Batch 34 ( Important medical notes)

Stages of Ulcer #جراحة

Courvoisier 's low #جراحة

Grades of pancreatic injury #جراحة

Biliary cysts are associated with an increased risk of cancer, particularly cholangiocarcinoma , but also pancreatic and gallbladder cancers. Cancer is more common in patients who are older and in those with type I and IV cysts. Because of the increased risk of malignancy, it is recommended that patients with type I or IV cysts have the cysts completely removed with Roux-en-Y hepaticojejunostomy. The risk of cancer appears to be lower in patients with type II or III cysts. Patients with type II cysts can often be treated with simple cyst excision, while those with type III cysts can be treated with sphincterotomy or endoscopic resection Patients with type V cysts have a moderate risk of cancer, but because of the intrahepatic nature of the cysts, treatment can be difficult and some patients require liver transplantation #جراحة

Clinical manifestations of necrotizing infection include : ●Erythema (without sharp margins ) ●Edema that extends beyond the visible erythema . ●Severe pain (out of proportion to exam findings in some cases ●Fever ●Crepitus ●Skin bullae, necrosis, or ecchymosis Fever ,tachycardia, and systemic toxicity may be observed. Hypotension may be present initially or develop with progressive infection. Other symptoms include malaise, myalgias, diarrhea, and anorexia. The subcutaneous tissue may be firm and indurated, such that the underlying muscle groups cannot be palpated distinctly. Marked edema may produce a compartment syndrome with complicating myonecrosis requiring fasciotomy. diminished sensation to pain develops in the involved area, due to thrombosis of small blood vessels and destruction of superficial nerves in the subcutaneous tissue. #جراحة

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Laboratory risk indicators for necrotizing fasciitis (LRINEC) score. #جراحة

Choledochal cyst #جراحة

How to approach manage hypertensive urgency Emergency #ER