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Patient has…..

What co-morbid conditions should you consider in his management? How would these influence your plan? . Patient has…. Chronic bronchitis Bowel obstruction. nausea. Absent bowel sounds. vomiting. Chronic bronchitis.

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Patient has…..

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  1. What co-morbid conditions should you consider in his management? How would these influence your plan?

  2. Patient has….. • Chronic bronchitis • Bowel obstruction nausea Absent bowel sounds vomiting

  3. Chronic bronchitis “ It must be remembered that patients who have a bad cough from chronic bronchitis should not be denied an operation, for these are the very people who are in danger of getting a strangulated hernia.”

  4. Complications: • Incarcerated • Strangulation

  5. incarcerated • The trapping of abdominal contents within the Hernia itself. The bulge cannot be reduced or pushed back. This could mean that intestine from within the abdomen is trapped in the hernia and the risk of injury to abdominal contents and intestine is increased. Surgical release and hernia repair are emergently necessary to avoid injury to the intestine.

  6. strangulation • Injury to the blood circulation to the intestine caused by incarceration. The Intestine will become gangrenous or die if not corrected early. This is an absolute emergency situation requiring immediate surgery. Mortality rates are high in patients not treated quickly with surgery

  7. management

  8. Incarcerated • Taxis - goal is to elongate the neck of the hernia so that the contents of the hernia may be guided back into the abdominal cavity with a rocking movement

  9. Strangulation • Rapid resuscitation with intravenous fluids is essential • electrolyte replacement • Antibiotics and nasogastricsuction • SURGERY

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