Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice (91 page)

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2.
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3.
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8.
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9.
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10.
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11.
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12.
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13.
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14.
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15.
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16.
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18.
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Index

NB: Page numbers followed by
f
indicate figures,
t
indicate tables and
b
indicate boxes.

A

Abdomen
See
Acute abdomen
Abdominal compartment syndrome (ACS),
237–240
,
238t
,
241f
,
242f
,
338–339
,
339b
abdominal perfusion pressure (APP),
240
definitions,
238
,
339b
IAP measurement,
239–240
pitfalls,
239–240
pathophysiology,
238
raised IAP, management,
240
,
241f
,
242f
general support,
240
reversible factors,
240
raised IAP, organ function,
238–239
cardiac function,
239
intracranial contents,
239
renal function,
238–239
respiratory function,
239
visceral perfusion,
239
raised IAP, surgery,
240
Abdominal hernias,
57–80
abdominal wall,
163
,
163f
aetiology,
57–58
antibiotic prophylaxis,
76–77
emergency surgery,
76
epigastric
See
Epigastric hernias
femoral
See
Femoral hernias
incisional
See
Incisional hernias
inguinal
See
Inguinal hernias
mesh repairs,
58–60
,
59f
infection, management,
77–78
post-site,
76
prophylactic surgery,
77
umbilical
See
Umbilical hernias
Abdominal pain, gastric band,
352–353
Abdominal perfusion pressure (APP),
240
,
339b
Abdominal sepsis,
328–343
chronic,
341
clinical manifestations,
331
,
331b
diagnosis,
331
,
332b
imaging,
332
incidence,
328
intestinal fistulas,
339–341
,
340b
pathophysiology,
328–329
,
329b
recognition,
329–330
systematic assessment,
330–331
,
331f
,
335
treatment strategies,
330
antibiotics,
332
damage control laparotomy (DCL),
336–337
early source control,
333
,
333b
intensive care unit (ICU),
334–335
,
334b
laparostomy,
337–338
,
338f
management bundle,
330
re-laparotomy,
337
re-operation,
335–336
,
336f
resuscitation bundle,
330
Surviving Sepsis Campaign,
330
,
330b
See also
Abdominal compartment syndrome (ACS)
Abdominal trauma,
229–267
assessment, emergency department,
230–231
diagnostic modalities,
231–233
,
231t
computed tomography (CT),
231–232
laparoscopy,
232
laparotomy,
232–233
peritoneal lavage (DPL),
232
radiography,
231
ultrasound,
232
interventional radiology,
249–251
management,
243–249
aorta/inferior vena cava,
246
colonic injury,
246–247
,
247b
extraperitoneal packing technique,
247–248
hepatic injury,
243–245
,
245f
pancreatic injury,
245–246
,
246b
pelvic fracture, complex,
247–248
,
248b
selective non-operative (SNOM),
248–249
operative management,
233–237
antibiotic prophylaxis,
243
,
243b
,
244b
,
245b
damage control laparotomy,
235–237
decision-making,
243
laparotomy,
233–235
,
233f
patient selection,
236
organ injury scaling systems,
240
,
254–267
penetrating injury,
249
,
250b
regional systems,
230
risk factors,
229
transport,
229–230
Abdominal vascular injury scale,
261t
Abdominal wall
neonatal defects,
223–224
reconstruction,
237
Aberdeen Varicose Vein Questionnaire,
25
Abscess
appendix,
173
,
173f
pelvic,
175
perianal
See
Perianal abscess
pilonidal,
209
,
209t
Academic units,
4–5
Acid suppression, peptic ulcers,
125
Acute abdomen
associated conditions,
84–85
,
84b
blood tests,
86
early assessment,
83–86
history/examination,
85–86
radiological investigations,
87–95
computed tomography (CT),
92–93
,
92f
,
93f
,
94f
contrast radiology,
87–91
laparoscopy,
94–95
,
94f
magnetic resonance imaging (MRI),
94
plain radiology,
87
,
87f
,
88f
ultrasound (US),
91
,
91f
,
92f
