PPT-Unusual case of gallstone ileus in a patient who underwent cholecystectomy 26 years ago

Dr Helena Blake Dr Nawal Al Khafagi Dr Hossam Mahrous Croydon University Hospital Case synopsis A 78 years old lady presented with abdominal pain vomiting and not passing flatus Examination revealed generalized abdominal tenderness more in the right iliac fossa with guarding and rebound tenderness She had no hernias Her past surgical history was remarkable for cholecystectomy in 1994 and Gastric bypass RouxenY in 2016 for weight reduction She has a past medical history of NASH and autoimmune hepatitis on azathioprine for 10 years and T2DM. Dr Samantha Walker, Dr Tom Pike, Miss A. Kausar. East Lancashire Hospital Trust. samantha.j.walker@doctors.org.uk. •. •. 1.. Identify Problem or Issue: Why is this important. ?. Day case surgery is an ongoing and . A Case Study . Approach. Danae. Gross. November 17, 2014. Objectives. Analyze family/social, clinical, and nutritional history. . for a patient that presents with postoperative ileus.. Evaluate the prescribed nutrition therapy as it relates to the diagnosis of ileus in the postoperative and critical care setting.. Harrison 2012. Baghbanian. M. MD . Bile Secretion and Composition. Hepatic bile . : . isotonic. . fluid with an electrolyte composition . resembling blood plasma. . Gallbladder. :. . water . reabsorption. Bernard M. Jaffe, MD. Professor of Surgery,. Emeritus. INTESTINAL OBSTRUCTION . Common Clinical Problem. Carries 3-5% Mortality Rate/Episode. Some Patients Have Multiple Bouts. Can Involve Small or Large Bowel. Abdominal Surgery Curriculum. Cholecystectomy. is performed most often . laparoscopically. for symptomatic gallstones . (usually causing . cholecystitis. with fever, RUQ pain and . leukocytosis. ), . November 3, 2018. Aleysia Kroptavich. Overview of presentation. Description of disease. Case report. General information. Medical history. Surgical history. Social history. Nutritional history. Case discussion. Dr. V Gandhi. DNB (GI Surgery), DNB (Gen Surgery), MNAMS. Consultant GI & HPB . Surgeon. Pune surgical Society. What is safe cholecystectomy ?. What is difficult cholecystectomy ?. Predict difficult gall bladder. Stuart Sherman, MDProfessor of Medicine & RadiologyIndiana University Medical CenterIndianapolis, In Figure 1 Figure 2 Dilation Assisted Stone Extraction (DASE) www.bostonscientic.com/endoscopy T Cholecystectomy. is performed most often . laparoscopically. for symptomatic gallstones . (usually causing . cholecystitis. with fever, RUQ pain and . leukocytosis. ), . pancreatitis or . acalculous. for Family medicine residents. Joanna R. Fair, M.D., Ph.D.. Vice Chair of Education. Department of Radiology. Some . images courtesy of . Radiology Department Faculty and Residents. and. Petra Lewis, M.D.. Define post operative ileus. Describe normal bowel function. Discuss modulators of bowel motility. Discuss symptoms, diagnosis, management and prevention of post-op ileus. Normal Digestion. Motility: Requires coordinated contraction behind food bolus and relaxation ahead of food bolus to move in correct direction. PAI. Y ELTINAY. SCUNTHORPE GENERAL HOSPITAL. HISTORY. 45 years old male had CT KUB with h/o haematuria. No renal stones but incidental lesions were identified . with-in . the anterior peritoneal cavity. Muhammad Singgih Nugraha. Ileus . Obstruktif. = ileus . mekanik. = ileus . dinamik. . adalah. . suatu. . gangguan. . jalannya. . isi. . usus. (. pasase. ) . yang . disebabkan. . karena. . penyumbatan. Gallbladder Disease Rebecca Kowalski, M.D. October 18, 2017 Overview  A (brief) history of gallbladder surgery  Anatomy  Anatomical variations  Physiology  Pathophysiology  Diagnosti