Anatomy and physiology of the breast The breast is a modified sweat gland made up of glandular tissue, fibrous supporting tissue and fat. Its purpose is to produce milk, but it also has a significant role in female sexual and…
Introduction Reconstructive plastic surgery, as opposed to cosmetic surgery, is concerned with the restoration of form and function following trauma, ablative surgery, necrotising infection or congenital anomaly. The various techniques by which this is achieved are applicable throughout the body,…
Introduction Anorectal complaints are extremely common; 2% to 3% of the population has anorectal symptoms at any given time. Pain, bleeding, discharge, itching and the presence of a lump are common presenting symptoms. Symptoms are often ignored, attributed to ‘haemorrhoids’…
Introduction Any individual can reasonably expect to suffer infrequent gastrointestinal (GI) symptoms. Most disorders are self-limiting, benign conditions, but serious pathology can have enigmatic symptoms or none until a late stage in the natural history of the disease. Infective diarrhoea…
The pancreas Surgical anatomy The pancreas is a glandular organ that lies in the retroperitoneum, behind the lesser sac and stomach. The pancreas develops from separate ventral and dorsal buds of endoderm that appear during the fourth week of foetal…
The liver Anatomy The liver is the largest abdominal organ, weighing approximately 1500 g. It extends from the fifth intercostal space to the right costal margin. It is triangular, and its apex reaches the left midclavicular line in the fifth…
Surgical anatomy Oesophagus The oesophagus is a fibromuscular tube that carries food through the neck, thorax and abdomen. It extends between the cricoid cartilage of the trachea (at the level of the sixth cervical vertebra) and the gastric cardia (at…
Introduction ‘The acute abdomen’ includes a spectrum of surgical, medical and gynaecologic conditions, ranging from trivial to life-threatening, which require hospital admission for urgent investigation and treatment. The primary symptom of the condition is abdominal pain. For the purposes of…
Umbilicus The umbilicus is a scar on the abdomen that all placental mammals have that can be flat, protruding or hollowed. Under the skin there is a dense fibrous ring that is easily palpable during examination. The skin around the…
Introduction The 2011 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) reported that, every year in the UK, there are between 20,000 and 25,000 deaths in patients undergoing surgical procedures. Although most of these deaths were in high-risk patients,…