Surgery: Upper
GIT
, Contents
1) Acute Upper Abdomen
2) Upper GI Haemorrhage
3) Approach to Dyspepsia
4) GORD
5) Approach to an enlarged liver and spleen
6) Gastric Ca
, Acute Upper Abdomen
Definition:
• Rapid onset of severe abdominal pain
Anatomy and Physiology:
• Abdominal Pain may be:
• Visceral
– Relating to the internal organs
• Parietal
– Relating to the walls
, Peritonitis
• Definition:
– Inflammation of peritoneum
– There are two ways to classify
peritonitis:
• Localised vs generalised
• Primary, secondary and tertiary
• Classification 1:
– Localised • Classification 2:
• This will produce a sharp localised pain – Primary peritonitis (aka
• E.g.’s of this include: spontaneous peritonitis)
– Appendicitis, Cholecystitis, Complicated • Occurs in:
divertivulitis – Children, Ascites, Cirrhosis
– Generalised – Secondary peritonitis
• Produces generalised pain • Occurs as a result of:
• E.g. of this include: – Infection, perforation, or
– Perforated ulcer gangrene
– Tertiary peritonitis
• Occurs in Post-operative patients
• Due to:
– Organ dysfunction, leading to
intra-abdominal infection
GIT
, Contents
1) Acute Upper Abdomen
2) Upper GI Haemorrhage
3) Approach to Dyspepsia
4) GORD
5) Approach to an enlarged liver and spleen
6) Gastric Ca
, Acute Upper Abdomen
Definition:
• Rapid onset of severe abdominal pain
Anatomy and Physiology:
• Abdominal Pain may be:
• Visceral
– Relating to the internal organs
• Parietal
– Relating to the walls
, Peritonitis
• Definition:
– Inflammation of peritoneum
– There are two ways to classify
peritonitis:
• Localised vs generalised
• Primary, secondary and tertiary
• Classification 1:
– Localised • Classification 2:
• This will produce a sharp localised pain – Primary peritonitis (aka
• E.g.’s of this include: spontaneous peritonitis)
– Appendicitis, Cholecystitis, Complicated • Occurs in:
divertivulitis – Children, Ascites, Cirrhosis
– Generalised – Secondary peritonitis
• Produces generalised pain • Occurs as a result of:
• E.g. of this include: – Infection, perforation, or
– Perforated ulcer gangrene
– Tertiary peritonitis
• Occurs in Post-operative patients
• Due to:
– Organ dysfunction, leading to
intra-abdominal infection
