9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 665
Index
Page numbers in italics refer to hepatic 72–3 figures; those in bold to tables. pelvic 73–4 perianal 360, 390–4, 392 ABCDE resuscitation sequence pericolic 386, 387, 388 601–3 pilonidal 393, 562–5 abdominal aortic aneurysms skin 561–2 492, 507–11 subphrenic 70–2, 358 abdominal examination 6 accessory pleomorphic adenoma abdominal pain 277–8, 278 158 central 303–17 achalasia 266–8 children 591 acids, ingestion 264–5 diverticulitis 387 acinic cell carcinoma 130 intestinal obstruction 308 acquired immune deficiency perforated peptic ulcer 286 syndrome (AIDS) 27–8 postoperative 35 acute limb ischaemia 514–17 abdominal surgery 41 acute renal failure 63–4, 91 antibiotic prophylaxis 103 acute tubular necrosis 63 bowel preparation 107–8 adenocarcinoma intravenous fluids 89 bladder 443 postoperative sepsis 66 gastro-oesophageal junction wound dehiscence 68, 68–9 270, 271 abdominal trauma 632–40 pancreas 342–3 blunt 633–40 stomach 294–5 penetrating 633 adenoid cystic carcinoma 130 abdominal wall defects, adenoma congenital 577–8 adrenal 196 abdominal X-rays (AXR) colonic 373–4 acute colitis 362 liver cell 336–7 intestinal obstruction 309, parathyroid 188, 190, 191–2 372 thyroid 181–2 kidneys, ureter and bladder admissions 2–8 (KUB) 428, 429 adrenalectomy neonates 581, 582, 582 Cushing’s syndrome trauma 636 196–7 abdominoperineal resection of laparoscopic 195–6 rectum 379–80, 383 adrenal glands aberration of normal (breast) adenomas 196 development and carcinoma 196, 197–8 COPYRIGHTEDinvolution (ANDI) 211 insufficiency MATERIAL 24 abscesses tumours 193–8 alveolar (dental) 156–7 adrenaline 49 breast 221–2 adrenocorticotrophic hormone cervical 137, 145, 147, 186 (ACTH) 196
665 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 666
666 Index
Advanced Trauma Life Support glossitis 163 (ATLS) 600, 661 Plummer–Vinson syndrome age 268–9 breast cancer surgery and 231 anaesthesia, previous history 4 breast changes 203–4 anaesthetist 8–9, 11 breast disorders and 205 anal canal 391 AIDS 27–8 anal fissures 369, 397–8 air embolus 94 children 595–6 air enema, reduction of analgesia 98–101 intussusception 591 acute mild pain 101 airway acute moderate pain 100 burns injury 658, 661 acute severe pain 98–100 major trauma 601 burns 661 obstruction 14, 15, 254 chest trauma 623, 624 oropharyngeal 601 chronic pain 101 surgical 254–6 pancreatitis 350 albumin solution 85, 86 patient-controlled (PCA) 99 alcohol consumption 5 pulmonary embolism 56 alcoholism 331, 333, 354 anal sphincterotomy, lateral 398 aldosterone 197 anal sphincters 391 alimentary system see anal surgery, bowel preparation gastrointestinal tract 108 alkalis, ingestion 264–5 anaphylactic shock 48–9 allergies 5, 9 anaplastic thyroid carcinoma 5-α-reductase inhibitors 183 457 anastrozole 237 α-blockers 194, 457 aneurysms α-fetoprotein 338, 484, 485 arterial 507–13 alveolar abscess 156–7 berry 507 amaurosis fugax 519–20 false 507 ameloblastoma 158–9 femoral 406, 513 aminophylline 15 mycotic 507 5-aminosalicylic acid (5-ASA) popliteal 513, 514 362, 363 syphilitic 507 ampulla of Vater carcinomas angina 18, 492, 498 342–3, 344 angioplasty, lower limb 498–9 amputations 504–7 angiosarcoma, hepatic 337 above knee 504–5 ankle brachial pressure index antibiotic prophylaxis 103 (ABPI) 493, 493–4, 498, below knee 505 532, 533 ray 505–6 anorectal malformations toe 506 587–8 transmetatarsal 506 anorexia 3 traumatic, fingertips 650–1 anterior resection (of rectum) amylase, serum 349, 639 378–9, 385 anaemia anterior triangle of neck 127 colorectal cancer 376 lumps 135–42 gastric cancer 295 antibioma 147 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 667
Index 667
antibiotics 102–5 digital subtraction 495 acute infections 104 , 105 hazards 495–6 acute pancreatitis 351 transbrachial/transaxillary prophylactic 9, 15, 19, 102–5, 495 103 transfemoral 494–5 anticoagulants 105–7 arteriovenous fistulae 517–19 deep venous thrombosis As, Bs and Cs, preoperative therapy 54, 105–7 8–10 management of patients on ascites 329, 331 24–5 aspiration pneumonitis 45 prophylactic 9, 53, 105 aspirin 4–5, 25, 358, 496, 521 pulmonary embolism 56 assessment, preoperative 2–8 ulcerative colitis 362 assistant, surgical 11, 29 antiemetics 36, 99 assisting antiestrogens 236–7, 243 at laparoscopic surgery 79 antihistamines 48 at operation 29 antiplatelet agents 4–5, 25, 496, asthma 16–17 521 nocturnal 267 antithyroid agents 176, 177 atelectasis, postoperative 43–4, anuria, postoperative 32, 40–1, 44 60, 62 atherosclerosis 507 anus assessment 492 absent or ectopic 587–8 management 496 see also perianal region risk factor management 498, aorta, thoracic, traumatic 521 rupture 628 risk factors 492 aortic aneurysms 507–13 auricle, cervical 127 abdominal 492, 507–11 AVPU acronym 602 conventional repair 510 axilla endovascular repair 510–11 dissection 233–4 ruptured 508, 511–13 excision of sweat glands aortofemoral bypass 501 575–6 aphthous ulceration 164–5 hyperhidrosis 574, 575 appendicectomy radiotherapy 236 laparoscopic 306, 307 axillary lymph nodes 206, 207 open 304–5, 305 axillary vein thrombosis 52 appendicitis, acute 103, 303–6 axillofemoral/axillobifemoral APUD cells 192, 198 bypass 503 aromatase inhibitors 236–7, 243 axonotmesis 656 arterial blood gases 55, 624 azathioprine 362, 363 arterial surgery 103, 488–525 arteries bacterial overgrowth, small acute occlusion 514–17, 655 bowel 302 aneurysms 507–13 bacteriology 9 thrombosis 514–16 bad news, breaking 117–18, 119 trauma 507, 654–5 balanitis xerotica obliterans 468 arteriography 494–6, 509 balanoposthitis (balanitis) carotid artery 521 467–8 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 668
668 Index
Ballance’s sign 636 preoperative preparation barium enema 361, 369, 376 9–10, 12 barium swallow 141, 259, 267 reactions 47–9 Barrett’s oesophagus 270, 275 trauma 602, 643 basal cell carcinoma (BCC; basal upper GI haemorrhage 291, cell epithelioma) 560–1 334 basal cell papilloma 539 blood vessel injuries 646, 654–5 basilic vein 93 blue naevus 553 Battle’s sign 611–12 blue toe syndrome 508 BCG, intravesical 446 Boerhaave’s syndrome 262–3 bed sores 76–7 boil 565 benign prostatic hyperplasia bone scan, technetium 461 (BPH) 454, 455–9 botulinum toxin injections 267, benzodiazepines 102 398 benzylpenicillin 103, 104 bowel see intestine β-blockers 194, 498 bowel habit 3 bile acid derivatives 320 change in 370, 376 bile duct bowel preparation 107–8 carcinoma Bowen’s disease 559 (cholangiocarcinoma) 337 brain common see common bile contusion 608 duct herniation 609 iatrogenic injury 323 laceration 608 biliary colic 319 brain injury 606–9, 608 biliary surgery, antibiotic primary 607–8 prophylaxis 103 secondary 608–9 biliary tract spasm 100 brain perfusion pressure (BPP) bilirubin metabolism 324 606 biochemistry 9 branchial cyst 137–8, 138 bisoprolol 498 branchial sinus/fistula 135–7 bladder BRCA1/2 genes 237–8 biopsy 449 breaking bad news 117–18, 119 outflow obstruction 455–9 breast 202–47 stones 441–3 abscesses 221–2 traumatic injuries 645 age changes 203–4 bladder tumours 443–8 augmentation 223–4 carcinoma in situ 444, 446 awareness 207 staging 444, 445, 446 benign nodularity (fibrocystic transurethral resection change) 211–13 (TURBT) 446, 447 cancer see breast cancer bleeding see haemorrhage cyclical changes 202, 217 blood cysts 204, 205, 215–16 cross-matched 9–10 developmental disorders loss estimation 291 223–4 preparations 87 dysplasia 211 blood-borne diseases 26–7 examination 206, 207 blood transfusion 87 fat necrosis 221 major burns 663 fibroadenoma 213–15 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 669
