Category: General Surgery

Diarrhoea

Diarrhoea is a very common complaint and may be the reason for a patient’s admission, or develop as a new problem during an inpatient stay. Diarrhoea related to inflammation of the stomach and small bowel is termed gastroenteritis, whilst inflammation of the large bowel is colitis. However, these are umbrella terms that describe syndromes, not

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Pre & Post Operative Care

As a junior doctor, you will frequently look after patients prior to and after their operation. You may be asked to clerk patients who are admitted to hospital the night before their operations. Here are some things to consider during your clerking & whilst you’re considering pre & post-operative issues. Pre-Operative Clerking Pre-Operative Considerations Post-Operative

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Gallstone Disease

Patients regularly present under the acute take with gallstone disease. The aim of this article is to supplement the surgical webinar series session on gallstone disease that can be found on this website. The key learning points are to understand the background of gallstone disease, appreciate how they can present, and understand key concepts for

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Pancreatitis

Pancreatitis is a condition characterised by the inflammation of the pancreas. These patients are usually managed conservatively. Your aim is to try to find out the underlying cause, optimise managing them conservatively whilst observing for complications. Signs and symptoms: Upper abdominal pain (usually described as radiating to the back) Pain that gets worse after eating

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PR Bleeding

The first thing when called is to identify whether the bleeding is truly a lower GI bleed or whether it is an Upper GI Bleed as the management differs. Both can quickly become emergencies so seek senior advice. When the nurse first calls you Check the observations & their trend (urgent review for haemodynamic instability) If

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Bowel Obstruction

Bowel obstruction is a common reason for admission or complication of patients under the surgical team, but doctors don’t frequently get that much exposure to it in medical school. It is a condition in which the normal passage of intestinal products is impaired. It can affect both large and small bowel. Bowel obstruction can be

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Nausea & Vomiting

You will frequently get calls regarding nausea & vomiting: many patients present with it or develop it because of their diagnosis or treatment. You must consider anything concerning that could be causing it and give appropriate treatment for the underlying cause, correct any electrolyte disturbances & dehydration due to it in addition to antiemetics. Certain

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Abdominal Pain

When you are on call, you will often get a bleep about a patient with abdominal pain. Abdominal pain can be a bit of a minefield and it is easy to get bogged down with all the possibilities. The key is to be systematic and take a clear history and thorough examination so that you

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Constipation

Constipation is one of the most common complaints in hospital, especially on the geriatric wards.Failure to treat constipation can lead to longer hospital stays and increased morbidity. What’s normal? Anything from 3 times per day to 3 times per week is normal for adults. What causes it?Many things cause constipation, most commonly in hospital, it

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Prescribing analgesia

When assessing pain, ensure you begin by taking a history to characterise the pain as neuropathic pain, inflammatory pain and oncological pain all respond to different analgesia. SOCRATES is a helpful way to systematically take this history as it will help identify any serious underlying disease that is causing the pain and whether any further

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