Abernathy's Surgical Secrets

Inguinal Hernia

1 Groin hernia refers to which three hernias? Direct and indirect inguinal hernias and femoral hernias. 2 Francois Poupart, a French surgeon and anatomist (1616–1708), described a ligament that bears his name. What is the anatomic name of the Poupart…

Anorectal Disease

1 What aspect of the initial patient encounter is most important in the diagnosis of anorectal disease? A careful history of anal complaints can point to the correct diagnosis even before completion of a physical exam. It is important to…

Colorectal Carcinoma

1 What are the top three causes of cancer deaths in the United States? Lung, breast or prostate, and colon cancer. 2 List a few of the presenting symptoms of patients with colorectal cancer Intermittent rectal bleeding, vague abdominal pain,…

Colorectal Polyps

1 What are polyps? A gastrointestinal (GI) polyp is an abnormal growth of tissue projecting from the mucosal layer anywhere along the GI tract. Almost half of patients with GI polyps do not complain of bowel symptoms. Bowel habit alteration…

Lower Gastrointestinal Bleeding

1 Describe the initial treatment of a patient who presents with massive lower gastrointestinal (GI) bleeding Assessment of ABCs (airway, breathing, circulation). Vital signs including orthostatics should be assessed to determine the severity of blood loss. Treatment begins with resuscitation.…

Upper Gastrointestinal Bleeding

1 What is upper gastrointestinal bleeding (UGIB)? Bleeding from a gastrointestinal (GI) source proximal to the ligament of Treitz (i.e., from the esophagus, stomach, or duodenum). 2 What is the ligament of Treitz? It is a thin, suspensory muscle that…

Inflammatory Bowel Disease

1 What clinical entities encompass the diagnosis of inflammatory bowel disease (IBD)? Crohn’s disease (CD) and ulcerative colitis (UC). A third entity called indeterminate colitis describes the situation when the clinical or pathologic features do not entirely fit the criteria…

Acute Large Bowel Obstruction

1 What are the mechanical causes of large bowel obstruction (LBO)? The most common mechanical causes are carcinoma (50%), volvulus (15%), adhesions (15%), and diverticular disease (10%). Extrinsic compression from metastatic carcinoma or noncolonic neoplasms is another cause of obstruction.…

Diverticular Disease of the Colon

1 What is a colonic diverticulum? A protrusion of mucosa and submucosa through the muscular layers of the bowel wall. It has no muscular covering. Because these diverticula do not involve all layers of the bowel wall, they are really…

Intestinal Ischemia

1 What is the arterial supply to the gut? The foregut (stomach and duodenum) receives its blood supply from the celiac artery, the midgut (jejunum to the proximal descending colon) from the superior mesenteric artery (SMA), and the hindgut (the…