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…
The acute abdomen is defined as undiagnosed pain that develops suddenly and is less than 7 days in duration. I Physiology of Abdominal Pain A Visceral Pain Visceral or intestinal contraction, spasm, stretching, distention, or chemical irritation results in visceral…
Care of the neurotrauma patient involves evaluation of injuries to the cranium, spine, peripheral nerves, or often a combination thereof. Rapid evaluation and decisive intervention are essential to significantly reduce the risk of morbidity and mortality. After stabilizing the airway,…
Each year, approximately 1 million people in the United States sustain burn injuries. Sadly, more than 90% of these injuries are preventable, many of which are related to smoking and substance abuse. Fortunately due to advances in burn care, as…
Investigation for extremity injuries is a critical portion of the trauma evaluation. During these examinations, the surgeon must look for fractures, dislocations, soft tissue damage, vascular injuries, and neurologic deficits. Upon completion of the tertiary survey, the patient should have…
I Pathophysiology 1. Significant blunt force, deceleration, and penetrating wounds should be considered to have intraperitoneal injuries until ruled out by further diagnostic evaluation. 2. The abdominal cavity can hold a significant amount of blood without obvious signs, so a…