Lesson 1Follow-up planning, reassessment for definitive elective surgery if indicated, and documentation for outpatient handoverThis section explains planning follow-up after ulcer surgery, rechecking need for planned full procedures, and making clear records and discharge notes for safe outside care continuity.
Scheduling early and long-term surgical follow-upCriteria for considering definitive elective surgeryKey elements of a safe discharge summaryCommunication with primary care and gastroenterologyPatient education for warning signs after dischargeLesson 2Nutrition and mobilization: NPO duration, nasogastric tube indications, timing of enteral feedingThis section addresses after-op nutrition and movement, including no-food time, nose-stomach tube reasons, timing and way of gut feeding, and plans for early walking and better recovery.
Criteria to discontinue nasogastric decompressionAssessing readiness to start oral intakeStepwise advancement of postoperative dietEnteral versus parenteral nutrition decisionsEarly mobilization and physiotherapy protocolsLesson 3Recognition and management of late complications: fistula, adhesive obstruction, recurrent ulcerationThis section reviews late after-op problems after ulcer surgery, including abnormal connections, sticky blockages, and returning ulcers, focusing on spotting, diagnostic checks, and step-by-step medical, scope, or surgery fixes.
Clinical features of postoperative enterocutaneous fistulaEvaluation and imaging of adhesive small bowel obstructionManagement of chronic fistula output and nutritionDiagnosis of recurrent ulceration after surgeryEndoscopic and surgical options for recurrent ulcersLesson 4Analgesia plans including multimodal strategies and opioid-sparing optionsThis section presents multi-way after-op pain plans, stressing area techniques, non-opioid adds, low-opioid regimens, watching side effects, and fitting pain control to boost recovery and movement.
Pain assessment scales and documentationUse of acetaminophen and NSAIDs safelyRegional blocks and epidural analgesia optionsAdjuvant agents such as gabapentinoidsDesigning opioid-sparing analgesia protocolsLesson 5Immediate postoperative monitoring in PACU/ICU: parameters, frequency, and escalation triggersThis section outlines structured watching in recovery and ICU after ulcer surgery, defining vital measures, pain and calm checks, watching frequency, and clear triggers for help, quick response, or higher care move.
Standard PACU monitoring set and documentationHemodynamic and urine output targets after surgeryRespiratory monitoring and pulse oximetry strategyPain, sedation, and delirium assessment toolsEscalation triggers and rapid response activationLesson 6Early postoperative investigations: labs, radiographs, CT indications for suspected leak or abscessThis section explains when and how to use labs, X-rays, and CT after ulcer surgery to spot leaks or pus pockets early, read key signs, and pick right escalation, drain, or re-op strategies.
Baseline and serial postoperative laboratory panelsUse of plain radiographs and contrast swallow studiesCT indications for suspected leak or abscessImaging signs of anastomotic leak and collectionsAlgorithm for escalating from labs to advanced imagingLesson 7Infection prevention and antibiotic stewardship: duration, de-escalation based on culturesThis section reviews infection stop and antibiotic wise use after ulcer surgery, covering around-op prevention time, culture-guided step-down, watching for failure, and ways to limit resistance and gut bugs.
Appropriate duration of surgical prophylaxisEmpiric therapy for suspected intra-abdominal sepsisCulture collection and interpretation principlesAntibiotic de-escalation and stop criteriaMonitoring for C. difficile and resistant organismsLesson 8Thromboprophylaxis, glycemic control, and wound care best practicesThis section details best ways for clot prevention, blood sugar control, and wound care after ulcer surgery, including risk sorting, drug and machine measures, sugar goals, and infection stop strategies.
VTE risk assessment and prophylaxis selectionTiming and dosing of pharmacologic anticoagulationMechanical prophylaxis and mobilization protocolsPerioperative glycemic targets and insulin regimensWound dressing choices and infection preventionLesson 9Recognition and management of early complications: leak, intra-abdominal abscess, sepsis, respiratory complicationsThis section covers spotting and handling early problems like join leaks, belly pus, sepsis, and breathing issues, stressing early signs, diagnostic paths, revival, and timely source fix.
Clinical red flags for anastomotic leakSepsis bundles and hemodynamic resuscitationDiagnosis and drainage of intra-abdominal abscessPrevention and treatment of postoperative pneumoniaCriteria for reoperation versus percutaneous drainageLesson 10Long-term medical management of peptic ulcer disease: H. pylori testing and eradication, PPI therapy, NSAID avoidance, smoking and alcohol counselingThis section focuses on long-term medical handling of peptic ulcer disease, including bug testing and killing, acid blocker plans, painkiller risk cut, and advice on smoking, drink, and sticking to treatment.
Indications and methods for H. pylori testingStandard and rescue H. pylori eradication regimensOptimizing PPI dosing and tapering strategiesManaging NSAID and antiplatelet exposureLifestyle counseling on smoking and alcohol
