Items tagged “general surgery”

Cecal volvulus describes torsion of the cecum around its mesentery which often results in obstruction. If unrecognised, it can result in bowel perforation and fecal peritonitis. Epidemiology Cecal volvulus accounts for ~10% of all intestinal volvuluses, and generally occur in somewhat younger ...

Colorectal cancer 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%.  Epidemiology ...

Epiploic appendagitis is a rare self-limiting ischemic/inflammatory process that affects the appendices epiploicae 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 infarct...

Hiatus hernias (alternative plural: herniae) occur when there is herniation of abdominal contents through the esophageal hiatus of the diaphragm into the thoracic cavity. Epidemiology The prevalence of hiatus hernia increases with age, with a slight female predilection. Clinical presentation ...

The Hinchey classification for acute diverticulitis (anywhere along the bowel, not just the colon) has been variously adapted and modified since its original description, and is useful not only in academia but also in outlining successive stages of severity 3,5,6.  Adoption and utility of the va...

Incisional hernias (alternative plural: herniae) are relatively common and along with parastomal hernias, umbilical hernias, paraumbilical hernias, and Spigelian hernias, they are usually anterior abdominal hernias. Epidemiology Incisional hernias usually develop within a few months of surgery...

Intussusception occurs when one segment of the bowel is pulled into itself or a neighboring loop of the 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...

Ischemic colitis refers to inflammation of the colon secondary to vascular insufficiency and ischemia. It is sometimes considered under the same spectrum as intestinal ischemia. The severity and consequences of the disease are highly variable. Epidemiology Ischemic bowel is typically a disease...

Multiple endocrine neoplasia type 1 (MEN1), also known as Wermer syndrome, is an autosomal dominant genetic disease that results in proliferative lesions in multiple endocrine organs, particularly the pituitary gland, pancreas, and parathyroid glands.  There are other multiple endocrine neoplas...

Esophageal carcinoma is relatively uncommon. It tends to present with increasing dysphagia, initially to solids and progressing to liquids as the tumor increases in size, obstructing the lumen of the esophagus. Epidemiology Esophageal cancer is responsible for <1% of all cancers and 4-10% of a...

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, centr...

The thyroid gland is a single midline endocrine organ in the anterior neck responsible for thyroid hormone production which lies in the visceral space completely enveloped by pretracheal fascia (middle layer of the deep cervical fascia). Gross anatomy The thyroid extends from C5 to T1 and lies...

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 (most common: 1.9-6.0%) right common carotid artery aortic arch internal thoraci...

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 hypoechoic bands. The echogenic bands are formed by mucosa and muscularis whereas the submucosa is responsible fo the hypoechoi...

Spigelian hernias (alternative plural: herniae), also known as lateral ventral hernias, are 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...

A direct inguinal hernia (alternative plural: herniae) is a type of groin herniation, that 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 Hesselbach's triangle. This type ...

Large bowel obstruction (LBO) is 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 only...

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, 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 ...