Complications of ventilation tubes: - Dr. Nassem Talaat

More documents

Recommendations

Info

Perforation of the oesophagus Aet : - During oesophagoscopy , dilatation , F.B extraction - Malignant growth or external injury Symptoms: -Severe retrosternal pain -Dyspnea (pneumothorax & empyema) -Dysphegia Signs: Fever, toxaemia, shock Tendernes & swelling in the neck Crepitation due to surgical emphysema ttt: -Control shock -Nothing by mouth (I.V alimentation or gastrostomy) -Heavy antibiotics -Intercostal tube connected to under water seal. *Indications: A) Diagnostic: examination - biopsy B) Theraputic: -FB extraction Oesophagoscopy -Dilatation of non malignant stricture -Excision of benign tumor -Stent in oesophageal carcinoma *Contraindications: -Acute necrotic ulceration from caustics -Marked kyphosis -Aortic aneurysm, vascular tumors. *Complications: -Perforation -Hge -Injury to teeth, tongue, pharynx Flexible esophagoscopy: Usually performed by gastroenterologists, to assess functional phenomenon suppressed by general anesthesia, or if rigid is contraindicated
Gastro esophageal reflux disease (G.E.R.D.) Def: Retrograde flow of gastric contents back into the esophagus Aet: Normally reflux is prevented by: Positive pressure of the cardia. Contraction of the crura of the diaphragm. The angle between the esophagus & the stomach. Decrease lower esophageal segment (LES) pressure is the major factor to GERD, it is affected by: smoking, alcohol, drugs, hormones, neuromuscular disease & delayed gastric emptying. ENT manifestations: - Heartburn, water brash (classic) - Choking, hoarseness, subglottic stenosis, globus hystericus - Asthma & chronic cough, otalgia, odynophagia Diagnosis: PH manometry (Ph less than 4 more than 6% of time is diagnostic) Management: Phase 1: Dietary & life style modification, with anti-acids Encourage protein meals (increase LES pressure) Discourage fatty meals (decrease LES pressure) Avoid chocolate, carbonated beverages & caffeine Avoid smoking, alcohol & over eating Last meal 3 hours before sleep Phase 2: if failed phase 1, give medication to decrease HCL production, increase LES pressure & promotes gastric emptying (H2 blockers e.g cimitidine,proton pump inhibitors e.g omeprazole) Phase 3: surgery in: failed medical ttt, complications or with hiatus hernia……correct hernia with fundoplication Dysphagia Def : Dysphasia is defined as difficulty on swallowing , when associated with pain is called odynophagia . Classification of the causes I. Oesophageal causes: A. Causes in the lumen: Foreign body
Page 1 and 2: Anatomy It is divided into: 1) Naso
Page 3 and 4: Blood supply: as pharynx (mainly to
Page 5 and 6: Complications : I. Anesthetic compl
Page 7 and 8: 4-Craniotomy if intra cranial exten
Page 9 and 10: Ttt: at age of 1-2 year: surgery an
Page 11 and 12: Chronic Tonsillitis Aet : repeated
Page 13 and 14: 3- Vincent’s angina 4- I.M.N 5- A
Page 15 and 16: D) Systemic Diseases 1) Infectious
Page 17 and 18: Local: - Trismus , tonticollis Trea
Page 19 and 20: Signs : - Fever , tachycardia, tort
Page 21 and 22: 3- Herpes zoster - caused by varice
Page 23 and 24: Indications 1- Repeated attacks of
Page 25 and 26: Complications of tonsillectomy : 1-
Page 27 and 28: - M.P Almost always squamous cell c
Page 29 and 30: Treatment: 1-If asymptomatic: no tt
Page 31 and 32: Clinical picture: rhinolalia aperta
Page 33 and 34: Less common: Morning headache, pers
Page 35 and 36: Trismus Def: Inability to open the
Page 37 and 38: Congenital: esophageal atresia Aet:
Page 39: Achalasia Cancer Def marked dilatat
Page 43 and 44: 2. in the thorax (middle 1/3) a. Me
Page 45 and 46: -septum: laser septoplasty -Neoplas
Page 47 and 48: 2-Neoplastic a. benign: Pleomorphic
Page 49: Ear: Trauma: Auricle: cut wound, he

Complications of ventilation tubes: - Dr. Nassem Talaat

Create successful ePaper yourself

Delete template?

Save as template?