Indications Gastric decompression Gavage (feeding) Gastric lavage (irrigation or dilution of gastric contents) Sampling of the gastric contents for analysis Sometimes used to instil air into the stomach to detect a gastric perforation on erect CXR Contraindications Basilar skull fractures (Risk of NG reaching brain) Facial fractures (risk of cribiform…
Tag: General Surgery
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Aspirin and Clopidegrol : Perioperative Guidelines
The average lifespan of platelets is 7 to 10 days. Aspirin and Clopidegrol inhibits platelets for around 21 days. Hence, when these agents are stopped 7 days before the surgery, it allows 33% regeneration of platelets. Stents and coronary lesions act as unstable plaque until they are completely covered by…
Case Reports 
Acute Pancreatitis – Case Discussion
Cases of Acute Pancreatitis Case 1 32 years old male came to emergency department with complaint of: Upper abdominal pain X 3 days Vomiting X 2 episode (3 days back) Yellowish discoloration of urine and decreased urine output X 2 days Vitals: Pulse rate BP RR TPR SpO2 Triage Level…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Simplified Approach to Parotid Enlargement
Diagnosis and management of a case of parotid enlargement requires systematic approach. Here, I have tried to present a simplified approach to parotid enlargement. A) DIFFERENTIAL DIAGNOSES OF PAROTID ENLARGEMENT: 1. Infectious: Child: Mumps, Coxsackie Adult: S.aureus 2. Non-infectious benign: Epithelial: Pleomorphic adenoma, Warthin tumor, Oncocytoma, Monomorphic adenoma Non-epithelial: Lymph…
Emergency Medicine 
The Continuum: SIRS, Severe Sepsis and Septic Shock
SIRS criteria are mostly used as a screening tool to identify patients that may need further workup for sepsis and severe sepsis. In the emergency department it is a triage tool that helps determine patient acuity and identify patients that are potentially septic and in need of further screening. Septic…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Strawberry Gallbladder (Cholesterolosis)
Synonyms: Strawberry gallbladder is also known as hyperplastic cholecystoses. Hyperplastic cholecystoses are a spectrum of non-neoplastic proliferative disorders caused by deposition of cholesterol-laden macrophages within the wall of the gall bladder. The cholecystose range from abnormalities of the gallbladder wall (adenomyomatosis and strawberry gall bladder) to gallbladder polyps extending into…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Courvoisier’s law of Obstructive Jaundice
Synonyms: Courvoisier’s sign, Courvoisier syndrome, Courvoisier-Terrier sign, Bard-Pic disease Over years, the use of the term Courvoisier’s sign or gallbladder has been suggested instead of law, because of rising number of exceptions. Eponymous to: Ludwig Courvoisier (1843-1918) Definition of Courvoisier’s law Courvoisier’s (koor-vwah-zee-ayz) law states that ‘a palpable non-tender gallbladder…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Summary of Clinical Tests and Signs in Orthopedics
Adson’s test: for thoracic outlet syndrome Allen’s test: for testing patency of radial and ulnar arteries Alli’s test: for DDH Anvil test: for testing tenderness of the spine Ape thumb: for median nerve injury Apley’s grinding test: for meniscus injury Apprehension test: for recurrent dislocation of the shoulder Barlow’s test:…