Index 669
fibroadenosis 211–13 pathological examination imaging 208 210–11 lobar anatomy 202, 203 triple assessment 204–5 lymphatic drainage 207 wide-bore needle (WBN) male 244–7 biopsy 209–10 ‘mouse’ 214 breathing, major trauma 601–2 normal 202–4 breathlessness, postoperative pain 204, 205, 216–17 32, 37 plastic surgery 223–4 Breslow thickness 554, 555 post-traumatic haematoma bronchodilators 15 221 bronchopneumonia, prosthesis 234–5, 238 postoperative 37, 43–4 reconstruction 238–41 bronchus, ruptured 628–9 reduction 224 bruits screening 209, 225–6 carotid artery 520, 521 self-examination 207 lower limb arteries 489, 490, breast cancer 224–47 492 advanced or recurrent 242–3 Buerger’s test 489 axillary dissection 233–4 burns 657–64 diagnosis 227 assessment 658–60, 659, 659 elderly women 230 fluid replacement 89, 661–3, familial 205–6, 237–8, 247 662 hormone receptors 236–7 major 661–4 late problems 241–3 minor 660 male 246–7 shock 658 management 229–30 burr holes, cranial 619–20 mastectomy see mastectomy bypass graft surgery, arterial metastatic 242 500, 501–4 nipple changes 218, 227 graft thrombosis 514 palliative care 236, 243 plastic surgery 238–41 calcitonin 184 postoperative adjuvant calcium 189 therapy 235–8, 239 calcium gluconate 63, 192, 351 screening 209, 225–6 calcium resonium 63 staging 227–9, 228, 229 candidiasis, tongue 163 surgery 230–5 caput medusae 330, 331 symptomatic 226–30 carbimazole 176, 177 wide local excision (WLE) carbuncle 565 226, 231–2, 235 carcinoembryonic antigen 338 breast care nurse 234 carcinoid syndrome 316 breast-feeding 205, 222 carcinoid tumours 316–17 breast lumps/disorders 204–24, cardiac tamponade 631 227 cardiovascular disease 17–19 benign 211–24 assessment 492 diagnosis 204–11, 212 management 496, 498 FNA cytology 209 risk factor management 498, malignant see breast cancer 521 open surgical biopsy 210, 226 risk factors 492 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 670
670 Index
cardiovascular system Charles’ operation 536 head injury 613 chemotherapy postoperative complications breast cancer 238, 239 46–58 malignant melanoma 558 preoperative assessment 3, 6 pancreatic carcinoma 344 carotid artery disease 519–23 chest carotid body tumour 139–40 closed injuries 628–31 carotid endarterectomy 522–3 examination 6 carpopedal spasm 192 flail 624 catheterization, urinary see pain, postoperative 35 urinary catheterization penetrating injuries 631–2 caustic fluids, ingestion 264–5 physiotherapy 15, 613 cefotaxime 104 surgery 248–56 cefuroxime 103 symptoms 3 cellulitis 70, 534, 535 trauma 601–2, 622–32 central venous (CVP) lines chest drains 248–52, 250 complications 94 insertion 248–51, 249, 626–7 removing 95 management 251–2 setting up 92–3 problems 252 central venous pressure (CVP) suction 251 liver rupture 635 thoracotomy 253 measurement 93, 94, 94–5 trauma 625, 626–7 normal 94 chest infections cerebrospinal fluid (CSF), antibiotic therapy 104 leakage 610, 621 postoperative 16, 358 cervical abscess 137, 145, 147, recurrent 267 186 chest wall cervical auricle 127 burns 663 cervical lymphadenopathy radiotherapy 236 144–9 trauma 622–5 acute inflammatory 145, 147 chest X-rays chronic inflammatory 145, preoperative 7, 10, 14, 17 147 pulmonary embolism 56 malignant neoplasms 145, trauma 623, 628, 629 147–9 children 577–99 cervical lymph nodes 145, 146 intravenous fluids 90, 598–9 biopsy 147 nursing 598–9 dissection 169–70 chiropody 496 tongue carcinoma spread chlamydial infections 464, 166, 167 478–9 cervical rib 142–4 chlorpheniramine 48 cervical spine chlorpromazine 661 injuries 641, 642 cholangiocarcinoma 337 protection 601, 604, 609 cholangitis, acute 319–20, 321 cervical sympathectomy cholecystectomy, laparoscopic open 524–5 321, 321–3, 351 transthoracic endoscopic 574, cholecystitis, acute 319, 320 575 Christmas disease 25–6 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 671
Index 671
chronic leg ischaemia 488–507 collapse, postoperative 32, acute thrombosis 514 38–40, 39 amputations 504–7 colloid solutions 85, 85–7 atherosclerosis 492 colon bypass surgery 500, 501–4 adenomas 373–4 clinical assessment 488–90 polyps 374, 376–7 endarterectomy 499 tumours 373–85 endovascular procedures colonoscopy 376, 377 498–9 colorectal cancer (CRC) 373–85 investigations 493–6 clinical features 375–6 management 496–507 hepatic metastases 338, 377 operative procedures hereditary non-polyposis 499–507 (HNPCC) 374 prosthetic grafts 500, 501, investigations 376 503, 504 management 376–85 risk factor assessment 492 staging 374–5, 375 severity 490–1 colorectal surgery 103, 359–90 site of lesion 490 complications 382–3 chronic obstructive pulmonary laparoscopically-assisted 385 disease (COPD) 13–16 colostomy chronic pelvic pain syndrome closure 384 464 double-barrelled 382, 383 Chvostek’s sign 192 end 379, 382, 383 ciprofloxacin 103, 455 neonates 588 circulation, major trauma 602 postoperative care 383–4 circulatory failure see shock transverse loop 382, 383 circumcision 468, 469–70 colour Doppler imaging 494, cirrhosis 329, 331, 337, 340 520, 527–9 claudication common bile duct (CBD) distance 488–9, 497 exploration 322–3 intermittent 488–9, 490, 497 T-tube 114, 322, 323 clear cell cancer of kidney 435–8 communication cleft lip and palate 151, 151–2 relatives 114–15, 117–18, 119 clerking 2–8 terminally ill patients 118 clopidogrel 25, 496 compartment syndrome 517 coagulation disorders 25–6 composite resection, mouth and co-amoxiclav 103 pharynx 169–70 codeine 100, 302 compression bandaging 533, colectomy 535 emergency total, with compression hosiery 529, 531, ileostomy 364 532–3, 535 sigmoid 388 computed tomography (CT) total, with ileorectal head injury 612, 616, 619 anastomosis 365 hepatobiliary disease 327–8 colitis 360 prostate cancer 461 acute severe 362, 362, 363 thyroid 172 Crohn’s 360, 361, 367 urinary tract 429, 434, 436, ulcerative see ulcerative colitis 446 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 672
672 Index
