DIAGNOSTIC INVESTIGATIONS surgery practice .pptx

main diagnostic investigations in surgery

1. REVIEW OF DIAGNOSTIC INVESTIGATIONS Dr JAGDISH MUTREJA AP SURGERY

2. Preoperative evaluation Risk of planned procedure (low, medium, high) Planned anaesthetic technique Postop disposition of pt ( outpt , inpt,ward,icu ) Identify pt risk factors for postop morbidity & mortality

3. ROUTINE INVESTIGATIONS CBC With ESR- Hb , TLC, DLC, ESR URINE – routine & microscopic Blood sugar R. fasting & PP in diabetic pt Kidney function tests – Blood urea, serum creatinine , serum electrolytes

4. Renal system Preop s.cr level Diagnostic tests include ECG, serum biochemistry , CBC Mx of hyponatremia & hyperkalemia NSAIDS avoided

5. Routine …… Liver function tests – s. billirubin SGOT/SGPT S. alk phosphatase S. albumin PTI INR

6. Routine ….. Viral markers – HIV 1 &2 HBsAg HCV TEST ECG ECHO CHEST X-RAY

7. Preoperative diabetic mx Blood sugar fasting & PP HBA1c Serum electrolytes BUN S. cr Urinanalysis ECG

8. Special invest. In a C/O swelling USG test – cystic or solid ASPIRATION of cyst- gram stain. C/S FNAC- with 22 – 26 G CT Biopsy – wedge Bx incisional Bx Excision Bx

9. Varicose veins Colour doppler or duplex scan – venous Various clinical tests

10. ULCER If discharge – C/S Xray of underlying bone & joint Biopsy – wedge Chest Xray

11. DYSPHAGIA BA SWALLOW UGIE – for biopsy & diagnosis CT chest

12. THYROID SWELLING TFT – T3, T4, TSH THYROID SCAN USG NECK FNAC NECK swelling CT chest

13. BREAST LUMP USG lump FNAC Mammogram B/L Imprint cytology Bx - excision For mets – Chest XRAY, bone scan , USG abd

14. ABDOMINAL CASE USG abd X ray Abd – supine & erect film CECT Abd USG or CT guided FNAC

15. Abdominal case…. BMFT BA ENEMA Colonoscopy Laparoscopy Exp . Laparotomy

16. Hepato billiary LFT - USG abd CECT ABD ERCP – endoscopic retrograde cholangoipancreatography MRCP PTC

17. Urinary case CBC URINE routine & microscopic URINE – culture & sensitivity KFT USG – KUB Xray – KUB region IVP – Na Diatrizoate CT or MR urography

18. Urinary case ….. RGU MCU Cystoscopy Urine cytology for malignant cells DTPA scan or renal isotope scan

19. HEAD TRAUMA NCCT head CT angiography

20. Chest trauma Chest Xray ABG CT chest USG chest – any collection

21. THANKS