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23:5323:53, 28 February 2026 Vascular trauma (hist | edit) [8,773 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Pre-operative assessment == * Hard signs of vascular injury: ** Pulsatile bleeding ** Expanding haematoma ** Presence of bruit/thrill ** Evidence of ischaemia (six P's) * Soft signs: ** History of significant haemorrhage ** Injury in proximity to a major vessel ** Non-expanding haematoma ** Diminished or asymmetric pulses ** Unexplained hypotension or tachycardia * Investigation ** CTA is best ** Duplex USS ** Segmental pressures Minor injuries - majority of these...") Tag: Visual edit
23:5123:51, 28 February 2026 Buerger's disease (hist | edit) [1,093 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " (Thromboangiitis obliterans) Segmental non-atherosclerotic inflammatory condition of arteries and veins characterised by thrombosis and recanalisation of small and medium vessels. * Impaired vasorelaxation and function of the sympathetic system * Ensuing inflammatory process leads to vessel thrombosis == Risk factors == * Males * Smokers (heavy, long-term) * Around 40 years old == Locations == * Most commonly upper/lower extremities * Look for symptoms in two extr...") Tag: Visual edit
23:4923:49, 28 February 2026 Raynaud's phenomenon (hist | edit) [2,618 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "Episodic pallor or cyanosis of the fingers caused by vasoconstriction in response to cold or emotional stress * Starts as sudden-onset pallor, followed by cyanosis as the capillary blood becomes desaturated. The attack subsides with the return of arterial inflow, and post-ischaemic vasodilation results in hyperaemia and rubor of the skin * Toes can also be affected, but much more often the fingers * Refer to primary Raynaud's as Raynaud's Disease, and secondary Raynaud'...") Tag: Visual edit
23:4323:43, 28 February 2026 Arm artery occlusion (hist | edit) [2,683 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Symptomatic arterial occlusive disease is seen much more in leg than arm. * However, functional impairment can be much more severe in arm The key to this is picking up on aetiology and treating specifically for that cause. == Aetiology == * Vasospasm * Intrinsic arterial disease ** Atherosclerosis (most common) ** Usually limited to more proximal arteries ** ESRF - azotaemic arteriopathy * Inflammatory ** Initial inflammatory phase - fever, arthritis, myalgias, ESR...") Tag: Visual edit
23:1823:18, 28 February 2026 Acute limb ischaemia (hist | edit) [12,209 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Pathophysiology: == * Result of a sudden deterioration in arterial supply to a limb * Almost always thrombosis or embolus. The distinction doesn't generally change management, but is important with respect to diagnosis and prognosis. * Pathophysiology of local ischaemia: ** Reduced perfusion lowers oxygen tension and metabolic substrate delivery ** Anaerobic metabolism starts which causes lactic acid to accumulate and local acidosis ** Depletion of ATP and inability...") Tag: Visual edit
23:1723:17, 28 February 2026 Arterial physiological assessment (hist | edit) [5,982 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Doppler ultrasonography''' == * Indications: ** Suspected symptomatic chronic PAD ** Suspected acute limb ischaemia ** Pedal infected without a palpable pulse ** Atheroembolic or thromboembolic disease states ** Surveillance post-revascularisation * Criteria for critical flow-limiting stenosis: ** Loss of triphasic waveform ** Spectral broadening with an increase in velocity (PSV >200cm/s, EDV > 0cm/s) ** Vr greater than 3 across the stenosis * Principles ** The...") Tag: Visual edit
23:1723:17, 28 February 2026 Vascular clinical evaluation (hist | edit) [5,412 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== History == * Broad categories of complaints: ** Pain ** Weakness ** Neurosensory complaints *** Warmth *** Coolness *** Numbness *** Hypersensitivity ** Discolouration ** Swelling ** Tissue loss/ulceration ** Varicosities * Ask about: ** Duration of symptoms ** Progression or changes since initial onset ** Location ** Character or quality ** Extent of functional limitation ** Precipitating/aggravating ** Associated signs and symptoms ** Risk factors == Examination =...") Tag: Visual edit
