The spleen is the largest organ of the reticuloendothelial system, responsible for many filtration and host defense mechanisms; however, it is not well understood. It plays a role in many childhood and adulthood hematologic and immunologic disorders and can cause…
I Anatomy A Embryology 1. The pancreas begins as dorsal (from duodenum) and ventral (from hepatic diverticulum) budding from the foregut endoderm at approximately the fifth week of gestation. 2. Both the dorsal and ventral portions of the pancreas possess…
I Overview A Anatomy 1. The appendix develops as a protuberance of the base of the cecum. a. The base is located at the convergence of the teniae coli, and the tip is variably located (e.g., retrocecal, pelvic). b. Blood…
I Anatomy A Rectum 1. The rectum is 12–15 cm in length and extends from the sacral promontory to the levator ani muscles. 2. The teniae coli splay out at the rectosigmoid junction and fuse to form a contiguous smooth…
I Anatomy A General Description 1. The esophagus is an approximately 30-cm-long, muscular tube that begins 15 cm from the incisors at the cricopharyngeus muscle and ends at the gastroesophageal junction (GEJ) along the cardia of the stomach. There are…
I Inflammatory Bowel Disease A Ulcerative Colitis 1. Diffuse inflammatory disease limited to mucosa of colon and rectum 2. Operative therapy is almost always curative; indicated for refractory disease, toxic distension, or dysplasia B Crohn Disease 1. Chronic, relapsing, transmural,…
If anyone should consider removing half of my good stomach to cure a small ulcer in my duodenum, I would run faster than he. Charles H. Mayo (1865–1939 In the era of Helicobacter pylori doing a gastrectomy for peptic ulcer…
I Terminology A Ileus 1. Mechanical or functional obstruction, usually caused by failure of movement of luminal contents secondary to poor motility B Mechanical Obstruction 1. Partial or complete physical blockage of lumen C Simple Obstruction 1. Occlusion at one…
Gastrointestinal (GI) bleeding can be characterized and managed by its location. Upper GI bleeding is defined as bleeding originating proximal to the ligament of Treitz, whereas lower GI bleeding occurs distal to the ligament of Treitz. I History History and…
I Historical Perspective Numerous surgeons and anatomists have participated in the development of the modern-day herniorrhaphy. Several warrant particular interest because of their major contributions to early hernia surgery. A Henry Marcy (1837–1924) 1. Boston surgeon who described anterior approach…