Essential Surgery: Problems, Diagnosis and Management

Thoracic Surgery

Introduction Thoracic surgery traditionally covers the diagnosis and management of all noncardiac disease within the chest. However, the practice varies between countries. For example, in the United Kingdom, unlike North America, most oesophageal disease is now managed by gastroenterologists and…

Anal and Perianal Disorders

Introduction Anal and perianal disorders make up about 20% of general surgical outpatient referrals. These conditions can be distressing or embarrassing and patients often tolerate symptoms for a long time before seeking medical advice. The common anal symptoms are summarised…

Disorders of Large Bowel Motility, Structure and Perfusion

Introduction Irritable bowel syndrome (IBS), chronic constipation and diverticular disease all arise from disordered peristaltic function and are at least partly attributable to the highly refined Western diet. These disorders could be regarded as endemic in developed societies. IBS causes…

Chronic Inflammatory Disorders of the Bowel

Introduction Substantial inflammation in any part of the small or large bowel usually presents with diarrhoea (i.e., frequent passage of loose stools). When inflammation affects the large bowel, the diarrhoea often contains blood. Chronic diarrhoea is defined as lasting for…

Colorectal Polyps and Carcinoma

Introduction Carcinoma of the colon and rectum is the third most common malignancy in both men and women in Western countries. In the United Kingdom, the lifetime risk of colorectal cancer is 5%, although the condition is less common in…

Appendicitis

Introduction Acute appendicitis is the most common cause of intraabdominal infection in developed countries and appendicectomy, the most common emergency operation. In the United Kingdom, 1.9 females per 1000 have the operation each year compared with 1.5 males, and about…

Pancreatitis

Introduction Pancreatitis is a common inflammatory disorder of the pancreas characterised by abdominal pain. Most cases present in an acute form known as acute pancreatitis and attacks range between mild to severe. Severe attacks can be life threatening, with a…

Tumours of the Pancreas and Hepatobiliary System; the Spleen

Introduction More than 90% of pancreatic cancers are adenocarcinomas derived from exocrine ductal cells. These have the worst survival of all gastrointestinal (GI) malignancies, with only about 12% surviving 1 year and 2% surviving 5 years. Much less commonly, neoplasia…

Tumours of the Stomach and Small Intestine

Introduction Most gastric tumours are malignant: nearly all are adenocarcinomas; the rest are lymphomas or rarely, carcinoid tumours or sarcoma. True adenomatous gastric polyps are rare; most gastric polypoid lesions are small benign hyperplastic nodules. Tumours of small bowel are…

Disorders of the Oesophagus

Introduction Benign oesophageal diseases form a small but significant part of upper gastrointestinal (GI) surgeons’ workload. Most are managed by medical gastroenterologists except those likely to require surgery; in which case close collaboration is needed between medical and surgical specialists.…