23:1623:16, 28 February 2026 Testicular trauma (hist | edit) [1,125 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "Ultrasound is mainstay of assessment Indications for exploration: * USS suggestive of rupture * Severe pain non-responsive to management * Increasing swelling Testicular rupture (rupture of albuginea) * Early exploration with debridement and repair of tubica albuginea is more likely to preserve useful testicular function - explore if USS is suggestive of breach * Completely ruptured - orchidectomy * Otherwise, evacuate the haematoma, debride, and loosely tack tunic...") Tag: Visual edit
23:1523:15, 28 February 2026 Testicular torsion (hist | edit) [5,862 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Risk factors == * Two peaks of incidence: ** Perinatal period *** Described as 'extravaginal' torsion - implying that torsion occurs due to failure of tunica vaginalis to attach to the surrounding structures, and is therefore torsion of the spermatic cord as a whole *** Some torsions can also be intravaginal in this period *** Urgent exploration and contralateral fixation should occur, as salvage is still possible ** 11-25yo == Pathophysiology == * Tends to twist...") Tag: Visual edit
23:1423:14, 28 February 2026 Testis mal-descent (hist | edit) [2,176 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Occurs when the testis is arrested in some part of its normal path to the scrotum * Differentiate from ectopic testis - abnormally placed outside this path == Incidence == * About 4% of boys have one or both incompletely descended at birth * 2/3 of these reach the scrotum during first three months * Full descent after first three months is uncommon * Overall incidence of testicular mal-descent at 1 year is 1% == Pathology == * More common on the right * Bilateral i...") Tag: Visual edit
23:1423:14, 28 February 2026 Testicular cancer (hist | edit) [3,276 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Risk factors == * Seminomas peak in 4th decade, while non-seminomatous germ cell tumours peak in 3rd decade * Testicular mal-descent * Contra-lateral testicular tumour * Klinefelter's syndrome == Pathophysiology == * '''Germ cell tumours (90-95%)''' ** '''Seminoma''' *** Homogenous, pinkish cream cut surface *** Appears to compress neighbouring testicular tissue *** Oval cells with clear cytoplasm and large, rounded nuclei with predominant acidophilic nucleoli. Sh...") Tag: Visual edit
23:1323:13, 28 February 2026 Orchitis (hist | edit) [594 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Aetiology * Mumps ** Develops in 20-30% of post-pubertal patients with mumps ** Usually develops as the parotid swelling is waning ** Diagnose with IgM antibodies in seum ** Main complication - testicular atrophy - can cause infertility if bilateral ** Persistent testicular pain can occur * Syphilis ** Now uncommon ** Can cause bilateral orchitis ** Can be associated with congenital syphilis ** Can lead to interstitial fibrosis (painless destruction of testis) or gumma...") Tag: Visual edit
23:1323:13, 28 February 2026 Epididymo-orchitis (hist | edit) [1,613 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Pathophysiology == * Infection reaches epididymis via the vas from a primary infection of the urethra, prostate or seminal vesicles * Younger men: STI - commonly chlamydia or gonococcal * Older men: UTI or IDC-related * Blood-borne may be possible - how else would it happen in post-vasectomy men? * Infection usually starts in the tail then spreads to the rest, and occasionally the testis * Tuberculous - usually affects lower pole first ** Typically firm, uncomfortab...") Tag: Visual edit
23:1323:13, 28 February 2026 Epididymal cysts (hist | edit) [1,595 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Epididymal cysts == * Common, usually found in middle age * Usually multiple at presentation, often bilateral * Filled with crystal-clear fluid * Represent cystic degeneration of epididymis * Examination ** Feels like a tiny bunch of grapes posterior to, and quite separate from, the testis ** Should transilluminate brilliantly * Investigation ** Confirm diagnosis with ultrasound * Treatment ** Aspiration is useless - too many, and multilocular ** If causing discomfo...") Tag: Visual edit
