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,…
Introduction Surgery is the field of medicine that uses operative or instrumental techniques to treat or investigate pathologic conditions. Most surgical procedures are invasive in nature in that they involve physically cutting into a patient to repair or remove tissues…
Introduction The importance of trauma Injuries kill 5 million people each year, and trauma is responsible for nearly 1 in 10 deaths worldwide. It is also the leading cause of death between 15 and 29 years of age. For survivors…
The biology of cancer A neoplasm or new growth consists of a mass of transformed cells that does not respond in a normal way to growth regulatory systems. These cells serve no useful function and proliferate in an atypical and…
Preoperative considerations Careful preoperative assessment is fundamental to achieve good surgical outcomes, both in emergency and elective settings. However, the amount of time available for full assessment and investigation may be compromised when an emergency condition requires urgent intervention. Assessment…