General Surgery

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General Surgery

مشاركةبواسطة دكتور كمال سيد » الاثنين فبراير 25, 2019 9:41 pm

General Surgical instruments part - I




Common Surgical Instruments, handling & uses
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الاثنين فبراير 25, 2019 9:43 pm

Gastroscopie




Gastroscopy
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الاثنين فبراير 25, 2019 9:45 pm

Preparing for Your Endoscopy Procedure at Springfield Clinic
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الاثنين فبراير 25, 2019 9:47 pm

When should I get a colonoscopy and what do the results mean?





Sandy's Colonoscopy Experience: A Video Diary
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الاثنين فبراير 25, 2019 9:49 pm

7 Early Symptoms of Colon Cancer Most People Miss! Natural Remedies
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الثلاثاء فبراير 26, 2019 6:14 pm

USMLE STEP 1
surgery
kamaleldirawi
kamalsono@hotmail.com
Sabahawad@2071954

Gastrointestinal High-Yield Topics
https://step1.medbullets.com/topic/dash ... tMenu=true
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الثلاثاء فبراير 26, 2019 7:00 pm

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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الأحد مارس 17, 2019 6:22 pm

AAST injury scoring scales
https://radiopaedia.org/articles/aast-i ... es?lang=gb

The American Association for the Surgery of Trauma (AAST) injury scoring scales are the most widely accepted and used system of classifying and categorising traumatic injuries. Injury grade reflects severity, guides management, and aids in prognosis. Currently (early 2019), 32 different injury scores are available.

Classification
The most commonly used injury scoring grades are for the solid viscera:

liver
kidney
spleen
pancreas

Injury is classified according to either imaging, operative, or pathologic criteria - the highest classification is assigned the final AAST grade 2. Grading of spleen, liver, and kidney injuries has been validated, with increasing grades of injury correlating with increasing mortality, operative rate, and hospitalisation cost 3.

Other scales are less commonly used, including:

cervical vascular injury
chest wall
heart
lung
thoracic vascular injury
diaphragm
extrahepatic biliary tree
oesophagus
stomach
small bowel
colon
rectum
abdominal vascular injury
ureter
bladder
urethra
uterus
pregnant
non pregnant
fallopian tube
ovary
vagina
vulva
testis
scrotum
penis
peripheral vascular organ injury

History and etymology
Early efforts to create organised system for describing and grading traumatic organ injuries included 4:

Abbreviated Injury Scale - developed in 1971 in collaboration with the automotive industry to improve vehicle safety, as well as the
Injury Severity Score - developed in 1974, first to predict survival
Abdominal Trauma Index - developed in 1981, updated for blunt trauma in 1990, organ-specific injury grading, estimating morbidity/mortality
In the last 1980s, the AAST formed an Organ Injury Scale (OIS) committee comprising trauma, orthopaedic surgery, urology, and neurosurgery specialists in order to create a more comprehensive classification.

The first AAST OIS guidelines published in 1989 classified injuries of spleen, liver, and kidney 5.
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الأحد مارس 17, 2019 6:24 pm

AAST kidney injury scale
https://radiopaedia.org/articles/aast-k ... le?lang=gb

The American Association for the Surgery of Trauma (AAST) renal injury scale, most recently updated in 2018, is the most widely used grading system for renal trauma.

The 2018 update incorporates "vascular injury" (i.e. pseudoaneurysm, arteriovenous fistula) into the imaging criteria for visceral injury.

Classification
Severity is assessed according to depth of renal parenchymal damage and involvement of the urinary collecting system and renal vessels.

grade I:
subcapsular haematoma or contusion, without laceration
grade II:
superficial laceration ≤1 cm depth not involving the collecting system (no evidence of urine extravasation)
perirenal haematoma confined within the perirenal fascia
grade III:
laceration >1 cm not involving the collecting system (no evidence of urine extravasation)
vascular injury or active bleeding confined within the perirenal fascia
grade IV
laceration involving the collecting system with urinary extravasation
laceration of the renal pelvis and/or complete ureteropelvic disruption
vascular injury to segmental renal artery or vein
segmental infarctions without associated active bleeding (i.e. due to vessel thrombosis)
active bleeding extending beyond the perirenal fascia (i.e. into the retroperitoneum or peritoneum)
grade V
shattered kidney
avulsion of renal hilum or laceration of the main renal artery or vein: devascularisation of a kidney due to hilar injury
devascularised kidney with active bleeding
Additional points

advance one grade for multiple injuries up to grade III
"vascular injury" (i.e. pseudoaneurysm or AV fistula) - appears as a focal collection of vascular contrast which decreases in attenuation on delayed images
"active bleeding" - focal or diffuse collection of vascular contrast which increases in size or attenuation on a delayed phase
Imaging Technique
The AAST guidelines recommend dual arterial/portal venous phase imaging for evaluation of vascular injury of liver, spleen, or kidney 8.

If there are imaging or clinical findings suggesting collecting system injury (e.g. haematuria or blood at the meatus), additional delayed excretory phase images should be obtained after 5-15 minutes delay to evaluate for urine extravasation 5,8. Urinary contrast is usually hyperdense and readily distinguished from haemorrhagic vascular contrast.

Note that multiphase scanning should not preempt emergent management in the setting of haemodynamic instability or other life-threatening injuries.

Treatment and prognosis
grade I - conservative management
grade II - conservative management under close observation
grade III - conservative management under close observation. May be managed surgically if undergoing laparotomy for other abdominal injuries
grade IV - surgical management, especially if undergoing laparotomy for other abdominal injuries
grade V - surgical management
Complications
grade IV renal injury places patient at risk for developing hypertension due to a decrease in the renal blood flow or secondary to compression of the renal vessels (see Page kidney), leading to an activation of the renin-angiotensin system
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Re: General Surgery

مشاركةبواسطة دكتور كمال سيد » الأحد مارس 17, 2019 7:30 pm

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