23:1223:12, 28 February 2026 Hydrocoele (hist | edit) [3,350 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " An abnormal collection of serous fluid in a part of the processus vaginalis, usually the tunica vaginalis * Hydrocoele fluid is made up of albumin and fibrinogen == Pathophysiology == # Excessive production of fluid within the sac (secondary) # Defective absorption of fluid (most primary hydrocoeles) # Interference with lymphatic drainage of scrotal structures # Connection with the peritoneal cavity via a patent processus vaginalis (congenital) == Aetiology == * A...") Tag: Visual edit
23:1223:12, 28 February 2026 Vasectomy (hist | edit) [1,859 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Technique for no-scalpel vasectomy:''' == * Three-digit grasp of cord * Vas forceps around cord * Sharp arteries to dissect onto cord * Keep alternating sharp arteries and ring forceps until you can pull the vas free * Artery across vas * Sharp monopolar diathermy into superior end of vas, coagulate * Divide and send some for histo * Suture superior end into u-shape then bury in fascia * Ligate inferior end == '''Follow-up:''' == * Semenalysis 3/12 * Phone clin...") Tag: Visual edit
23:1223:12, 28 February 2026 Varicocoele (hist | edit) [2,211 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Varicose dilatation of the veins draining the testis == Pathophysiology == * Pampiniform plexus is formed by veins draining testis and epididymis. Veins gradually join together as they traverse the inguinal canal. At the inguinal ring, there are only one or two testicular veins, which then pass upwards through the retroperitoneum. Left vein to left renal vein, while right vein goes to IVC. The testicular veins usually have valves near their terminations, but these are...") Tag: Visual edit
23:1123:11, 28 February 2026 Penis (hist | edit) [4,270 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Phimosis == * Note that physiological phimosis is present until 6yo in some cases - don't stress until then * Inability to retract the foreskin without fissuring it, due to scarring of the prepuce * May result in ballooning of the foreskin during micturition and can result in balanoposthitis * Can rarely cause urinary obstruction if the aperture in the prepuce is extremely tight * In adults, can occur secondary to inflammation (balanitis, posthitis, balanitis xerot...") Tag: Visual edit
23:1123:11, 28 February 2026 Female urethra (hist | edit) [1,085 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Prolapse - urethrocoele == * Occurs in conjunction with cystocoele * Largely due to childbirth * See separate topic on pelvic organ prolapse == Stricture == * Uncommon in women * Urethritis * Difficult labour * Respond well to urethral dilation in women == Fowler's syndrome == * Idiopathic condition with abnormal myotonic discharge in the striated urethral sphincter * Causes retention * Probably have to do ISC == Diverticulum == * Rare * Local pain and repeate...") Tag: Visual edit
23:1023:10, 28 February 2026 Male urethra (hist | edit) [1,467 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Hypospadias == * Indications for surgery: ** Improve sexual function ** Correct problems with urinary stream ** Cosmetic reasons * Avoid circumcision before the hypospadias has been repaired == Epispadias == * Urethral opening on dorsum of the penis == Urethral stricture == * Aetiology ** Inflammatory *** Urethritis - most commonly in bulbar urethra *** Balanitis xerotica obliterans - fibrosis of the foreskin resulting in phimosis ** Traumatic *** Bulbar urethra...") Tag: Visual edit
23:0323:03, 28 February 2026 Prostatitis (hist | edit) [647 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Microbiology == * Haematogenous or secondary to UTI * Usually E coli * Can be chlamydia/gonorrhoea == Presentation == * Malaise * Rigors * Myalgia * Fever up to 39 * Dysuria is common, but not always there * Local symptoms - perineal heaviness, rectal irritation, pain on daefecation * Tender prostate - can be asymmetrical - sometimes frankly fluctuant abscess == Treatment == * Prolonged Abx or it will recur == Prostatic abscess == * Severe, unremitting perineal...") Tag: Visual edit