concussion 608 cystolitholapaxy 443 confusion, postoperative 32, cystoscopy 440, 442, 446, 449 37–8 cysts coning 609 breast 204, 205, 215–16 Conn’s syndrome 197 dental 156 conscious level dentigerous 156 assessment 602, 610, 611 dermoid 155, 546 deteriorating 614–15 developmental 155 consent 10, 124–5 epidermoid 543–5, 545 constipation epididymal 477–8 children 597 mouth 152–7 large bowel obstruction 371 mucous retention 152–3, 153 opiate-induced 100 myxoid 546 postoperative 32, 36 pilar (sebaceous) 544 controlled drugs 97 solitary lymph 150 co-proxamol 101 thyroglossal 184–7, 185–6 coroner, referral to 122–3 thyroid 181 corticosteroids see steroids cortisol 196 dartos pouch procedure 473–5, countryman’s lip 159 474 Courvoisier’s dictum 343 D-dimers 53, 55 cranial burr holes 619–20 death 117–23 cremation forms 120–2 certificates 120–2 CREST syndrome 259 confirming 118–19 cricothyroidotomy 254–5, 255 informing relatives 119 Crohn’s disease (CD) 359, referral to coroner 122–3 359–68 see also terminal illness clinical features 360 deep venous thrombosis 52–4, investigations 361 531 management 362, 363 prevention 53, 105, 498 surgical management 367–8 risk factors 52 cross-matched blood 9–10 treatment 54, 105–7, 533 cryptorchidism 472–5 dehydration 61, 90 crystalloid solutions 82–5 dental cysts 156 CT see computed tomography dentigerous cysts 156 Cullen’s sign 349 De Quervain’s thyroiditis 173, Cushing’s syndrome 196–7 174–5 cyclosporin 362 dermoid cysts 155, 546 cylindroma 130 dermoids, implantation 543–4 cystectomy, radical 446, 447–8 developmental cysts 155 cystic fibrosis 585–6, 596 dextran 85, 86–7 cystic hygroma 149–50 dextropropoxyphene 101 cystic medial necrosis 507 dextrose cystitis 439, 440, 448–50, 449 infusions 21, 22, 199 interstitial 449, 450 solutions 83–4, 83–4 radiation 449, 450 dextrose saline 83–4, 84, 598 see also urinary tract infections diabetes mellitus 20–4 cystocoele 451 acute pancreatitis 351 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 673
Index 673
chronic limb ischaemia 492, types and uses 113–14 496, 498 see also chest drains diet-controlled 21 drug history 4–5, 8 emergency surgery 23–4 drugs 95–108 insulin-dependent 22–3 controlled 97 oral hypoglycaemic- on discharge 97, 116 controlled 21–2 see also prescriptions diabetic ketoacidosis 20, 24 ductal carcinoma in situ (DCIS) diagnosis, pitfalls 8 208, 226, 241 diamorphine 50 Dukes’ classification 374–5, 375 diaphragm, traumatic rupture duloxetine 451–2 629–30 dumping, postgastrectomy diaphragmatic hernia 299–302 congenital 578–9 duodenal ileus 351 traumatic 629 duodenal ulcers 189, 284–5 diarrhoea bleeding 290–2 fluid replacement 89, 90 perforated 285–8 postgastrectomy 302 pyloric stenosis 288–90 diaxozide 199 duodenoplasty 289 diazepam 34, 60, 102 duodenotomy 292 diclofenac 100 duodenum 277–303 Dieulafoy malformation 294 atresia 582, 582 diffuse axonal injury 608 dying see terminal illness digital nerve injuries 656 dyspepsia 318 dihydrocodeine 100 dysphagia 257–60 diphenoxylate 302 after antireflux surgery 281, disability, major trauma 602 283 discharge 116–17 causes 258 drug supply 97, 116 history 257–9 patient information 116 investigations 259–60 summary 116–17 oesophageal carcinoma 271 diuretics 50 dysrhythmias 19, 630 diverticular disease 385–9, 386 diverticulitis 386, 387–8 ejaculation, retrograde 458 diverticulosis 386 elderly patients doctor–patient relationship 1–2 acute urinary retention 60 documentation breast cancer 230 interviews with relatives intravenous infusions 91 115–16 left ventricular failure 50 operations 30 postoperative confusion 37–8 trauma 600 electrocardiogram (ECG) dopamine 63 preoperative 7, 10, 17 Doppler ultrasound, ankle pulmonary embolism 55 brachial pressure index trauma 630 493, 493–4 electrolytes double bubble sign 582, 582 acute renal failure 63, 64 drains 31, 112–14 basic requirements 81, 81, removal 114 87–8, 88 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 674
674 Index
electrolytes (cont.) enoxaparin 105 children 599 enteral feeding 92 intravenous fluids 82–5, 85 inflammatory bowel disease replacing abnormal losses 364, 368 88–91 epidermoid cysts 543–5, 545 embolectomy epididymal cysts 477–8 peripheral artery 516–17 epididymo-orchitis 478–9 pulmonary artery 57–8 epidural analgesia 98 embolism epigastric hernia 420 acute arterial 514, 515 epilepsy, post-traumatic 614 air 94 epulis 157–8 carotid artery 519 bony 157 fat 653–4 fibrous 157 pulmonary 54–8, 55 granulomatous 158 retinal artery 519–20 erectile dysfunction 471–2 embolization, arteriovenous erythroplasia of Queyrat 470 fistulae 518 estrogen receptors (ER) 236 emphysema, surgical 260, 626 etherified starch 86 empyema, gallbladder 319 ethical issues 123–5 encephalopathy, portosystemic examination 330, 331 intimate 125 endocarditis, bacterial 19 major trauma 603–4 endocrine surgery 171–201 postoperative 31 endocrine therapy preoperative 6–7 breast cancer 236–8, 239, 243 exemestane 237 prostate cancer 462 exomphalos 577–8 endocrine tumours of pancreas exposure, major trauma 602 198–201, 344 extracorporeal shock-wave endoluminal ultrasound (EUS), lithotripsy (ESWL) 430, oesophageal cancer 272 432 endoscopic mucosal resection extradural haematoma 617, 618, (EMR), gastric cancer 296 619–20 endoscopic retrograde eyes cholangiopancreatography bilateral black 611 (ERCP) 327, 328 burns around 663–4 endoscopic sphincterotomy (ES) 327, 328 facial nerve 131–2, 135 endoscopic surgery 78–80 faecal impaction 36 endoscopic treatment familial adenomatous polyposis bladder stones 442–3 coli (FAP) 374 ureteric stones 432 family see relatives endoscopic ultrasound (EUS) family history 5 328 fat embolism 653–4 endoscopy, upper GI see upper fat necrosis, breast 221 gastrointestinal endoscopy femoral artery aneurysms 406, endovascular procedures 513 aortic aneurysms 510–11 femoral canal 403, 411, 412 chronic leg ischaemia 498–9 femoral hernia 403, 411–16 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 675
Index 675
femoral lymph nodes 406 non-retractile 467 femoral vein thrombosis 52 trauma 469 femoropopliteal/femorodistal fractures 651–4 bypass 501, 502 fat embolism 653–4 FEV1/FVC ratio 14 management 652–3 fever see pyrexia pelvis 642–6 fibre, dietary 385 rib 622–3, 624 fibroadenoma, breast 213–15 skull 610–12, 620–1 fibrolamellar carcinoma, hepatic spine 640–2 337 sternum 624–5 fibroma 157 types 651, 651 fine-needle aspiration (FNA) fresh frozen plasma (FFP) 334 cytology frusemide 50, 63, 615 breast lumps 209 full blood count 7 thyroid 172, 179 fundoplication, Nissen 281–3, fingers 282 myxoid cyst 546 furuncle 565 traumatic amputation 650–1 ulceration 524 galactocoele 221 fistulae galactorrhoea 218 arteriovenous 517–19 gallstone ileus 318 branchial 135–7 gallstone pancreatitis see intestinal see intestinal fistulae pancreatitis, gallstone mamillary 223 gallstones 318–23 perianal 394, 394–7 ganglion 546–7 rectocutaneous 587 gangrene 489, 490 tracheo-oesophageal 579, 580 management 497–8, 504 urinary 64 Raynaud’s phenomenon fixation, fracture 653 524 flucloxacillin 103, 104 gas bloat syndrome 283 fluid balance 31, 61, 81–2, 93 gastrectomy fluid replacement see complications 298–303 intravenous fluids D1–D4 classification 296–7 fluid requirements 81, 81–2 distal 297 flurazepam 102 extended total 276–7, 297 FNA see fine-needle aspiration subtotal 296 focal nodular hyperplasia 336–7 thoracoabdominal 297–8 follicular thyroid carcinoma 183 total 296, 297 foot gastric ulcers 284 amputations 505–6 bleeding 290–2 care 496 perforated 285–8 ulcers see lower limb ulcers gastrinoma 198, 200–1 forced expiratory volume in one gastritis, acute 293–4 second (FEV1) 14 gastroduodenal disease forced vital capacity (FVC) 14 278–303 foreign body, impacted in gastroenterostomy 289 oesophagus 260–1 gastrointestinal stromal tumours foreskin 466–70 (GISTs) 294, 315 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 676
