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Management of Acute Upper GI Bleed
With a mortality rate of 2-10%, upper gastrointestinal bleeding (UIB) is a frequent medical emergency. Patients who have been determined to have a very low risk of dying or needing an intervention can be treated as outpatients. Red cell transfusion at a hemoglobin level of 70–80 g/L and intravenous fluids as needed for resuscitation are advised for all other patients. Proton pump inhibitors (PPIs) and the prokinetic drug erythromycin may be delivered when resuscitation is started, with antibiotics and vasoactive medications advised in patients with cirrhosis. Endoscopy should be performed within 24 hours, with early endoscopy being explored in high-risk patients, such as those with hemodynamic instability, following resuscitation.
About the Speaker
Dr. PRITHVI PRIYADARSHINI SHIVALINGAIAH
MBBS,MD,DNB DM, Gastroenterology in CMC Hospital Dubai
Case Discussion on Purpose of Gastrectomy
Gastrectomy is a surgical procedure that involves the removal of all or part of the stomach. This procedure is usually performed to treat various conditions such as stomach cancer, ulcers, and obesity. A case discussion on gastrectomy typically involves a group of healthcare professionals who review and analyze a specific patient's medical history, diagnosis, treatment plan, and outcomes. During the discussion, the healthcare team considers various factors such as the patient's age, overall health, the extent of the surgery, and the potential risks and benefits. The team also discusses the potential impact of the procedure on the patient's quality of life, nutritional needs, and long-term prognosis. Overall, a case discussion on gastrectomy is a collaborative effort aimed at providing the best possible care and outcomes for the patient. During the gastrectomy procedure, the surgeon may remove a portion of the stomach or the entire stomach. The remaining stomach is then reattached to the esophagus and small intestine. Like any surgery, gastrectomy carries risks such as bleeding, infection, and blood clots. Additionally, some patients may experience complications such as dumping syndrome, a condition that occurs when food moves too quickly from the stomach to the small intestine, causing nausea, vomiting, and diarrhea.
Gastrointestinal dysfunction in the Critically ill Patients
Gastrointestinal dysfunction can be caused by a variety of factors, including stress, infections, food intolerances, medications, and autoimmune disorders. Some gastrointestinal disorders, such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), can be chronic and require ongoing management. Gastrointestinal dysfunction can impact overall health and wellbeing, leading to malnutrition, dehydration, and other complications if left untreated. Treatment for gastrointestinal dysfunction may include dietary changes, medications, and lifestyle modifications, such as exercise and stress reduction. Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics, can disrupt the balance of bacteria in the gut and contribute to gastrointestinal dysfunction.
Case Based Discussion on Hernia Management
Hernia management involves the treatment of a condition in which an organ or tissue protrudes through a weakened area of the surrounding muscle or connective tissue. The most common types of hernias include inguinal hernias, which occur in the groin, and umbilical hernias. Surgical hernia repair is typically recommended for larger, more symptomatic hernias, or those that have the potential to become incarcerated or strangulated. Open hernia repair involves making an incision at the site of the hernia, while laparoscopic repair involves using a small camera and specialized instruments to repair the hernia through several small incisions. Recovery from hernia surgery typically involves a period of rest and limited physical activity, as well as pain management and follow-up care with the surgeon.
Non Alcoholic Fatty liver Diseases: An Overview
Non-alcoholic fatty liver disease is the most common liver disease worldwide, affecting up to 25% of the global population. The exact cause is unknown, but it is often associated with obesity, insulin resistance, high blood pressure, and high cholesterol levels. It is divided into two types: simple fatty liver and non-alcoholic steatohepatitis (NASH). NASH is a more severe form of NAFLD that can lead to liver damage and cirrhosis. It is typically diagnosed through blood tests, imaging tests (such as ultrasound or MRI), and sometimes a liver biopsy. Treatment involves lifestyle changes such as losing weight, exercising regularly, and eating a healthy diet. In some cases, medications may be prescribed.
Case Discussion on Complication of Esophageal Resection
Technically difficult operations include esophageal resection and gastrointestinal continuity restoration. Morbidity and mortality rates are influenced by a variety of variables, including patient comorbidities, surgical technique, and hospital/surgeon volume. The total incidence of postoperative complications ranges from 20 to 80%, and they can be either systemic (such as pneumonia or cardiac infarction) or surgical procedure-specific (such as anastomotic leaks or recurrent laryngeal nerve damage). The majority of individuals (16–67%) who experience postoperative problems have pulmonary issues.