23:0323:03, 28 February 2026 Prostate cancer (hist | edit) [1,733 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Histopathology == * Adenocarcinoma * Usually originates in PZ - so prostatectomy for BPH is not actually protective against developing cancer later * Incidence in men >80yo is about 70%, but most of these are tiny and may never cause a problem * Gleason score - two histological areas are scored between 1 and 5, giving an overall score of between 2 and 10. This appears to correlate well with the likelihood of spread. == Presentation == * Elevated PSA - about 30% of...") Tag: Visual edit
23:0323:03, 28 February 2026 Benign prostatic hypertrophy (hist | edit) [3,941 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Pathophysiology == * Proposed to occur secondary to increasing oestrogenic stimulus over time * Affects both glandular epithelium and connective tissue * Typically affects submucosal glands in transitional zone, forming a nodular enlargement * Complex relationship between BPH, BOO and LUTS ** * '''Bladder outlet obstruction:''' ** Urodynamic concept - low flow rates in the presence of high voiding pressures ** Can result from: *** BPH *** Bladder neck stenosis *** Bl...") Tag: Visual edit
23:0223:02, 28 February 2026 IDC insertion (hist | edit) [1,888 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Anatomical considerations == * Average male urethra accomodates ** Meatus: 24Fr ** Prostatic urethra: 32Fr ** Bladder neck: 28Fr * Female urethra - normal calibre is 22Fr == Indications == * Retention * Therapeutic eg bcg * Etc * Extraperitoneal bladder injury and SOME intraperitoneal bladder injury * Small vesicovaginal fistulae == Contraindications == * Absolute ** Suspected or confirmed urethral injury ** History of bladder neck closure or repair * Relative **...") Tag: Visual edit
23:0223:02, 28 February 2026 SPC insertion (hist | edit) [814 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Technique == * Guidewire and Seldinger ** USS prior to confirm bladder location ** LA to skin, fascia and retropubic space ** Prep skin ** Small incision in skin ** USS guidance ** Approx 19G needle advanced vertically until urine is returned (can use long spinal needle). Avoid going into peritoneal cavity. ** Remove needle and place a super-stiff guidewire into the bladder ** Advance catheter over guidewire and fill balloon * Open ** Incision 2cm above pubic symphy...") Tag: Visual edit
23:0123:01, 28 February 2026 UTIs (hist | edit) [4,836 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Classification == * Uncomplicated * Complicated: episode of infection with increased risk of serious complications or treatment failure * Upper: loin pain, pyrexia, rigors, malaise * Lower: frequency, urgency, suprapubic discomfort, dysuria and cloudy offensive urine == Acute pyelonephritis == * Aetiology ** Haematogenous - often tonsils, carious teeth, cutaneous infections, renal TB ** Ascending infection - most common - a/w VUR, urinary stasis, calculi * Microbio...") Tag: Visual edit
23:0123:01, 28 February 2026 Urinary fistulas (hist | edit) [2,230 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Fistula: communication between two epithelium-lined surfaces == Vesicocutaneous fistulae: == * Congenital: ** Ectopia vesicae ** Patent urachus - urine leakage from umbilicus ** In a/w imperforate anus * Traumatic ** Perforating wounds ** Radiotherapy - avascular necrosis ** Damage during surgery == Vesicovaginal fistulae: == * Aetiology: ** Obstetric - ischaemia due to prolonged pressure from fetal head ** Gynaecologic - hysterectomy/anterior colporrhaphy *** Grasp...") Tag: Visual edit
23:0023:00, 28 February 2026 Urinary incontinence (hist | edit) [4,363 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Urge incontinence - involuntary leakage, immediately preceded by urgency - often overactive bladder or bladder neuropathy. Stress incontinence - involuntary leakage which occurs when intra-abdominal pressure rises. == Incidence == * 5% men, 20% of women lifetime incidence * 40% of women >60yo * 50% of institutionalised elderly patients == Aetiology == * Children - often a/w ** Infections ** Constipation ** Psychological factors ** Intentional misconduct ** Increase...") Tag: Visual edit
23:0023:00, 28 February 2026 Urinary diversion (hist | edit) [1,109 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Temporary == * IDC * Suprapubic catheter == Permanent == * Ileal conduit ** Isolate a 20cm coil of ileum, about 30cm from ICV (or less commonly, colon) with its blood supply intact ** Implant ureters into ileum either end to side or end to end ** The ileal conduit diverts the urine onwards to a cutaneous stoma for collection in an ileostomy bag ** Complications: *** Ureteroileal stricture *** Stenosis at ileocutaneous site - keep the conduit short * Ureterosigmoid...") Tag: Visual edit
