Items tagged “general surgery”
306 results found
Caecal volvulus describes torsion of the caecum around its mesentery which often results in obstruction. If unrecognised, it can result in bowel perforation and faecal peritonitis. Epidemiology Caecal volvulus accounts for ~10% of all intestinal volvuluses, and generally occur in somewhat youn...
Colorectal carcinoma (CRC) is the most common cancer of the gastrointestinal tract and the second most frequently diagnosed malignancy in adults. CT and MRI are the modalities most frequently used for staging. Surgical resection may be curative although five-year survival rate is 40-50%. Epidem...
Epiploic appendagitis is a rare self limiting inflammatory/ischaemic process involving an appendix epiploica of the colon and may either be primary or secondary to adjacent pathology. This article pertains to primary (spontaneous) epiploic appendagitis. The term along with omental infarction is ...
Fournier gangrene is a necrotising fasciitis of the perineum. It is a true urological emergency due to the high mortality rate but fortunately, the condition is rare. Epidemiology Fournier gangrene is typically seen in diabetic men aged 50-70 but rarely in women. Other than age, predisposing f...
Hiatus hernias (HH) occur when there is herniation of abdominal contents through the oesophageal hiatus of the diaphragm into the thoracic cavity. Epidemiology The prevalence of hiatus hernia increases with age, with a slight female predilection. Clinical presentation Many patients with hiat...
Hinchey classification of acute diverticulitis
E J Hinchey et al. 3 proposed a classification for acute diverticulitis, that has been variously adapted, and is useful not only in academia but also in outlining successive stages of severity. Classification stage 1a: phlegmon stage 1b: diverticulitis with pericolic or mesenteric abscess st...
Intussusception occurs when one segment of bowel is pulled into itself or a neighbouring loop of bowel by peristalsis. It is an important cause of an acute abdomen in children and merits timely ultrasound examination and reduction to preclude significant sequelae including bowel necrosis. Intu...
Ischaemic colitis refers to inflammation of the colon secondary to vascular insufficiency and ischaemia. It is sometimes considered under the same spectrum as intestinal ischaemia. The severity and consequences of the disease are highly variable. Epidemiology Ischaemic bowel is typically a dis...
Multiple endocrine neoplasia type I
Multiple endocrine neoplasia type I (MEN1) is also known as Wermer syndrome. Clinical presentation Primary hyperparathyroidism is one of the commonest presentations. Pathology The abnormality is related to a tumour suppressor gene located in chromosome 11q13. MEN type I is an autosomal domin...
Oesophageal carcinoma is relatively uncommon. It tends to present with increasing dysphagia, initially to solids and progressing to liquids as the tumour increases in size, obstructing the lumen of the oesophagus. Epidemiology Oesophageal cancer is responsible for <1% of all cancers and 4-10% ...
Portal venous gas
Portal venous gas is the accumulation of gas in the portal vein and its branches. It needs to be distinguished from pneumobilia, although this is usually not too problematic, when associated findings are taken into account along with the pattern of gas (i.e. peripheral in portal venous gas, cent...
The thyroid gland is an endocrine organ in the neck which is completely enveloped by pretracheal fascia (middle-layer of the deep cervical fascia) and lies in the visceral space. Gross anatomy The thyroid extends from C5 to T1 and lies anterior to the thyroid and cricoid cartilages of the lar...
Thyroidea ima artery
The thyroidea ima artery is an uncommon variant of the blood supply to the inferior aspect of the thyroid gland. It is reported in ~7.5% (range 1.5-12.2%) of individuals and can arise from: brachiocephalic trunk right common carotid artery aortic arch internal thoracic artery The thyroidea ...
Target sign (intussusception)
The target sign of intestinal intussusception, also known as the doughnut sign or bull's eye sign. The appearance is generated by concentric alternating echogenic and hypoechogenic bands. The echogenic bands are formed by mucosa and muscularis whereas the submucosa is responsible fo the hypoec...
Spigelian hernia, also known as lateral ventral hernia, is a type of abdominal hernia along the semilunar line, resulting in herniation between the muscles of the abdominal wall. Epidemiology They are rare and account for ~1% (range 0.1-2%) of ventral hernias 2-3. The incidence is thought to p...
Small bowel obstruction secondary to caecal tumour
Published 01 May 2009
Direct inguinal hernia
A direct inguinal hernia arises from protrusion of abdominal viscera through a weakness of the posterior wall of the inguinal canal medial to the inferior epigastric vessels, specifically through the Hesselbach's triangle. This type of hernia is termed direct as the hernial sac directly protrud...
Large bowel obstruction
Large bowel obstruction (LBO) are often impressive on imaging, on account of the ability of the large bowel to massively distend. This condition requires prompt diagnosis and treatment. Epidemiology Large bowel obstructions are far less common than small bowel obstructions, accounting for onl...
Sigmoid volvulus is a cause of large bowel obstruction and occurs when the sigmoid colon twists on its mesentery, the sigmoid mesocolon. Epidemiology Large bowel volvulus accounts for ~5% of all large bowel obstructions, with ~60% of intestinal volvulus involving the sigmoid colon 6. It is mor...
Richter hernias are an abdominal hernia where only a portion of the bowel wall is herniated and comprise 10% of strangulated hernias. These hernias progress more rapidly to gangrene than other strangulated hernias but obstruction is less frequent. Pathology In contrast to most other types of ...