Pathophysiology of Acute Abdominal Disease with Intestinal Obstruction
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Questions and Answers

Patients with a prior history of abdominal surgery, particularly in the pelvic region, are at a higher risk of developing intraabdominal adhesions due to:

  • A decrease in inflammatory response in the abdominal cavity
  • Increased peristalsis in the bowel leading to adhesions formation
  • Chronic inflammation from previous surgeries (correct)
  • Genetic predisposition to bowel adhesions
  • Which factor increases the risk of developing hypotonic bowel in patients?

  • Regular physical activity
  • Consuming a high-fiber diet
  • Taking antibiotics
  • Being on bed rest (correct)
  • How do bowel obstruction, strangulation, and perforation lead to hypovolemia?

  • By reducing electrolyte balance
  • By increasing fluid intake
  • By enhancing intravascular volume
  • Through vomiting and diarrhea causing fluid losses (correct)
  • What is the main cause of sepsis in cases of perforated bowel?

    <p>Inflammatory response to enterotoxins and bacteria</p> Signup and view all the answers

    How does multisystem organ dysfunction syndrome primarily contribute to increased mortality?

    <p>By initiating an inflammatory response</p> Signup and view all the answers

    What physiologic concern is associated with toxic megacolon?

    <p>Systemic absorption of bacterial endotoxins leading to mucosal inflammation</p> Signup and view all the answers

    What are the typical signs and symptoms of bowel obstruction?

    <p>Pain, absence of bowel sounds, and leukocytosis</p> Signup and view all the answers

    What physiologic manifestation is associated with bowel perforation?

    <p>Hypersecretion of fluid enhanced by prostaglandin release</p> Signup and view all the answers

    Why is toxic megacolon more likely to occur in critically ill patients undergoing aggressive antibiotic therapy?

    <p>The antibiotic therapy promotes bacterial overgrowth</p> Signup and view all the answers

    What are the implications of aggressive resuscitation in cases of toxic megacolon?

    <p>Increased risk of sepsis due to enhanced prostaglandin release</p> Signup and view all the answers

    Why is it important to consider preoperative data and preexisting comorbidities for fluid management in patients undergoing bowel resection surgery?

    <p>To estimate the magnitude of fluid deficit and select appropriate resuscitative fluid</p> Signup and view all the answers

    What consequences can occur due to fluid losses caused by vomiting and diarrhea in patients undergoing bowel resection surgery?

    <p>Electrolyte imbalances requiring replacement</p> Signup and view all the answers

    How does bowel obstruction contribute to the failure in barrier function during bowel resection surgery?

    <p>By causing third-space loss into the interstitium within the intestinal wall</p> Signup and view all the answers

    What is a potential benefit of administering oral antibiotics in combination with mechanical bowel preparation (MBP) for patients undergoing elective intraabdominal surgery?

    <p>Lower rates of surgical site infections</p> Signup and view all the answers

    What physiological consequences may malnourished or medically compromised patients face as a result of preoperative bowel preparation for surgery?

    <p>Tachycardia and hypotension</p> Signup and view all the answers

    Which modality may be employed effectively as a primary modality or as a supplement to an epidural technique for postoperative analgesia after laparotomy?

    <p>Patient-controlled analgesia (PCA)</p> Signup and view all the answers

    What may effectively decrease postoperative opioid requirements and has shown analgesic properties in patients undergoing laparotomy?

    <p>Combination therapy with NSAIDs and opiates</p> Signup and view all the answers

    What approach, if instituted, may significantly decrease the degree of postoperative pain after laparotomy?

    <p>Laparoscopic approach</p> Signup and view all the answers

    Which medication, when administered in low IV doses, effectively augments the effect of opioids for postoperative pain management?

    <p>Ketamine</p> Signup and view all the answers

    What technique anesthetizes sensory nerves of the anterior abdominal wall and can be utilized for postoperative analgesia after laparotomy?

    <p>Transverse abdominis plane block</p> Signup and view all the answers

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