12 Thank you


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