CHOLELITHIASISANASTOMOSISGASTRIC STAPPLINGCOLONOSCOPYPRESENTATION 8

HANNINGTON M MUWANGA

CHOLELITHIASIS

Also called Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball.

CAUSES OF GALLSTONES Stones made out of

cholesterol Stones made from too much

bilirubin in the bile.

Symptoms Pain in the right upper or middle

upper abdomen Fever Yellowing of skin and whites of the

eyes Abdominal fullness Clay-colored stools Nausea and vomiting

Abdominal ultrasoundAbdominal ultrasound is an imaging procedure used to examine the internal organs of the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys

Abdominal CT scanMethod that uses x-rays to create cross-sectional pictures of the belly area.You will be asked to lie on a narrow table that slides into the center of the CT scanner. Usually, you will lie on your back with your arms raised above the head

Gallbladder radionuclide scanThis uses radioactive material to check gallbladder function or to look for signs of an infection or bile duct obstruction.You lie face up on a table under a scanner called a gamma camera. The scanner detects the rays being emitted from the tracer. A computer displays images of where the tracer is found in the organs

OTHER PROCEDURES INCLUDE

Endoscopic retrograde cholangiopancreatography

Endoscopic ultrasound Magnetic resonance

cholangiopancreatography Percutaneous transhepatic

cholangiogram

Anastomosis An anastomosis is

a surgical connection between two structures. It usually means a connection that is created between tubular structures, such as blood vessels or loops of intestine

GASTRIC STAPLING

The stomach reduction technique known as "gastric stapling" to restrict food intake in morbidly obese patients.

surgeons use gastric stapling to divide the stomach into two sections: a small upper pouch and a larger lower section. A narrow gap (stoma) between the two sections is left unstapled. The idea behind this type of stomach stapling is that food which the patient eats is held up in the segment of stomach above the staple line causing a sensation of fullness and thus a reduced calorie-intake. The food then empties slowly through the stoma into the stomach below the staple line where digestion takes place normally.

Gastric Staples

Gastric Stapling Complications Using staples to reduce the stomach

and restrict food intake has one problem. The muscular stomach wall has a tendency to stretch, thus widening the stoma and permitting greater food and calorie intake. Early gastroplasty patients would therefore stop losing weight and would frequently regain all weight lost.

Benefits of Stomach Stapling -Procedure is reversible

- Digestive anatomy is unaltered- No dumping syndrome (rapid gastric emptying)- Low risk of serious complications- Gradual weight reduction

Risks of Stomach Stapling

- Breakage of staples- Erosion of band- Risk of vomiting if food is not properly chewed- Some risk of nutritional deficiencies- Reduced weight loss due to non-compliance with diet and exercise guidelines

COLONOSCOPY Is an internal examination of the colon (large

intestine) and rectum, using an instrument called a colonoscope.

You will lie on your left side with your knees drawn up toward your chest. After you have received a sedative and pain reliever, the colonoscope is inserted through the anus. It is gently moved into the beginning of the large bowel and sometimes into the lowest part of the small intestine.

Air will be inserted through the scope to provide a better view. Suction may be used to remove fluid or stool.

colonoscopy

How to Prepare for the Test You will need to completely cleanse your intestines. Your

health care provider will give you instructions for doing this. This may include a combination of enemas, not eating solid foods for 2 or 3 days before the test, and taking laxatives. You will usually be told to stop taking aspirin, ibuprofen, naproxen, or other blood-thinning medications for several days before the test.

You will be asked to drink plenty of clear liquids for 1 - 3 days before the test. Examples of clear liquids Like,

Clean coffee or tea Fat-free bouillon or broth Gelatin Sports drinks Strained fruit juices Water

WHY SOMEONE NEEDS COLONOSCOPY. Abdominal pain, changes in bowel movements, or

weight loss Abnormal changes (such as polyps) found on

sigmoidoscopy or x-ray tests (CT scan or barium enema)

Anemia due to low iron (usually when no other cause has been found)

Blood in the stool, or black, tarry stools Follow-up of a past finding, such as polyps or colon

cancer Inflammatory bowel disease (ulcerative colitis and

Crohn's disease) Screening for colorectal cancer

Risks after procedure

Heavy or persistent bleeding from biopsy or polyp-removal sites

Hole or tear in the wall of the colon (bowel perforation) that requires a repair operation

Fluid imbalances in the body due to enemas and laxatives given before the procedure

Infection needing antibiotic therapy (very rare) Nausea, vomiting, bloating, or rectal irritation

caused by medicines taken by mouth to cleanse the bowel

Reaction to sedative medication, causing breathing problems or low blood pressure

RESULTS

Normal findings are healthy intestinal tissues.

Abnormal Results Mean Diverticulosis (abnormal pouches on the

lining of the intestines, which increase with age)

Inflammatory bowel disease Lower gastrointestinal (GI) bleeding Polyps (which can be removed through the

colonoscope during the exam) Tumor