Acute acalculous cholecystitis (ACC),
139–140
Acute anal fissure,
209–210
Acute appendicitis,
167–176
atypical presentation,
172–174
appendix abscess,
173
,
173f
appendix mass,
172–173
chronic appendicitis,
173–174
,
174f
pregnancy,
174
clinical features,
168–169
complications/outcome,
174–176
hospital stay,
174–175
septic,
175
wound infection,
175
differential diagnosis,
169–170
investigations,
169
,
169f
management,
170–172
surgical,
170–172
non-surgical,
172
pathology,
168
prognosis,
175–176
Acute cholangitis,
140–142
investigations,
141
management,
141–142
pathogenesis,
140
presentation,
140–141
Acute cholecystitis,
132–139
acute gallstone disease,
139
clinical presentation,
132–133
gallbladder torsion,
139
gallbladder/bile duct stones,
134–135
,
134f
,
135f
,
136f
pathogenesis,
132
radiological imaging,
133–134
,
133f
treatment,
136–139
,
137f
,
138f
Acute colonic diverticulitis,
91
,
191–193
investigations,
191–192
,
191f
management,
192–193
operative,
192–193
presentation,
191
,
191t
Acute colonic pseudo-obstruction (ACPO),
185–187
,
185b
aetiology,
185
investigations,
186
,
186f
management,
186–187
presentation,
185–186
Acute fluid collection, defined,
142b
Acute gallbladder disease,
134–135
,
134f
,
135f
,
136f
Acute gallstone disease,
139
Acute pancreatitis,
142–151
aetiology,
142
,
143b
,
144
,
144f
classification,
142b
clinical presentation,
143
,
143f
diagnosis,
143–144
,
143b
,
144f
gallstones,
150–151
management,
145
general guidelines,
145
imaging,
145
initial resuscitation,
145
severity stratification,
145
pathogenesis,
142–143
prognosis,
150
sequelae, management,
151
haemorrhage,
151
infected necrosis,
151
therapies,
145–150
antibiotics,
146–148
anticytokine,
150
enteral nutrition,
148–150
ERCP,
146
probiotic,
150
Acute pseudocysts, defined,
142b
Acute respiratory distress syndrome (ARDS),
324
ADEPT® (icodextrin),
162
Adrenal organ injury scale,
262t
Adrenaline,
49
Adult hernias
inguinal,
66–70
umbilical,
63
Advanced Trauma Life Support Programme (ATLS®), American College of Surgeons,
231
Age factors
day surgery,
44–45
venous thromboembolism (VTE),
271
Agency for Health Care Policy and Research,
14
,
14t
Air Medical Taskforce (NAEMSP),
229–230
Albumin,
312–313
Aldosterone,
309b
Alfentanil,
48
Alvarado Score, appendicitis,
225
American Association for the Surgery of Trauma (AAST),
240
,
249
American College of Surgeons,
1
Advanced Trauma Life Support Programme (ATLS®),
231
Committee on Trauma,
230
National Surgical Quality Improvement Program Database,
81
,
291
,
291t
American Society of Anesthesiologists (ASA),
44
,
101
patient classification,
45–46
,
45b
,
46t
,
52
,
53
,
290
,
290b
American Society of Colon and Rectal Surgeons,
210
American Society for Parenteral and Enteral Nutrition (ASPEN),
317
Amethocaine (tetracaine),
49
,
49t
Amikacin,
147
Amino acids,
308
,
310
,
318
branched-chain,
322
Amphotericin,
147
Anaerobic threshold (AT),
293–294
Anaesthesia, day case,
48–50
general,
49–50
local/regional,
49
,
49t
premedication,
48
sedation,
48
Anal fissure, acute,
209–210
Anastomotic dehiscence,
195–197
causes,
195
investigations,
196
management,
196–197
presentation,
195–196
Angio-embolisation
blunt splenic injury,
250
liver injury,
249–250
pelvic fracture, complex,
250–251
Angiography,
198–199
computed tomography pulmonary (CTPA),
277
magnetic resonance (MRA),
276
Anorectal emergencies,
204–214
acute anal fissure,
209–210
anatomy,
204
foreign bodies,
211–212
haemorrhage,
211
haemorrhoids,
210
thrombosed,
210–211
,
211t
perianal
See
Perianal abscess
pilonidal abscess,
209
,
209t
trauma,
211
Anorectal malformations,
219–220
Anthropometric measures,
312
Antibiotics,
141
,
146–148
,
192
abdominal conditions,
76–77
,
332
abdominal trauma,
243
,
243b
,
244b
,
245b
acute cholecystitis,
136–137
,
138
Anticoagulation
duration,
280–281
new oral,
274
venous thromboembolism (VTE),
278–280
Anticytokine therapy,
150
Antidiuretic hormone,
309b
Antiphospholipid syndrome (APLS),
270

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