BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= ii BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= Emergency Surgery i BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= ii BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= Emergency Surgery EDITED BY Adam Brooks, FRCS (Gen Surg), DMCC Consultant in HPB Surgery Major Trauma Pathway Lead General Surgery Service Lead Nottingham University Hospital NHS Trust Nottingham, UK; and Senior Lecturer Academic Department of Military Surgery and Trauma Royal Centre for Defence Medicine Birmingham, UK Bryan A. Cotton, MD, MPH Associate Professor Department of Surgery and the Center for Translational Injury Research The University of Texas Health Science Center Houston, Texas, USA Lt Col Nigel Tai, MS, FRCS (Gen Surg), RAMC Consultant in Trauma and Vascular Surgery, Defence Medical Services Trauma Clinical Academic Unit Royal London Hospital Whitechapel London, UK and Senior Lecturer Academic Department of Military Surgery and Trauma Royal Centre for Defence Medicine Birmingham, UK Col Peter F. Mahoney, OBE, TD, MSc, FRCA, RAMC Defence Professor Anaesthesia and Critical Care RCDM Birmingham Research Park Vincent Drive Birmingham, UK Associate Editor David J. Humes, BSc, MBBS, MRCS Lecturer in Surgery QMC Campus University of Nottingham Nottingham, UK A John Wiley & Sons, Ltd., Publication iii BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= This edition first published 2010, C 2010 by Blackwell Publishing Ltd BMJ Books is an imprint of BMJ Publishing Group Limited, used under licence by Blackwell Publishing which was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing programme has been merged with Wiley’s global Scientific, Technical and Medical business to form Wiley-Blackwell. Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data Emergency surgery / edited by Adam Brooks ... [et al.]. p. ; cm. ISBN 978-1-4051-7025-3 1. Surgical emergencies. I. Brooks, Adam, 1969– [DNLM: 1. Emergencies. 2. Surgical Procedures, Operative. 3. Emergency Medical Services. WO 700 E53 2010] RD93.E4496 2010 617.026–dc22 2009026824 ISBN: 9781405170253 A catalogue record for this book is available from the British Library. Set in 9.5/12pt Meridien by Aptara R Inc., New Delhi, India Printed and bound in Singapore 1 2010 iv BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= Contents List of Contributors, vii 14 Small Bowel Obstruction, 74 J. Edward F. Fitzgerald 15 Surgical Jaundice and Cholangitis, 80 Part 1 Approach John S. Hammond & Ian Beckingham 1 The Initial Approach to the Emergency Surgery 16 Large Bowel Obstruction, 86 Patient, 3 Igor V. Voskresensky & Bryan A. Cotton Adam Brooks & J. Alastair D. Simpson 17 Emergency Surgical Management of Herniae, 92 2 Preoperative Considerations, 6 John Simpson & David J. Humes Paul Wood 3 Emergency Anaesthesia, 14 Part 3 Vascular Giles R. Nordmann 4 Analgesia, 20 18 Ruptured Abdominal Aortic Aneurysm, 101 Jeff L. Tong Ross Davenport & Nigel Tai 19 Acute Limb Ischaemia, 106 Matthew Button & Nigel Tai Part 2 Abdomen 5 Acute Appendicitis, 29 Part 4 Soft Tissue Infection Tom Palser, David J. Humes & Adam Brooks 6 Colonic Diverticulosis, 34 20 Superficial Sepsis, Cutaneous Abscess and Necrotising David Luke & Douglas M. Bowley Fasciitis, 115 Conor D. Marron 7 Biliary Colic and Acute Cholecystitis, 40 Tom Palser & Mark Taylor 8 Perforated Peptic Ulcer, 43 Part 5 Urology A. Morris & Mark J. Midwinter 21 Emergency Urology, 127 9 Fulminant Colitis, 46 Thomas J. Walton & Gurminder S. Mann Deborah Nicol & Richard L. Wolverson 10 Mesenteric Ischaemia, 50 Justin Manley & Tracy R. Bilski Part 6 Trauma 11 Acute Upper Gastrointestinal Haemorrhage, 56 22 Abdominal Trauma: Evaluation and Decision John S. Hammond Making, 139 12 Lower Gastrointestinal Bleeding, 61 Lesly A. Dossett & Bryan A. Cotton J. Alastair D. Simpson 23 Thoracic Trauma: Evaluation and Decision 13 Acute Pancreatitis, 67 Making, 145 Euan J. Dickson, Colin J. McKay & C. Ross Carter Stella R. Smith, Thomas Konig¨ & Nigel Tai v BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= Contents 24 Vascular Trauma, 153 Part 7 Critical Care Nigel Tai & Nora Brennan 29 Critical Care, 195 25 Damage Control Surgery, 161 Andrew McDonald Johnston Timothy C. Nunez, Igor V. Voskresensky & Bryan A. Cotton 30 Postoperative Complications, 203 26 Trauma Laparotomy, 169 Abeed Chowdhury & Adam Brooks Victor Zaydfudim & Bryan A. Cotton 27 Operative Management of Thoracic Trauma, 180 Thomas Konig¨ & Nigel Tai Index, 213 28 Abdominal Trauma: Operative and Non-Operative Management, 185 Roland A. Hernandez,´ Aviram M. Giladi & Bryan A. Cotton vi BLBK236-FM BLBK236-Brooks Trim: 219mm × 276mm February 8, 2010 21:30 Char Count= List of Contributors Ian Beckingham Abeed Chowdhury Roland A. Hernandez´ HPB and Laparoscopic Surgeon Department of Surgery Medical Student Queens Medical Centre Queen’s Medical Centre University of Michigan Nottingham University Medical School Nottingham, UK Medical School Nottingham, UK Ann Arbor, MI, USA Bryan A. Cotton David J. Humes Tracy R. Bilski Department of Surgery and the Center for Lecturer in Surgery Assistant Professor Translational Injury Research QMC Campus Mary Washington Hospital The University of Texas Health Science Center University of Nottingham Fredericksburg Houston, TX, USA VA, USA Nottingham, UK Andrew McDonald Johnston Douglas M. Bowley Ross Davenport Trauma Research Fellow Specialist Registrar in Respiratory and Intensive Consultant Surgeon Trauma Clinical Academic Unit Care Medicine Heart of England NHS Royal London Hospital Department of Military Medicine Foundation Trust London, UK Royal Centre for Defence Medicine Senior Lecturer Birmingham, UK Royal Centre for Defence Medicine Birmingham, UK Euan J. Dickson Thomas Konig¨ West of Scotland Pancreatic Unit Specialist Registrar in General Surgery Nora Brennan Glasgow Royal Infirmary Defence Medical Services Specialist Registrar in Emergency