Download General Surgery by M. Alex Jacocks M.D. (auth.) PDF

By M. Alex Jacocks M.D. (auth.)

ISBN-10: 0387979581

ISBN-13: 9780387979588

ISBN-10: 1468404547

ISBN-13: 9781468404548

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Sample text

6. Inhalation injury is manifested by singed nasal hairs, carbonaceous sputum, hypoxia, tachypnea and other history suggesting possible inhalation injury, including flame burn in a closed environment, explosion, etc. a. II. Entry site, exit site may be the only external manifestations of the injury, however severe muscle injury may occur subcutaneously that requires fluid resuscitation and careful electrolyte balance. May need to be managed with endotracheal intubation and mechanical ventilation.

Treat with antibiotics. Alkaline reflux gastritis 1. Weakness, weight loss, nausea, abdominal pain and anemia due to reflux of alkaline biliary/pancreatic fluid into stomach. 2. Treatment - divert biliary fluid away from stomach. Nutritional deficiencies 1. Especially vitamin B 12, folate, iron. 2. Many patients have diarrhea and weight loss. Gastric cancer A. Adenocarcinoma most common - rare lymphoma, leiomyosarcoma, etc. B. Associated factors same as with gastric ulcers - also achlorhydria, pernicious anemia, Barrett's esophagus, lye ingestion.

Pathophysiology A. Normal healing 1. Inflammatory phase (also substrate phase, lag phase, exudative phase) a. 2. Consists of aggregation of platelets, polymorphonuclearcytes and macrophages to occlude damaged blood vessels and begin phagocytosis of foreign bodies. Release of local vasoactive hormones such as bradykinin, along with activation of the complement pathway, induces white cell migration and induction of macrophage activity. This local hormonal milieu includes angiogenesis growth hormone to stimulate the development of new blood vessels and macrophage derived growth factor which stimulates replication of fibroblasts.

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General Surgery by M. Alex Jacocks M.D. (auth.)


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