676 Index
gastrointestinal tract groin development 583, 583–4 anatomy 403, 404, 405 haemorrhage see rectal block dissection 557–8 bleeding; upper lumps 403–16, 406 gastrointestinal Guedel airway 601 haemorrhage gynaecomastia 244–6, 245 postoperative complications 41–3 Hadfield’s operation 219, 220 preoperative assessment Haemaccel 85, 86, 86 3 haemangioma, liver 336–7 gastro-oesophageal junction haematemesis 290–2, 293, 333 (GOJ) cancer 270, 271, haematoma 298 breast 221 gastro-oesophageal reflux intracranial 615, 617–20, 618 disease (GORD) 278–83 perianal 402 admission 3 scrotal 477 complications of chronic 265, subungual 574 270, 271 haematuria 438–40 diagnosis 279–81 causes 439 history 279 painful 439 management 266, 281–3 haemodialysis 64 gastroschisis 577–8 haemoglobin concentration 9 gastrotomy, anterior 292 haemolytic transfusion reactions gelatin solutions 86 47–8 Gelofusine 86 haemopericardium 631 general practitioners (GPs) haemophilia 25–6 116–17 haemorrhage gentamicin 103, 104, 105 fluid replacement 91 giant cell tumour 157 over-anticoagulation 107 GI tract see gastrointestinal tract pelvic fractures 643–4 Glasgow Coma Scale (GCS) postoperative 46–7 610, 611 rectal see rectal bleeding glossectomy, partial 168 ruptured liver 634, 635 glossitis 163 trauma 602 glucagonoma 198 upper GI see upper glucose (sugar), blood 21, 22, gastrointestinal 23 haemorrhage glyceryl trinitrate (GTN) 398, haemorrhoidectomy 401 bowel preparation 108 goitre 171 Milligan–Morgan 400–1 diffuse 173–8 stapled 401–2 inflammatory 173–5 haemorrhoids 398–402 nodular 173 strangulated 400 physiological 173 thrombosed external 402 toxic 175–8 haemothorax, traumatic 627 Goodsall’s rule 395, 395 HAES (hydroxyethyl starch) 85, Graves’ disease 175–8 86 Grey Turner’s sign 349 halo naevus 553 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 677
Index 677
hands inguinal see inguinal hernia burns 664 irreducible 424 injuries 650–1 obturator 403, 422–4 Hartmann’s procedure 381, paraoesophageal 279, 281 388–9 paraumbilical 419, 594–5 reversal 384 reduction en masse 423, Hartmann’s solution 83, 85, 662 424–5 Hashimoto’s disease 173, 174 Richter’s 423, 424 head and neck 126–70 Spigelian 421, 421–2 anatomical areas 127 strangulated 311, 412–13, burns 664 423, 424–6 lumps 126–50 umbilical 418–19, 594–5 suture removal 111 herniotomy, children 594 head injuries 605–21 herpetic whitlow 571 deteriorating 606, 614–15 hiatus hernia 278–83, 280 major 605, 609–15 hidradenitis suppurativa 562 minor 606, 615–17 Hirschsprung’s disease 586–7 pathology 606–9, 608 history heart, blunt trauma 630–1 postoperative 30 heartburn 3, 279 preoperative 3–5, 8 heart failure 18–19, 61, 630 trauma 603 heart murmurs 19 hoarseness 173 Helicobacter pylori 284, 295 Hodgkin’s disease 145, 147–8, Heller’s myotomy 268 149 hemicolectomy Homans’ operation 536 left 378 hormone therapy see endocrine right 378 therapy hemiglossectomy 169 Horner’s syndrome 575 hemiplegia 619 human chorionic gonadotrophin Henry operation 415 484, 485 heparin 25, 53, 105–6 human immunodeficiency virus hepatectomy 339, 635 (HIV) 26–8 hepatitis B 26, 337 human papillomavirus hepatitis C 26 infections 539–41 hepatobiliary disease 318–42 Hunner’s ulcer 449 hepatocellular carcinoma Hurley–Shelley procedure 575 (hepatoma) 337, 338 Hutchinson’s melanotic freckle hepatorenal syndrome 328 555 herald bleed 333 Hutchinson’s pupil 618 hereditary non-polyposis hydatid of Morgagni, torsion colorectal cancer (HNPCC) 482–3 374 hydrocoele 475–7 hernias 403–26 congenital/infantile 592–4, diaphragmatic 578–9, 629 593 epigastric 420 hydrocortisone 24, 49, 196 femoral 403, 411–16 hydronephrosis 440–1 hiatus 278–83, 280 hydroxyethyl starch (HAES) 85, incisional 68, 416–18, 419 86 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 678
678 Index
5-hydroxyindole-acetic acid (5- ileus HIAA) 316 duodenal 351 hyperaldosteronism 197 gallstone 318 hypercalcaemia 189, 190, 243 meconium 585–6 hyperhidrosis 574–6 paralytic see paralytic ileus hyperkalaemia 63 iliac artery injuries 646 hyperlipidaemia 492, 496 iliac vein thrombosis 52 hypernephroma 435–8 iliofemoral/femorofemoral hyperparathyroidism 187–92 cross-over bypass 504 primary 188–90 immunotherapy, intravesical secondary 188, 191 446 tertiary 188 implantation dermoids 543–4 hypertension 18, 51, 193, 492 incisional hernia 68, 416–18, hypertensive crisis 194 419 hypertrophic scars 541, 541, 542 incontinence, urinary 450–2 hypnotics 101–2 ‘infant Hercules’ syndrome 484 hypocalcaemia infections acute pancreatitis 351 antibiotic therapy 104 , 105 children 599 burns 663 postoperative 178, 180–1, catheter-related 94 192 intravenous drip site 70 hypoglossal nerve lesion 523 neonatal 588–9 hypoglycaemia 20–1 occupational exposure 26–7 insulinoma 198, 199 postoperative 65–78, 66 neonatal 599 skin 561–5 hypokalaemia 599 wound 65–7, 104 hypotension 47, 61, 512 see also chest infections; hypothyroidism 172 urinary tract infections hypovolaemia/hypovolaemic inflammatory bowel disease shock 359–68, 596 phaeochromocytoma 194 infliximab 363 trauma 602, 606, 658 infraclavicular lymph nodes hypoxia 206, 207 collapse 38–9 ingrowing toenails 565–71, 566 confusion 37, 38 inguinal hernia 403, 404–11 childhood 405–7, 592–4, 593 identification, preoperative 8 laparoscopic repair 410–11 ileal conduit 446, 447 open repair 408–10 ileal pouch 366, 447–8 recurrent 408, 409 ileocaecal resection 367 inguinal ligament 403, 404, 413 ileocaecal valve, competence inguinal lymph nodes 406, 471 371, 373 inhalation of vomit 45 ileocystoplasty, clam 451 inoculation injuries 26–7 ileostomy 384 inquests 123 closure of loop 366–7, 384 insulin restorative proctocolectomy intravenous infusion 22–3, 23 after 366 perioperative therapy 21–4 ulcerative colitis 364–5 insulinoma 198–200, 344 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 679
Index 679
intensive care unit 80 burns 89, 661–3, 662 interferon-α2b 558 children 90, 598–9 intermittent claudication commonly used fluids 82–7 488–9, 490, 497 indications 81–2 internal jugular vein 93 monitoring 92–5 international normalized ratio prescribing 87–92 (INR) 25, 106, 107 replacing abnormal losses interstitial (Spigelian) hernia 88–92 421, 421–2 replacing normal losses 87–8, intestinal fistulae 88 Crohn’s disease 360 trauma 602, 614 diverticular disease 387, 388 upper GI haemorrhage 291 external 74–6 intravenous urogram (IVU) intravenous fluids 89, 90 429, 434, 436, 440, 446 intestinal obstruction 308–11, intussusception 315, 590–2 370–3 investigations closed loop (competent major trauma 604–5 ileocaecal valve) 309–10, peroperative 12 371, 373 postoperative 31 Crohn’s disease 360 preoperative 7–8, 10 diagnosis 309–10, 310 iodine, radioactive 176, 183 functional see paralytic ileus iron deficiency anaemia 268–9, mechanical 308, 309 295, 303 Meckel’s diverticulum 312 ischaemic bowel 313–15 neonatal 581–9 ischaemic limb postoperative 36 acute 514–17, 655 strangulated hernias 424, 425 chronic see chronic leg intestine ischaemia adhesions 311 islet cell tumours 198–201 bleeding 312 Ivor–Lewis oesophagectomy traumatic injury 637–8 274 see also large bowel; small IVU see intravenous urogram bowel intimate examinations 125 jaundice 323–4 intracerebral haematoma 617, gallstones 319, 320 618 hepatic 325 intracranial haematoma 615, obstructive 325–8, 326 617–20, 618 pancreatic carcinoma 342, intracranial pressure (ICP) 343 changes in trauma 606, 607 prehepatic 325 raised 608 surgical 323–8 intraoperative care 28–9 jaw tumours 161 intravenous drip site infection joints, examination 7 70 intravenous feeding see Kausch–Whipple operation parenteral nutrition 345–7, 346 intravenous fluids 81–95 Kehr’s sign 636 acute pancreatitis 350 keloid 541, 541–2 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 680
