Items tagged “general surgery”

Richter hernias, also known as parietal hernias, (alternative plural: herniae) 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 ...

Distal intestinal obstruction syndrome (DIOS), formerly known as meconium ileus equivalent, is one of the many abdominal manifestations of cystic fibrosis. In older children or young adults with cystic fibrosis, the distal small bowel may become obstructed with a mucofaeculent material in the di...

The Puestow procedure or lateral pancreaticojejunostomy is a lateral side-to-side pancreaticojejunostomy that is used for the treatment of chronic pancreatitis. The pancreas is essentially filleted along its long axis from the uncinate process to the tail and connected to a Roux en-Y loop of je...

Obturator hernias (alternative plural: herniae) are characterized by bowel herniating between the obturator and the pectineus muscles. They are a rare type of abdominal hernia and can be a challenge to diagnose clinically. Epidemiology Typically obturator hernias occur in older women 2,3 or pa...

A mnemonic for the common causes of adynamic ileus is: 5 Ps Mnemonic The classic "5 Ps" are: P: postoperative P: peritonitis P: potassium: low (also disturbances of other electrolytes) P: pelvic and spinal fractures P: parturition However, there are a few further Ps that can be included...

Mirizzi syndrome refers to an uncommon phenomenon that results in extrinsic compression of an extrahepatic biliary duct from one or more calculi within the cystic duct or gallbladder. It is a functional hepatic syndrome but can often present with biliary duct dilatation and can mimic other hepat...

Pheochromocytomas are an uncommon tumor of the adrenal gland, with characteristic clinical, and to a lesser degree, imaging features. The tumors are said to follow a 10% rule: ~10% are extra-adrenal ~10% are bilateral ~10% are malignant ~10% are found in children ~10% are not associated wit...

Bile sump syndrome refers to a complication following a side-to-side choledochoduodenostomy.  Epidemiology This complication occurs in ~1% of patients following a side-to-side choledochoduodenostomy.  Clinical presentation Recurrent abdominal pain, cholangitis, pancreatitis, or biliary obstr...

In most instances predicting benign versus malignant histology of a gallbladder polyp based purely on imaging features is not possible. However, a number of features are helpful in helping to decide the management of a gallbladder polyp.  Benign features size polyps that are less than 5 mm in...

A number of pancreatic injury grading systems have been proposed for pancreatic trauma. Classifications American Association for the Surgery of Trauma (AAST) 5,7 The proximal pancreas is defined as the gland to the right of the superior mesenteric vein (SMV)-portal vein axis whereas the dista...

Rectus sheath hematomas, as the term implies, occur when a hematoma forms in the rectus abdominis muscle/rectus sheath. It is most common in its lower segment and is generally self-limiting. Epidemiology Rectus sheath hematomas are more common in women with a 3:1 F:M ratio. Clinical presentat...

Despite its small size, the adrenal gland is affected by a relatively large number of neoplastic entities: adrenal adenoma adrenal myelolipoma adrenal cortical carcinoma adrenal pheochromocytoma adrenal neuroblastoma adrenal sarcoma adrenal metastases See also adrenal lesions: for a mor...

Acute cholecystitis refers to the acute inflammation of the gallbladder. It is the primary complication of cholelithiasis and the most common cause of acute pain in the right upper quadrant (RUQ). Epidemiology Acute cholecystitis is a common cause of hospital admission and is responsible for a...

Diaphragmatic rupture often results from blunt abdominal trauma. The mechanism of injury is typically a motor-vehicle collision. Epidemiology Given that the most common mechanism is motor vehicle collisions, it is perhaps unsurprising that young men are most frequently affected. The estimated ...

Inguinal hernias (herniae also used) is the type of groin herniation (part of the larger group of abdominal wall hernias) that occurs above the inguinal ligament and through the inguinal canal. Epidemiology Inguinal hernias are the commonest type of abdominal wall hernias (up to 80% 3) and are...

The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualize the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). In ge...

Chronic pancreatitis represents the end result of a continuous, prolonged, inflammatory, and fibrosing process that affects the pancreas. This results in irreversible morphologic changes and permanent endocrine and exocrine pancreatic dysfunction. Epidemiology The most common cause of chronic ...

Internal hernias (alternative plural: herniae) are protrusions of the viscera through the peritoneum or mesentery but remaining within the abdominal cavity. Epidemiology Internal hernias have a low incidence of <1% and represent a relatively small proportion, up to 5.8%, of presentations with ...

Retained gallstones, also called dropped or slipped gallstones, are common during a laparoscopic cholecystectomy, with a reported incidence of 0.1–20%, and occur when gallstones are inadvertently spilled into the peritoneal cavity. Clinical presentation Many cases of dropped gallstones will be...

Esophageal food impaction (or steakhouse syndrome) refers to a food bolus acutely obstructing the esophagus. Clinical presentation The main symptom is usually acute dysphagia. Radiographic features Plain radiograph Depending on the composition of the ingested content, the bolus may be visib...