22:5922:59, 28 February 2026 Bladder neoplasm (hist | edit) [1,790 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Histopathology == * 95% originate in transitional epithelium * Remainder arise from connective tissue (angioma, myoma, fibroma, sarcoma) * Benign papillary tumours - red sea anemone appearance * Urothelial cell carcinoma ** Risk factors *** Smoking *** Urothelial carcinogens **** Textile workers **** Dye workers **** Tyre rubber and cable workers **** Petrol **** Leather **** Shoe manufacturers and cleaners **** Painters **** Hairdressers **** Lorry drivers **** Dr...") Tag: Visual edit
22:5922:59, 28 February 2026 Urinary retention (hist | edit) [6,619 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Causes: == * Outflow obstruction (most common) ** Mechanical factors *** Men: **** BPH **** Bladder/prostate cancer **** Urethral stricture **** Phimosis/paraphimosis *** Women: **** Anatomic distortion - can be due to retroverted gravid uterus *** Both genders **** Blood clot **** Urethral calculus **** Urethral rupture **** Constipation/faecal impaction **** Anal pain (haemorrhoidectomy) **** Drugs (see below) ** Dynamic factors *** Increased muscle tone within and...") Tag: Visual edit
22:5822:58, 28 February 2026 Nephrolithiasis (hist | edit) [5,116 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Aetiology == * Idiopathic calcium urolithiasis ** Unexplained hypercalciuria with normal serum calcium ** Makes up 70% of patients with stones * Hypercalcaemic disorders ** Primary hyperparathyroidism ** Prolonged immobilisation - bone resorption ** Milk alkali syndrome *** Ingestion of large quantities of calcium, vitamin D3 and alkali *** Leads to hypercalcaemia, alkalosis and possible renal impairment *** Alkalosis compromises renal excretion of calcium ** Sarcoi...") Tag: Visual edit
22:5822:58, 28 February 2026 Renal cysts (hist | edit) [1,277 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "Bosniak classification: {| class="wikitable" |Grade |Description |Rate of malignancy |Follow-up |- |I |Simple benign cysts with hairline-thin walls. No septations, calcifications or solid components. No enhancing soft tissue components. |~0% |None None at all |- |II |Benign cystic lesions. The cysts may have hairline-thin septations with fine calcifications in the walls. Minimal enhancement of the hairline-thin smooth wall may be seen. No enhancing soft tissue component...") Tag: Visual edit
22:5722:57, 28 February 2026 Renal infarction (hist | edit) [1,287 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " May involve the whole kidney (renal artery occlusion) or small areas of cortex and medulla == Aetiology == * Trauma * Embolism ** AF ** Atrial or mural thrombi ** Intracardiac mass ** Valvular lesions * Iatrogenic complications of endovascular procedures * Thrombotic ** Atherosclerotic disease of aorta/renal arteries ** Fibromuscular hyperplasia ** Takayasu's arteritis ** Polyarteritis nodosa ** Marfan's syndrome ** Ehler's-Danlos syndrome ** Hypercoagulable states **...") Tag: Visual edit
22:5722:57, 28 February 2026 Circumcision (hist | edit) [751 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Technique * Penile block infiltrated just under pubic symphysis and penoscrotal base * Prep with foreskin retracted * Deal with any phimosis present * Mark extent of resection ** Put the foreskin on tension (below the corona on the dorsal aspect, and following the natural tapering of the corona on the ventral aspect) ** Apply artery clips transversely - haemostasis and marking * Excise the foreskin ** Use a scalpel/scissors to incise the skin over the marked line (exte...") Tag: Visual edit
22:5522:55, 28 February 2026 Congenital urinary tract abnormalities (hist | edit) [4,225 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Kidneys == * Unilateral renal agenesis ** 1 in 500-1,000 births ** Results from failure of connection between the metanephric blastema and the ipsilateral ureteric bud ** Autosomal dominant trait with incomplete penetrance ** Typically, absent ipsilateral ureter ** Remaining kidney usually hypertrophic ** Ipsilateral testis and vas deferens/ovary and fallopian tube are usually absent, and sometimes adrenal gland * Bilateral renal agenesis ** Incomplatible with life...") Tag: Visual edit