680 Index
keratoacanthoma 550–1, 551 lentigo maligna 555 kidney Leriche’s syndrome 490 stones 428, 430–1 Leydig cell tumours 484 traumatic injury 639–40 lichen planus 163 tumours 434–8 Lichtenstein operation 409 Killian’s dehiscence 140, 141 limb Klatskin tumour 337 circumferential burns 663 Klinefelter’s syndrome 246 ischaemia see ischaemic limb trauma 647–64 lactulose 334 see also lower limb Ladd’s bands 583, 584, 585 lingual thyroid 166 laparoscopic surgery 78–80 lip adrenalectomy 195–6 carcinoma 159–60, 161, 559 appendicectomy 306, 307 cleft 151, 151–2 cholecystectomy 321, 321–3, mucous retention cysts 351 152–3, 153 colorectal 385 lipoma 542–3 exploration of common bile litholapaxy 442–3 duct 322–3 liver Heller’s myotomy 268 abscess 72–3 ileocaecal resection 367 biopsy 148, 328 incisional hernia 418 failure, acute 340 inguinal hernia repair 410–11 resection 338, 339 nephrectomy 437 transplantation 332, 339–42 Nissen fundoplication 281–3, traumatic rupture 634–6 282 liver cell adenoma 336–7 pancreatic pseudocyst liver disease drainage 352–3 chronic 331–2, 340 splenectomy 356–8, 357 metabolic 340 large bowel liver function tests 7, 327, 327 anastomotic leaks 382 liver tumours 336–9, 340 fistulae 387, 388 benign 336–7 obstruction (LBO) 370–3, malignant 337–9 381 secondary (metastatic) perforation 386 316–17, 337, 338, 377 strictures 387 local anaesthetics 98 surgery 103, 359–90 Lockwood’s operation 414 see also colon; rectum locomotor system, assessment 4 laryngeal oedema 254 loin pain 427, 428 lateral (anal) sphincterotomy long saphenous vein 398 grafts 498, 500, 501 latex sensitivity 5 high tie (flush ligation) 530 latissimus dorsi myocutaneous stripping 530 flaps 240 varices 528 left thoracoabdominal resection loperamide 302 of oesophagus 275 Lotheissen operation 415 left ventricular failure 18–19, 50 lower limb leg see lower limb acute ischaemia 514–17 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 681
Index 681
amputations 504–7 mammography, X-ray 208, 225 arterial supply 491 mannitol 615, 619 chronic ischaemia see chronic Marfan’s syndrome 507 leg ischaemia Marjolin’s ulcer 532 examination 489–90 marking, skin 10 postoperative pain 35 mastalgia (breast pain) 204, 205, lower limb ulcers 216–17 arterial 489, 490, 497–8 mastectomy 226, 231 venous 531–3 breast reconstruction 238–41 lower urinary tract postoperative adjuvant surgery 441–66 therapy 236–8 traumatic injuries 644–5 postoperative care 234–5 Ludwig’s angina 133, 254 radical 233, 241 lumbar sympathectomy 574 salvage 242–3 lymphangitis 241 skin-sparing 241 lymph cyst, solitary 150 subareolar 246 lymphoedema 534–6 total (simple) 232–3 breast cancer surgery 241–2 mastitis 211 groin block dissection 558 plasma cell 219, 222 primary 534 maxillary antrum carcinoma lymphoma, malignant 147–9 161 management 149 McBurney’s point 304, 305 staging 148–9 McEvedy operation 415 testicular 484 McKeown oesophagectomy thyroid 184 275 lymphosarcoma 162 mean arterial pressure (MAP) lymphoscintogram 535 606, 607 Meckel’s diverticulum 311–13, magnetic resonance (MR) 596 angiography 495, 520 meconium ileus 585–6 magnetic resonance median sternotomy 253 cholangiogram 327 mediastinal injuries 622 magnetic resonance imaging mediastinitis 262, 263 (MRI) 139, 149 medical diseases, pre-existing male genitalia 466–87 12–28 Mallory–Weiss tear 290, 294 medical history, past 4 malnutrition 3 medullary thyroid carcinoma malrotation 583–5, 584 184 mamillary fistula 223 melaena 290–2, 293 mammary duct melanoma 554–8 papilloma 218 acral lentiginous 555–6 subareolar resection amelanotic 555 (Hadfield’s operation) 219, clinical features 556 220 juvenile 553 mammary duct ectasia 218–19, lentigo maligna 555 222 malignant 554–8 complicated/symptomatic management 557–8 219–20 mouth 161 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 682
682 Index
melanoma (cont.) squamous cell carcinoma nodular 555 160–1 staging 555 MSU see midstream urine superficial spreading 555 mucocoele, gallbladder 319 melphalan 558 mucoepidermoid tumour 130 Mendelson’s syndrome 45 mucous retention cysts 152–3, menstrual cycle, breast changes 153 202, 217 multiple endocrine neoplasia mental state examination 6 192, 193, 200 Merendino procedure 276 mumps 128, 478 mesenteric adenitis 306–8 Murphy’s sign 319 mesenteric venous thrombosis myocardial infarction (MI) 313 postoperative 49 metabolic diseases 340 previous history 17–18, 492, methicillin-resistant 498 Staphylococcus aureus myxoid cyst 546 (MRSA) 4 metoclopramide 36, 42, 99 naevi metronidazole 103, 104, 401 benign 553–4 MIBG scintigraphy 194 blue 553 microcalcification, breast 208 compound 551–2 microdochectomy 219 congenital 552 micturition 3 dysplastic 553 midstream urine (MSU) 428, halo 553 433, 449, 451 junctional 551 milk–alkali syndrome 190 pigmented 551–4, 552 Milligan–Morgan removal of suspicious 554, haemorrhoidectomy 554 400–1 signs of malignancy 556 Milroy’s disease 534 Spitz 553 minimal access surgery 78–80 nail matrix Mirizzi syndrome 319 excision (Zadik procedure) mitotane 198 569–70, 570 mixed salivary tumours 130–2, phenol matricectomy 571, 158 572 moles (pigmented naevi) 551–4, wedge excision 571 552 nails removal of suspicious 554, disorders 565–74 554 pincer 567, 567–8 shave excision 553–4 trephining 574 signs of malignancy 556 see also toenails molluscum sebaceum 550–1 nausea morphine 98–9, 661 opiate-induced 99 Mount Vernon formula 662 postoperative 32, 35–6 mouth 151–63 see also vomiting benign tumours 157–8 neck dissection 169 cysts 152–7 necrotizing enterocolitis (NEC) malignant tumours 158–63 588 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 683
Index 683
