Items tagged “surgery”

Raccoon eyes sign (or panda eyes in the UK and Ireland) refers to periorbital ecchymosis with sparing of the tarsal plate 3 and is a physical examination finding indicative of a base of skull fracture of the anterior cranial fossa. However it is not pathognomonic for trauma, and there are sever...

Transsphenoidal hypophysectomy is a commonly used surgical approach for pituitary region masses, with many significant advantages over open craniotomy.  History The transsphenoidal approach was first described in 1907 by Schloffer, modified by Halstead and subsequently popularized by Harvey Cu...

Retroperitoneal hemorrhage can be a source of significant yet occult blood loss. Terminology Some articles conflate and/or confuse retroperitoneal hemorrhage and Wunderlich syndrome 5. However Wunderlich syndrome refers primarily to bleeding around the kidney, not the retroperitoneum in genera...

Abdominal aortic aneurysm (AAA) rupture is a feared complication of abdominal aortic aneurysm and is a surgical emergency. It is part of the acute aortic syndrome spectrum. Epidemiology Abdominal aortic aneurysms are common and affect ~7.5% of patients aged over 65 years 6. The risk of ruptur...

The Appleby procedure is a type of pancreatic cancer resection.  For some patients with pancreatic cancer involving the body and tail of the pancreas, involvement of the celiac axis is a classic contraindication to pancreaticoduodenectomy (Whipple procedure).  With the Appleby procedure, there...

The Senning repair is one of two "atrial switch" procedures used to functionally correct transposition of the great arteries (the other being the Mustard repair).  The two repairs share a similar fundamental principle. Systemic blood flow is redirected away from the right ventricle and toward t...

The Glenn shunt, also known as Glenn procedure, is a palliative surgical procedure for a variety of cyanotic congenital heart diseases. Rationale In this procedure, the systemic venous return is re-directed to the pulmonary circulation, bypassing the right heart 1-3. It can be used in a varie...

The Rastelli procedure is a surgical procedure to correct certain combinations of cardiovascular defects in patients with cyanotic congenital heart disease. Rationale The operation is based on a redirection of ventricular outflows using an intracardiac baffle that tunnels the left ventricle to...

Total repair of tetralogy of Fallot is a corrective surgical procedure that involves closure of the ventricular septal defect (VSD) and relief of right ventricular outflow tract (RVOT) obstruction. Procedure Most patients with tetralogy of Fallot (TOF) undergo elective surgical repair between ...

A unifocalisation procedure is a corrective surgical technique used in patients with complete pulmonary artery atresia with major aortopulmonary collateral arteries (MAPCAs). In this technique, the collateral vessels supplying blood from the aorta directly to the lungs are brought into continuit...

Abdominal compartment syndrome is a disease defined by the presence of new end-organ dysfunction secondary to elevated intra-abdominal pressure. Radiological diagnosis is difficult and usually suggested when a collection of imaging findings are present in the appropriate clinical setting or if t...

Hysterectomy (plural: hysterectomies), the surgical resection of the uterus, is the most commonly performed gynecological procedure in the USA 3. It is usually performed electively. Epidemiology Approximately 600,000 hysterectomies are performed in the United States annually. After Cesarean se...

Fecal impaction is the inability to spontaneously evacuate solid feces. It is common in the elderly population. A severe form of fecal impaction is often referred to as a fecaloma.  Terminology Fecal loading is a poorly defined term but generally refers to the volume of fecal material in the c...

Tapia syndrome , also called matador's disease, is a rare syndrome that is characterized by unilateral paralysis of the tongue and vocal cords. Although the problem typically occurs after anesthetic airway management or manipulation, it can be due to central causes in rare cases 11.  The syndrom...