22:5422:54, 28 February 2026 Renal and upper tract tumours (hist | edit) [2,780 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Histopathology == * Benign ** Adenoma *** Cortical adenomas *** Generally small *** Asymptomatic ** Angioma *** May cause profuse haematuria, often in young adults *** Needs angiogram to diagnose ** Angiomyolipoma *** Often associated with tuberous sclerosis *** Typical appearance on CT *** Can bleed into themselves *** Malignant elements present in about 25% * Malignant ** Renal cell carcinoma *** Derives from renal tubular epithelial cells *** Median age 64yo ***...") Tag: Visual edit
22:5322:53, 28 February 2026 Haematuria (hist | edit) [495 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "Blood in urine * Visible haematuria - 20% cancer * Non-visible haematuria - <5% cancer * Investigation is designed to exclude cancer * Consider trauma, infection and neoplasm at all levels of the urinary tract History * Timing of the blood ** Initial - urethral pathology ** Throughout - bladder or upper tracts ** Terminal - bladder neck or prostate Aetiology * Trauma * Infection * Neoplasm Investigation * Renal ultrasound * Flexible cystoscopy * Urine MCS...") Tag: Visual edit
22:5322:53, 28 February 2026 Urologic symptoms (hist | edit) [1,415 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "* Renal pain - constant, gnawing pain in renal angle/loin * Ureteric colic - colicky lateral pain; can radiate to groin or testicle/labia, but not to chest or back of leg * LUTS ** Frequency ** Nocturia ** Strangury - sensation of constantly needing to void - most commonly caused by UTI ** Urgency - sudden, compelling need to pass urine ** Urge incontinence - involuntary leakage, immediately preceded by urgency - often overactive bladder or bladder neuropathy ** Stress i...") Tag: Visual edit
22:5222:52, 28 February 2026 Bite injuries (hist | edit) [573 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Dog bites == * Need to cover against Pasteurella multocida, Capnocytophaga, Strep viridans, Bacteroides, Fusobacterium * Tazocin or meropenem IV, then augmentin df or bactrim == Cat bites == * Pasteurella multocida * Staphylococcus == Human bites == * Strep viridans * Staphylococcus * Eikenella corrodens * Bacteroides == Antibiotics for all the above == * No established infection: Augmentin DF * Established infection IV: Tazocin OR metronidazole + ceftriaxone...") Tag: Visual edit
22:5222:52, 28 February 2026 Trauma laparotomy (hist | edit) [8,252 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Risk prediction * See 'frailty' under 'periop medicine' for NSQIP/NELA == Goals == * Arrest haemorrhage * Control contamination * Minimise operative time in the unstable patient * Aim for quick transfer to ICU for physiological correction == Principles == * Rapid entry, large incision * Control of bleeding * Identify injuries * Control contamination * Consider reconstruction == Causes of spontaneous intra-abdominal haemorrhage == * Vascular ** Ruptured AAA ** Rup...") Tag: Visual edit
22:5022:50, 28 February 2026 PTA (hist | edit) [2,000 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Age 8 or up: * Mild TBI (GCS 13-15 at scene): A-WPTAS ** Pass within 24 hours - 'out of PTA' ** Fail after 4 hours - go on to WPTAS ** Not administered within 24 hours - needs daily PTA * Mod TBI (GCS 9-12 at scene): WPTAS 1-7 days * Severe TBI (GCS 8 or less): WPTAS > 7 days Age 4-7: * Sydney Post-Traumatic Amnesia Scale (SYPTAS) - needs 5/5 on 3 consecutive days to be cleared Age 0-3: * No PTA available * OT or neuropsych should do play/activity based assess...") Tag: Visual edit
22:5022:50, 28 February 2026 REBOA (hist | edit) [1,532 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "Conceptualised as a tourniquet for the trunk - indicated where rapid proximal control of truncal haemorrhage would be lifesaving. == Indications: == * Traumatic cardiac arrest: ** Penetrating abdo/pelvis trauma and severe haemorrhage below the diaphragm ** Blunt trauma in the absence of significant PTX/HTX/cardiac tamponade * Trauma and shock (SBP < 90mmHg) ** If evidence of truncal haemorrhage, and no/transient response to blood, and no thoracic cause for shock (PTX/H...") Tag: Visual edit