needles, suture 111, 112 nutrition, postgastrectomy needle-stick injuries 26–7 problems 302–3 negligence 123 nutritional support 91–2 neo bladder 446, 448 acute pancreatitis 351 neomycin 334 head injury 613 neonates 577–89, 598–9 inflammatory bowel disease nephrectomy 364, 368 radical 437–8 see also enteral feeding; renal stones 430 parenteral nutrition nephrocalcinosis 189 nephrolithotomy, percutaneous obturator hernia 403, 422–4 (PCNL) 430, 431 octreotide 75, 317 nephrostomy tube 431 odynophagia 259 nephroureterectomy 435 oesophageal carcinoma 270–7 nerve blocks, regional 98 palliation 272–3 nerve injuries 646, 655–6 staging investigations 271–2 neurilemmomas 547, 548 surgical procedures 272–7, neurofibromas 547–50, 548 273 cutaneous 549 oesophageal perforation 261–4 plexiform 549 iatrogenic 261–2 subcutaneous 549 repair 263–4 neurofibromatosis spontaneous 262–3 type 1 (NF1) 547 oesophageal strictures type 2 (NF2) 547–8 anastomotic 277 neurological examination 610 caustic injury 265 neuropraxia 655, 656 chronic benign 265–6 neurotmesis 656 dilatation 266, 277 nipple oesophageal varices 329, 331 changes, breast cancer 227 band ligation 334 discharge 205, 218–19 bleeding 332, 333–5 inversion 220 injection sclerotherapy 334 Paget’s disease 243–4 tamponade 334–5, 335 Nissen fundoplication 281–3, oesophagectomy, total 273, 282 274–5 nitrazepam 102 oesophagitis 294 nitroprusside, sodium 194 oesophagogastrectomy 273, non-Hodgkin’s lymphoma 276–7 147–8, 149 oesophagogastroduodenoscopy non-steroidal anti-inflammatory see upper gastrointestinal drugs (NSAIDs) 100, 284, (GI) endoscopy 293 oesophagoscopy, rigid 261–2, norfloxacin 104 266 normal saline 82, 83 oesophagus 257–77 notes see documentation 24-h pH measurement 259 Nottingham Prognostic acute caustic injury 264–5 Index (NPI) 228–9, atresia 579–80, 580 229 Barrett’s 270, 275 nursing observations 30 impacted foreign body 260–1 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 684
684 Index
oesophagus (cont.) necrosectomy 353–4 manometry 259 pseudocyst 348, 352–3 pain 258–9 resection 199–200, 201 postcricoid web 269 traumatic injury 638–9 traumatic rupture 630 pancreatectomy, distal 345, 346 oliguria, postoperative 32, 40–1, pancreatic carcinoma 342–7 60, 62 bypass operation 346, 347 omeprazole 201 clinical features 343 oophorectomy, surgical 237–8 investigations 343–4 operating list 10–12, 12, 28–9 management 344–7 operating theatre 11, 28–30 pancreaticojejunostomy, operation(s) 28–31 longitudinal 355 assisting during 29 pancreatitis 189, 347–55 notes 30 acute 347–52 previous history 4 chronic 354–5 opiates 98–100 gallstone 319, 321, 348–9, 351 chronic pain 101 panda eyes 611 contraindications 100 panproctocolectomy, and side effects 99–100 terminal ileostomy 364–5 oral contraceptive pill 5, 336–7 papaveretum 99, 99 oral hypoglycaemics 21–2 papillary thyroid carcinoma orchidectomy, radical 485–6 182–3 orchidopexy 473–5, 474 papilloma, skin 537–9 oropharyngeal airway 601 paracetamol 101 orthopaedic implants 103 paralytic ileus 36, 41–2, 308 osteoclastoma 157 major burns 663 ovarian ablation 237–8 neonates 588–9 paraoesophageal hernia 279, paediatric patients see children 281 Paget’s disease of nipple 243–4 paraphimosis 468–9 pain parathormone 188, 189–90 chronic 101 parathyroidectomy 191–2 management 98–101 parathyroid glands 187–92 postoperative see adenomas 188, 190, 191–2 postoperative pain carcinoma 188, 191 relief see analgesia hyperplasia 188, 191 see also specific sites of pain paraumbilical hernia 419, 594–5 palate, cleft 151, 151–2 parenteral nutrition 91–2 palliative therapy indications 82 breast cancer 236, 243 intestinal fistulae 75 malignant melanoma 558 massive small bowel resection oesophageal cancer 272–3 315 pancreatic carcinoma 344 Parkland formula 662 rectal cancer 380 paronychia pancreas 342–55 acute 571–4 endocrine tumours 198–201, chronic 571–3 344 parotid duct, obstruction infected necrosis 348, 353 129–30 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 685
Index 685
parotidectomy, superficial perforated 285–8 131–2 Zollinger–Ellison syndrome parotid gland 127 200 generalized enlargement see also duodenal ulcers; 128–30 gastric ulcers localized lumps 130–2 percutaneous nephrolithotomy parotid neoplasms 130–2 (PCNL) 430, 431 adenolymphoma 130, 132 perianal region benign mixed tumours 130–2 abscesses 360, 390–4, 392 malignant 130 anatomy 391 parotid region 127 Crohn’s disease 360, 361 lumps 128–32 fistula 394, 394–7 parotitis glands 390 autoimmune 129 haematoma 402 bacterial 128–9 pain 390–402 viral (mumps) 128 pericolic abscess 386, 387, 388 past medical history 4 periods 3 Paterson–Kelly peripheral vascular disease see (Plummer–Vinson) chronic leg ischaemia syndrome 268–9 peritoneal dialysis 64 patient-controlled analgesia peritonitis (PCA) 99 abscess formation 70, 72, 73 patients biliary 323 admission 2–8 diverticular disease 386, building relationships 1–2 387 daily management 1–80 pethidine 98–9, 350 discharge instructions 116 phaeochromocytoma 193–6 documenting interviews pharyngeal pouch 140–2, 141, 115–16 268 peak expiratory flow rate (PEFR) pharyngolaryngo- 14 oesophagectomy 273, 274 pelvic abscess 73–4 phenol pelvic fractures 642–6 matricectomy of ingrown associated injuries 644–6 toenail 571, 572 open book 642, 643 pilonidal sinus injection pelvic lymph node sampling 461 564–5 pelvic phlebothrombosis 52 phenoxymethylpenicillin 104 pelvic venous plexus, injury 646 phentolamine 194 pelviureteric junction (PUJ) phimosis 468 obstruction 440, 441 phosphate 189 pelviureteric transitional cell phosphate enemas 108 cancers 434–5 phyllodes tumour 214 penis physiotherapy carcinoma 470–1 chest 15, 613 erythroplasia of Queyrat 470 fracture rehabilitation 653 peptic ulcers 3, 283–93 Picolax 108 bleeding 290–3 pilar cysts 544 Meckel’s diverticulum 312 piles see haemorrhoids 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 686
686 Index
pilonidal sinus (abscess) 393, postoperative complications 562–5 31–78, 32 pipe-smoking 159 postoperative pain 30, 32, 34–5 pituitary adenoma 218 relief 98–101 plasma cell mastitis 219, 222 postoperative ward rounds 30–1 plasma protein fraction 85, 86 potassium (KCl) plasma substitutes 86–7 depletion, i.v. replacement 90 plaster of Paris casts 653 infusions 21, 22, 85 plastic surgery requirements 81, 81–2 benign breast problems prednisolone 24, 175 223–4 pre-existing medical diseases breast cancer 238–41 12–28 pleomorphic adenoma (mixed pregnancy 205 salivary tumour) 130–2, preoperative assessment 2–8 158 preoperative preparation 8–28 pleuritic pain 35 operating list organization Plummer–Vinson syndrome 10–12, 12 268–9 patients 8–10 pneumonia see chest infections pre-existing medical diseases pneumothorax 37, 45–6 12–28 central venous lines causing prerenal failure 61–4 94 prescription chart 30, 31 open 622 prescriptions tension 626–7 abbreviations 96 traumatic 622, 625 at discharge 97 polyps drug 95–108 colon 374, 376–7 intravenous infusions 87–92 fibroepithelial, skin 537–9 review 97 rectal 596 writing 95–7 small bowel 315 pressure ulcers (bed sores) 76–7 popliteal arterial aneurysms primary survey 601–3 513, 515 processus vaginalis 592, 593 thrombosis 514 failure of closure 405–7, 592 portal hypertension 329, persistent 475, 592 329–33, 330 prochlorperazine 36, 99 portosystemic encephalopathy proctocolectomy, restorative 330, 331 366 portosystemic shunts 332–3 proctoscopy 369 positron emission tomography profundoplasty 503 (PET) 272 progesterone receptors (PR) posterior triangle of neck 127 236 lumps 142–4 propranolol 176, 178, 194 postgastrectomy syndromes propylthiouracil 176 298–303 prostate postmortems 120, 123 benign hyperplasia (BPH) postoperative care 454, 455–9 immediate 29–30 biopsy 461 laparoscopic surgery 79–80 carcinoma 459–63, 460 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 687
