Queries 3

• sengstaken blakemore tube
• blakemore tube
• post splenectomy leukocytosis
• esophageal varices
• abdominal trauma hematoma,calcium nodule
• dextrose
• colon benign obstruction web
• forum for people with imperforate anus
• barium enema in neonates
• disease of anorectal
• empyema necessitans
• penetrating neck trauma management asymptomatic
• open abdominal surgery in cirrhotic patients
• what is stump pressure?
• suturing facial laceration
• surgically correctable causes of hypertension
• solution dakin sinus pilonidale
• rejection of hernia mesh neuroma formation
• albumin and Lasix sandwich

Oxygen Monitoring & Assessment. Extra Credit Questions

EXTRA-CREDIT QUESTIONS

22. Four hours after your patient undergoes an exploratory laparotomy following a motor vehicle accident, the nurse reports that the patient’s vital signs, urine output, and oxygen transport numbers are normal. Can the patient still be in trouble?

Thoracic Surgery For Non-Neoplastic Disease. Empyema

EMPYEMA

10. What is an empyema, and what causes it?

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An empyema is a purulent (infected) effusion. Fluid or blood in the pleural space can be directly innoculated (with bugs) during surgery or trauma (33%) or by contamination from contiguous sites (50%) such as bronchopulmonary infection (most common). Most empyemas are parapneumonic, and the most commonly involved organisms are Staphylococcus aureus, enteric gram-negative bacilli, and anaerobes. Many times, infections are polymicrobial. Often there is no growth of an empyema culture because of effective antibiotic therapy or inadequate culture techniques, particularly with anaerobes.

Intestinal Ischemia. Controversies

CONTROVERSIES

30. What is celiac compression syndrome (Dunbar’s syndrome)?

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Celiac compression is a rare and controversial disorder most commonly described in women (female-to-male ratio = 4:1) between the ages of 20 and 50 years. Patients appear to suffer from chronic mesenteric ischemia without angiographic evidence of atherosclerotic disease. The mechanical compression is believed to be caused by the left crus of the diaphragm (i.e., marginal arcuate ligament), and diagnosis occasionally is confirmed by demonstrating transient celiac compression during expiration. The associated pain is the result of a complicated and still heavily debated redirection of flow (foregut steal) away from the SMA. Effective treatment has required not only release of the compression but also bypass to improve the likelihood of pain resolution.