22:4922:49, 28 February 2026 Mass Transfusion Protocol (hist | edit) [3,473 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " There are two main definitions used: * '''Austin guideline:''' the transfusion of 50% blood volume in 4 hours, or >1 blood volume in 24 hours (blood volume is approx. 70mL/kg). ** Which is going to be approx. 8 units per 4 hours, or 16 units per 24 hours ** Activate the protocol when you anticipate >4 units required, or when 4 have been transfused in 4 hours and more is required. * '''ATLS''' defines adult MTP as 4 units in one hour or 10 units in 24 hours == '''Goals...") Tag: Visual edit
22:4922:49, 28 February 2026 Crush injuries (hist | edit) [2,020 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "The result of severe physical trauma from prolonged compression of the torso/limbs == Pathophysiology == * Severe compression results in direct trauma to local muscle/nerve * Failure of sodium-potassium pump and sodium-calcium exchanger on sarcoplasmic membrane -> influx of water, sodium and calcium to myocytes -> cellular swelling and death -> rhabdomyolysis * Rhabdomyolysis and compartment syndrome is common * Systemic manifestations result from reperfusion and myone...") Tag: Visual edit
22:4822:48, 28 February 2026 Blast injuries (hist | edit) [1,384 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "The physiological and anatomical insult to the human body caused by the physical properties of an explosion. Most deaths occur at the scene. == Mechanics: == * Initial high-pressure shockwave * Negative pressure at site of blast then draws atmosphere back towards point of blast, causing 'blast wind' and potentially more tissue damage == Classification == * Primary blast injury ** Effects of direct pressure (barotrauma) ** Gas-enclosing organs are most vulnerable - l...") Tag: Visual edit
22:4722:47, 28 February 2026 Burns (hist | edit) [18,861 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== '''Aetiology''' == * Fire/flame 41% ** Common in young adults ** Damage from super-heated oxidised air by convection and radiation * Scalds 33% ** Damage from contact with hot liquids ** Common in children * Contact burns 9% ** Damage from contact with hot or cold solids * Chemical burns 3% * Electrical burns 3% ** Conduct of electrical current through tissues * Always consider NAI in infants/children == '''Pathophysiology''' == * Thermal burns cause damage to skin...") Tag: Visual edit
22:4622:46, 28 February 2026 Hand trauma (hist | edit) [4,216 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "For infections - see separate section under 'skin' == Examination == * See separate topic under 'MSK' == Operative planning == * RUN (emergency - OT same day) ** High-pressure injections ** Compartment syndrome ** Amputations ** Deep space infections (flexor tenosynovitis, septic arthritis) * WALK (less urgent - may require care on same day, but not necessarily OT) ** Open fractures ** Joint and carpal bone dislocations ** Open wounds ** Lacerations ** Nail bed injur...") Tag: Visual edit
22:4522:45, 28 February 2026 Bony injuries (hist | edit) [550 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Traction splint for femur: * Analgaesia * Measure on the unaffected leg ** Cushioned ring under buttocks, and distal end 15cm beyond the ankle * Align the femur by manually applying traction through the ankle, then slide the splint underneath ** Reassess neurovascular status after applying traction * Apply straps, including ankle hitch attached to traction hook * Apply traction in increments until the extremity appears stable or until pain and muscle spasm are relieved...") Tag: Visual edit
22:4522:45, 28 February 2026 Pelvic trauma (hist | edit) [5,694 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Approach: == * Most pelvic fractures are benign and not life-threatening ** 60% don't need intervention ** 40% need pelvic ORIF ** 5% need angiography * Key is to discern the vulnerable patients with high-energy patterns early == Mechanism == * Most common injury is fall from standing height (generally elderly patients with osteoporotic bone). Direct impact through GT or iliac crest, placing a lateral compression force across the pelvis, which typically generates a...") Tag: Visual edit

28 February 2026