Index 687
transurethral resection colorectal cancer 376 (TURP) 458–9 diverticular disease 386 prostatectomy haemorrhoids 399 radical 462–3 rectal examination 125, 376 simple 454, 458–9 preoperative 6 prostate-specific antigen (PSA) prostate 456–7, 461, 463 457, 461 rectocoele 451 prostatitis rectocutaneous fistula 587 acute 463 rectum chronic 464 abdominoperineal resection proton-pump inhibitors (PPI) 379–80, 383 201, 281, 289, 293 anterior resection 378–9, pulmonary artery embolectomy 385 57–8 biopsy 376 pulmonary collapse, cancer 376, 377 postoperative 43–4, 44, local excision 380 358 polyps 596 pulmonary contusion/laceration prolapse 389–90, 596 627–8 transanal endoscopic pulmonary embolism 54–8, 55 microsurgery (TEM) pulses, lower limb 489, 490 380–1 pupils, examination 615, 618 transanal resection 380 pyelonephritis 433–4 traumatic injuries 645–6 pyloric stenosis 288–90 recurrent laryngeal nerve palsy congenital hypertrophic 173, 183 589–90 Redivac drains 113 pyloroplasty 289 red rubber tube drain 114 pyonephrosis 428 regurgitation 259 pyrexia relatives 114–16 fluid replacement 89 breaking bad news 117–18, postoperative 32, 33–4 119 post-transfusion 48 dealing with 114–15 documenting interviews radioactive iodine 176, 183 115–16 radiotherapy renal cell cancer 435–8 breast cancer 231, 235–6 renal disease 189 malignant lymphoma 149 renal failure malignant melanoma 558 acute 63–4, 91 salivary gland tumours 132 acute pancreatitis 351 thyroid carcinoma 183 intravenous fluids 62–3, 91 Randall’s plaques 427 postoperative 61–4 ranula 153–4 renal pain 427 Raynaud’s disease 523, 524 renal tract stones 189, 427–32 Raynaud’s phenomenon 523–5 renal tumours 434–8 record keeping see respiration, head injury 613 documentation respiratory complications rectal bleeding 368, 368–9 41–6 children 591, 595–6 respiratory depression 99, 102 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 688
688 Index
respiratory disease 13–17 scars, hypertrophic 541, 541, acute 13 542 chronic 13–17 schistosomiasis 329 respiratory function tests 14, 15 schwannomas (neurilemmomas) restorative proctocolectomy 547, 548 366 sciatic nerve injury 646 rest pain 489, 490, 497–8 sclerotherapy restrictive airways disease 14, 15 oesophageal varices 334 resuscitation varicose veins 529 fractures 652 screening, breast 209, 225–6 head injuries 609–10 scrotum large bowel obstruction 372, conditions 472–87 373 lumps 475–8 major trauma 601–3 sebaceous cysts 544 pulmonary embolism 56 seborrhoeic keratosis (warts) upper GI haemorrhage 291, 539, 540 334 secondary survey 603–5 retinal artery embolism 519–20 sedatives 101–2 retroperitoneal lymph node seminomas 484, 485, 486 dissection 486–7 Sengstaken tube, four-lumen rheumatic fever 4 334–5, 335 rheumatoid arthritis 4 sentinel lymph node biopsy 234 ribs, fractured 622–3, 624 sentinel pile (skin tag) 369, 397 Richter’s hernia 423, 424 sepsis, postoperative 65–78, 66 Riedel’s thyroiditis 173, 175 septal defects, atrioventricular road traffic accidents 604, 637, 19 638 septicaemia 77–8 rodent ulcer 560–1 septic shock 262 Roux-en-Y reconstruction 297, Sertoli cell adenomas 484 299, 300 seton 396, 397 rule of nines, Wallace’s 658–60, Shirley wound drain 113 659 shock (circulatory failure) anaphylactic 48–9 salbutamol 15 burn 658 saline, normal 82, 83 postoperative 39, 40 salivary glands ruptured aortic aneurysm accessory 158 512 see also parotid gland; septic 262 submandibular gland upper GI haemorrhage 291, salivary tumours, mixed 130–2, 333 158 see also hypovolaemia/ saphena varix 406, 527 hypovolaemic shock saphenofemoral junction short saphenous vein incompetence 527, 530 ligation 530–1 saphenopopliteal junction varices 528 incompetence 527, 530 Shouldice operation 409 ligation 530–1 sialectasis 129–30, 134 sarcoidosis 145 sigmoid colectomy 388 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 689
Index 689
sigmoidoscopy Spigelian hernia 421, 421–2 flexible 361, 369, 376 spinal cord injuries 640, 641, rigid 372, 376 642 sigmoid volvulus 310, 372, 373 spinal injuries (fractures) 640–2 Silastic tube drain 113–14 spirometry 14 Sjögren’s syndrome 129 spironolactone 197 skin 537–76 Spitz naevus 553 abscess 561–2 spleen benign lesions 537–51 surgical conditions 355–8 cancer 554–61 traumatic rupture 636–7 care 532, 535, 614 splenectomy 355–8 grafts 649 laparoscopic 356–8, 357 infections 561–5 open 356, 637 lumps and bumps 126, 537 splenic artery aneurysms 355 metastases 561 splenomegaly 329–30, 331, papilloma (skin tag) 537–9 355–6 pigmented naevi 551–4 splinting, fracture 652 traumatic wounds 647–50, split-skin grafts 649 652 squamous cell carcinoma skull fractures 610–12, 620–1 bladder 443 skull X-rays 612, 616, 621 cutaneous 559–60 small bowel 277–317 in situ (Bowen’s disease) 559 adhesions 311 lip 159 atresia 581–3 mouth 160–1, 162, 166 bacterial overgrowth 302 oesophagus 270 Crohn’s disease 360, 361, 363, parotid gland 130 367–8 penis 470–1 enema 361 staghorn calculus 427, 430, 431 fluid levels 309, 310 Staphylococcus aureus ischaemia 313–15 breast abscess 222 obstruction 308–11, 360, 371 methicillin-resistant (MRSA) resections 315, 367, 638 4 stenosis 581 skin/soft tissue infections strictureplasty 368 561, 565, 571 traumatic injury 637–8 staples 111–12 tumours 315–17 statins 496 webs 581 steatorrhoea 354 smoking stenting, lower limb arteries chronic leg ischaemia 492, 499 496 sternotomy, median 253 hernia repair and 408 sternum, fractured 624–5 preoperative 5, 13, 14–15 steroids tongue carcinoma 166 inflammatory bowel disease social history 5 362, 363 sodium, requirements 81, 81–2 intralesional injections 542 specimens, laboratory 29 patients on 24 sphincterotomy, lateral (anal) see also hydrocortisone; 398 prednisolone 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 690
690 Index
stomach 277–303 removal 111 acute dilatation 42–3, 358 sizes 110–11 carcinoma 294–8 skin wounds 648 postgastrectomy sweating, excessive 574–6 reconstruction 299 sympathectomy 524–5, 574, volvulus 279 575 stoma nurse 108 syphilis 165, 507 stomas systemic inflammatory response postoperative care 383–4 syndrome (SIRS) 348 see also colostomy; ileostomy Stoppa operation 409 T4 see thyroxine streptozotocin 199 tamoxifen 237 stress incontinence 450–2 teeth 7 strictureplasty 368 temazepam 102 string sign 361 tendon injuries 656–7 stroke tension-free transvaginal tape carotid artery disease 519, 452 520, 521–2 teratomas, testicular 484, 485, postoperative 50–1 486 prevention 521 terminal illness 118 subclavian vein 93 breast cancer 243 subdural haematoma 617, 618 informing relatives 117–18 submandibular area 127 see also death; palliative submandibular gland 132–3, therapy 133 testes removal 135 absent 472–5 submandibular lumps 132–5 appendage, torsion 482–3 submandibular stones 133–5 bell clapper 480, 481 removal from duct 134–5 painful 478–87 subphrenic abscess 70–2, 358 retractile 472 subungual haematoma 574 torsion 479–82, 480 succussion splash 288 trauma 478 sugar (glucose), blood 21, 22, tumours 483–7 23 undescended 472, 473–5, sump drain 113 481, 484 superior mesenteric artery tetanus prophylaxis 649–50 occlusion 313, 314 tetany 192 supraclavicular lymph nodes tetra-iodothyronine see 206, 207 thyroxine suprapubic catheterization theatre, operating 11, 28–30 454–5 thoracic outlet syndrome 142–4 surgeon 11 thoracocentesis, needle 249, surgical assistant 11, 29 249–50, 626–7 sutures 108–11 thoracoscopic surgery 254 absorbable 108, 109, 110 thoracotomy 252–3 assisting with 29 anterolateral 253 needles 111, 112 penetrating chest injury 632 non-absorbable 109–10, 110 posterolateral 253 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 691
