Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice

BOOK: Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice
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Core Topics in General and Emergency Surgery
A Companion to Specialist Surgical Practice

Fifth Edition

Simon Paterson-Brown, MBBS MPhil MS FRCS(Ed) FRCS(Engl) FCS(HK)

Honorary Senior Lecturer, Clinical Surgery School of Clinical Sciences, The University of Edinburgh

Consultant General and Upper Gastrointestinal Surgeon, Royal Infirmary of Edinburgh, Edinburgh, UK

Table of Contents

Cover image

Title page

Copyright

Contributors

Series Editors' preface

Editor's preface

Evidence-based practice in surgery

Chapter 1: Evidence-based practice in surgery

Introduction

The need for evidence-based medicine

The process of evidence-based medicine

Sources of evidence

Critical appraisal

Systematic literature reviews

Meta-analysis

Clinical guidelines

Integrated care pathways (ICPs)

Grading the evidence

Implementation of evidence-based medicine

Audit

Appendix

Chapter 2: Outcomes and health economic issues in surgery

Introduction

Outcome measures

Costs, charges and resource use

Economic evaluation

Summary

Chapter 3: Day case surgery

Introduction

The development of day surgery

How does it work for the patient?

How do we do it?

What will happen next?

Chapter 4: Abdominal hernias

Introduction

Aetiology

Mesh

Epigastric hernia

Umbilical and para-umbilical hernias

Inguinal hernias

Femoral hernia

Incisional hernia

Emergency hernia surgery

Port-site hernia

Antibiotic prophylaxis in hernia surgery

Prophylatic hernia surgery

Management of an infected mesh

Chapter 5: Organisation of emergency general surgical services and the early assessment and investigation of the acute abdomen

Introduction

Organisation of emergency general surgical services

Early assessment of the acute abdomen

Radiological investigations

Chapter 6: Perforations of the upper gastrointestinal tract

Introduction

Peptic ulcer perforation

Oesophageal perforation

Corrosive perforation

Perforation after endotherapy for mucosal/submucosal tumours

Duodenal and jejunal perforations during endoscopic retrograde cholangiopancreatography (ERCP)

Chapter 7: Acute non-variceal upper gastrointestinal bleeding

Introduction

Aetiology

Initial assessment and triage

Initial management

Endoscopy

Management of bleeding due to causes other than peptic ulceration

Endoscopic management of bleeding peptic ulcers

Pharmacological management of bleeding peptic ulcers

Surgical management of bleeding peptic ulcers

Management of recurrent bleeding

Helicobacter pylori eradication

Use of NSAIDs

Summary

Chapter 8: Pancreaticobiliary emergencies

Introduction

Biliary colic and acute cholecystitis

Acute acalculous cholecystitis

Acute cholangitis

Acute pancreatitis

Iatrogenic pancreaticobiliary emergencies

Chapter 9: Acute conditions of the small bowel and appendix

Introduction

Small-bowel obstruction

Peritonitis

Haemorrhage

Acute appendicitis

Chapter 10: Colonic emergencies

Introduction

Colonic ischaemia

Colonic obstruction

Inflammation and infection

Perforation

Colonic bleeding

Chapter 11: Anorectal emergencies

Introduction

Anorectal anatomy

Perianal abscess

Pilonidal abscess

Acute anal fissure

Haemorrhoids

Thrombosed haemorrhoids

Anorectal haemorrhage

Anorectal trauma

Foreign bodies

Chapter 12: Paediatric surgical emergencies

Introduction

Neonatal period

Infancy

Children

Chapter 13: Abdominal trauma

Introduction

Risk factors

Transport

Regional trauma systems

Assessment in the emergency department

Diagnostic modalities in blunt abdominal trauma

Operative management of abdominal trauma

Abdominal compartment syndrome

Organ injury scaling systems

Surgical decision-making in abdominal trauma

Management of abdominal injury

Interventional radiology

Appendix: Scaling system for organ-specific injuries

Chapter 14: Venous thromboembolism: prevention, diagnosis and treatment

Introduction

Epidemiology of VTE

Pathophysiology of venous thromboembolism

Risk factors for VTE

Prevention of venous thromboembolic disease

Diagnosis of venous thromboembolic disease

Management of venous thromboembolic disease

Chapter 15: Patient assessment and surgical risk

Introduction

Estimation of surgical risk

Communicating risk

Chapter 16: Perioperative and intensive care management of the surgical patient

Introduction

Variables associated with postoperative complications and death

Strategies to improve outcomes

Conclusions

Chapter 17: Surgical nutrition

Introduction

Metabolic response to feeding, trauma and sepsis

Nutritional requirements

Identification of patients who are malnourished

Nutritional support in surgical practice

Nutritional support in defined clinical situations

Nutritional supplementation with key nutrients: application to clinical practice

Chapter 18: Abdominal sepsis and abdominal compartment syndrome

Introduction

Pathophysiology of sepsis

The slippery slope of sepsis

Treatment strategies in sepsis

Systematic assessment

Antimicrobial therapy in abdominal sepsis

Imaging in abdominal sepsis

Early source control in abdominal sepsis

Aims of treatment in abdominal sepsis

Abdominal sepsis on the ICU

Re-operating in abdominal sepsis

Damage control laparotomy

Second-look or planned re-laparotomy

Leaving the abdomen open (laparostomy)

Abdominal compartment syndrome

Intestinal fistulas

Chapter 19: Complications of bariatric surgery presentingto the general surgeon

Introduction

Causes of obesity

Mechanisms of weight loss surgery

Bariatric operations

Complications of bariatric surgery

Clinical presentation

Other postoperative problems

Index

Copyright

Fifth edition © 2014 Elsevier Limited. All rights reserved.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher's permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website:
www.elsevier.com/permissions
.

This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

First edition 1997

Second edition 2001

Third edition 2005

Fourth edition 2009

Fifth edition 2014

ISBN 978-0-7020-4964-4

e-ISBN 978-0-7020-4972-9

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress

 

Notice

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.

With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

Printed in China

Commissioning Editor:
Laurence Hunter

Development Editor:
Lynn Watt

Project Manager:
Vinod Kumar Iyyappan

Designer/Design Direction:
Miles Hitchen

Illustration Manager:
Jennifer Rose

Illustrator:
Antbits Ltd

BOOK: Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice
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