Podcast: Play in new window | Download

Bowel Perforations History Perforation takes time, frequently symptoms were either ignored or not noticed as can occurring in… Elderly, diabetic, or immunosuppressed patients (frequently have minimal symptoms) Pediatric patients (unable to or scared to mention symptoms) Exam Commonly have “peritoneal signs” Guarding Rebound Tenderness Rigidity Testing CT Scan X-Ray? (not your primary test, but a […]

Podcast: Play in new window | Download

Mesenteric Ischemia Celiac truck supplies blood to the stomach and duodenum SMA supplies blood to the rest of the small bowel and proximal colon IMA supplies blood to the distal colon and rectum Arterial flow can be blocked because of emboli (atrial fibrillation) Venous flow can be blocked because of thrombosis (hypercoagulable states) Effective flow […]

Podcast: Play in new window | Download

Biliary Diseases Biliary Colic- A gallstone DOES NOT GET STUCK, but it slowly rolls out of the gallbladder, through the cystic duct, then the common bile duct and pancreatic duct. This results in several hours of crampy “colicky” pain as the stone passes. Cholecystitis- A gallstone gets stuck IN THE NECK OF THE GALLBLADDER OR […]

Podcast: Play in new window | Download

Appendicitis History Vague nonspecific abdominal cramping and nausea (Nonspecific Phase) gradually progresses to localized pain (Localized Phase). The pain most commonly localizes in the RIGHT LOWER QUADRANT near McBurney’s Point. Exam Focal tenderness in the right lower quadrant McBurney’s Point: 1/3 the distance traveled from anterior superior iliac spine (ASIS) to the navel. Psoas Sign: […]