Index 691
thrombolytic therapy 107 tongue 163–70 acute arterial thrombosis 515, benign neoplasms 165–6 516 carcinoma 166–70, 167 intra-arterial catheter-directed ulcers 164–5 516 tonsils, malignant disease 162–3 pulmonary embolism 56–7 total extraperitoneal (hernia) thrombophlebitis migrans 343 repair (TEP) 410–11 thrombosis tracheo-oesophageal fistula 579, arterial 514–16 580 deep vein see deep venous tracheostomy 254, 255, 255–6 thrombosis traction 653 postsplenectomy 358 transabdominal preperitoneal thyroglossal cysts 184–7, 185–6 (hernia) repair (TAPP) thyroid (gland) 410–11 adenomas 181–2 transanal endoscopic carcinoma 182–4 microsurgery (TEM) cysts 181 380–1 development 184, 185 transanal (rectal) resection 380 lingual 166 transhiatal oesophageal resection lobectomy 179–80 275 scan 172–3 transient ischaemic attack 519, solitary nodule 178–81 520, 521–3 swellings 171–87 transillumination, scrotum 475 thyroid crisis 177, 178 transitional cell carcinoma thyroidectomy 174, 176–8 (TCC) subtotal 177–8 bladder 443–8 total 180–1 pelviureteric 434–5 thyroiditis transjugular intrahepatic De Quervain’s 173, 174–5 portosystemic shunt Riedel’s 173, 175 (TIPSS) 332–3, 334 thyroid-stimulating hormone transurethral resection of (TSH) 172 bladder tumour (TURBT) thyrotoxicosis 172, 175–8 446, 447 thyrotrophin-releasing hormone transurethral resection of (TRH) test 172 prostate (TURP) 458–9 thyroxine (T4) transurethral resection (TUR) replacement therapy 174, syndrome 459 177, 181 transversalis fascia 404–5 serum 172 transverse rectus abdominis suppressive therapy 183 muscle (TRAM) flaps 240 tinzaparin 106 trauma 600–64 toe amputation 506 abdominal 632–40 toenails arterial 507, 654–5 avulsion of big 568–9 breast 221 congenital malformations chest 601–2, 622–32 567, 567–8 foreskin 469 cutting 568, 569 head 605–21 ingrowing 565–71, 566 major 600–5 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 692
692 Index
trauma (cont.) upper gastrointestinal (GI) primary survey 601–3 endoscopy 260 resuscitation 601–3 achalasia 267 secondary survey 603–5 acute caustic injury 264–5 skin and limbs 647–64 dilatation of oesophageal spinal 640–2 strictures 266, 277 testicular 478 foreign body removal 261 see also fractures oesophageal perforation triamcinolone 542 during 261–2 trichilemmal cysts 544 postcricoid web 269 tri-iodothyronine (T3) 172 upper GI haemorrhage Troisier’s sign 295 291–2, 293, 294 trophic changes, ischaemic limb upper gastrointestinal (GI) 489, 490, 497–8 haemorrhage 290–4 Trousseau’s sign 192 acute pancreatitis 351 truss 408 oesophageal varices 332, T-tube, bile duct 114, 322, 323 333–5 tuberculosis 145, 165 Rockall score 293 tubes, surgical 30, 31 upper gastrointestinal (GI) TUR syndrome 459 surgery 257–317 upper urinary tract disorders ulcerative colitis (UC) 359, 427–41 359–68 urea and electrolytes 7 clinical features 360 ureteric colic 428 investigations 361 ureteroscopy 432 management 362–3 ureters surgical management 363–7 landmarks 429 ulcers obstruction 440–1 fingers 524 pain 427 Hunner’s 449 stones 432 lower limb see lower limb urethra ulcers bulking injections 451 Marjolin’s 532 strictures 464–6, 645 peptic see peptic ulcers traumatic injuries 644–5 rodent 560–1 urethral catheterization 453–4 tongue 164–5 urethrography 465 ultrasound imaging urethroscopy 465 abdominal trauma (FAST) urethrotomy, internal optical 633 466 breast 208 urge incontinence 450, 451 hepatobiliary disease 327 urinary calculi 427–32 thyroid 173 urinary catheterization 453–5 urinary tract 449–50, 451, long-term 454–5 457 postoperative retention 60–1 umbilical discharge 595 postprostatectomy 463 umbilical hernia 418–19, 594–5 suprapubic 454–5 unconscious patient 613–14 trauma 614 universal precautions 26 urethral 453 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 693
Index 693
urinary diversion 446, 447–8 vasoactive intestinal peptide urinary fistula 64 (VIP) 198 urinary incontinence 450–2 venous disorders 525–33 urinary retention venous guttering, persistent acute 452–5, 456 489–90 chronic 454, 456 venous sampling, selective 199 postoperative 41, 59–61 venous thrombosis, deep see urinary tract deep venous thrombosis obstruction 433–4, 440–1 venous ulceration 531–3 postoperative complications ventilation, artificial 58–65 fluid management 89 surgery 103, 427–66 head injury 613 traumatic injuries 644–5 major trauma 601 urinary tract infections 448–50 ventilation perfusion scans 56 antibiotic therapy 104 Verner–Morrison syndrome children 597–8 198 haematuria 439, 440 villous adenomas, colon 374 postoperative 58–9 Virchow’s node 146, 295 renal tract stones 428 Virchow’s triad 52 urine vitamin B12 deficiency 302–3 microscopy and culture 440, vitamin D 188, 190, 192 446, 449 vitamin K 25, 107, 328, 334 midstream see midstream volvulus 311, 371 urine gastric 279 red coloration 438 large bowel obstruction 373 specific gravity 61–2 midgut 584, 585 urine output sigmoid 310, 372, 373 children 598–9 vomiting intravenous infusions 92 acute gastric dilatation 43 postoperative 40–1, 61 bilious postgastrectomy urinoma 65 298–9 urobilinogen 326–7 fluid replacement 88–9, 90 urodynamic studies 451 inhalation 45 urothelial tumours 434–5 intestinal obstruction 308, 371, 373 vaginal examination 125 intussusception 591 vaginal injuries 646 neonates 581, 585, 589 vagotomy 289, 302 opiate-induced 99 valvular heart disease 19 postoperative 32, 35–6 varices, oesophageal see pyloric stenosis 288, 589 oesophageal varices von Hippel–Lindau disease 436 varicocoele 483 von Recklinghausen’s disease varicose veins 525–31, 526, 532 547 clinical features 527, 528 injection sclerotherapy 529 walking exercise programme operations 529–31 497 vascular injuries 646, 654–5 Wallace’s rule of nines 658–60, vascular surgery 488–536 659 9781405129213_5_ind.qxd 7/29/08 1:11 PM Page 694
694 Index
wards infections 65–7, 104 daily management of patients operative contamination 67 1–80 painful 34 operating list 11 resuture of abdominal 68–9 postoperative rounds 30–1 traumatic skin 647–50, 652 warfarin 25, 106–7, 107, 521 Warthin’s tumour (parotid X-rays adenolymphoma) 130, 132 hyperparathyroidism 190 warts skull 612, 616, 621 infective (viral) 539–41, 541 thoracic outlet syndrome 143 seborrhoeic 539, 540 trauma 604–5, 642, 652 weight loss 3, 259, 271 see also abdominal X-rays; Whipple’s triad 198–9 chest X-rays wounds closure techniques 647 Zadik’s procedure 569–70, 570 contaminated or infected 648 Zollinger–Ellison syndrome dehiscence 68, 68–70 198, 200–1 discharging 32, 35 zopiclone 102