Important points to remember when reporting a post operative abdomen
Fig. Different type of post op leaks.
1. Note the surgery type
2. Note which day post op it is!
3. You should know the operative surgeon's name and be in communication
4. Plan the scan in advance based on the surgery type, symptoms-signs and definite indication.
5. Oral contrast - either not given or usually it is positive type. Positive contrast to be given for leaks or in case of prolonged ileus to differentiate from subacute obstruction. Sometimes it is therapeutic also.
6. IV contrast - plan the phases. Angiography can be an important phase to rule out active extravasation in case of drop in hemoglobin.
7. Note for the routine post op changes that are expected
8. Note for any lines, drains and catheters. Look for positions. Any improper position, should be informed to the treating team.
Fig 2. Displaced catheters & retained gauze
9. Note for any free fluid / loculated collections - mention the sizes
10. Inter-loop collections may mimic bowel loops. If required can be assessed after giving positive contrast.
11. Make note of the degree of free air (expected vs unexpected)
12. Look for any retained gauze etc.
To be continued.........
Prepared by Dr. Sharad Maheshwari
27.02.2023
Updated: 08.03.2023
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