Index

Abdominal aortic aneurysm (AAA) necrosis , 141 demographics and natural history , 77 presentation , 139–140 elective AAA repair , 79–80 severe acute pancreatitis , 141 EVAR , 80 severity, evaluation of , 139–141 imaging and surveillance , 77–78 Acute pelvic pain indications , 78–79 bladder , 320 infl ammatory aneurysms , 80–81 cervix/uterus preoperative considerations , 79 clinical diagnosis , 320 ruptured AAA repair , 79 dysmenorrhea , 321 Abdominal ultrasound , 292 endometritis , 321 Abdominal wall defects leiomyomata , 321 anatomy , 233 uterine perforation , 320–321 enterotomy , 237 fallopian tube , 321 history , 233 ovary imaging and preoperative workup , 233, 235 endometriosis , 321–322 mesh infection , 236 Mittelschmerz , 321 operative repair ovarian torsion , 321 laparoscopic approach , 236 PID/TOA , 321 nonsynthetic/natural tissue mesh , 236 ruptured ovarian cyst , 322 polypropylene mesh , 235 treatment algorithm , 319, 320 PTFE , 236 vagina synthetic mesh products , 235 diagnosis , 319 physical examination , 233 foreign bodies , 320 seromas , 236 laceration , 319 types , 233, 234 vaginal cuff dehiscence , 320 Abdominoperineal resection (APR) vulva , 319 anal cancer , 199 Acute respiratory distress syndrome (ARDS) , 347 low anterior resection , 195 Acute tubular necrosis (ATN) , 241, 337, 339 Achalasia , 129 Adnexal masses Acral lentiginous melanoma , 266 differential diagnosis , 323, 324 Actinomyces , 272 management of , 323, 324 Acute cold leg prevalence , 323 decision making , 71–72 radiographic modality , 323 history , 71 treatment algorithm , 323, 325 physical examination , 71 ultrasound features , 323, 324 Acute failure , 243 Alcoholic liver disease , 244 Acute pancreatitis Alpha fetoprotein (AFP) , 284 edematous changes , 142 American Society for Radiation Oncology (ASTRO) , 262 ERCP , 142 American College of Surgeons Oncology Group , 255 fl uid collection , 142 American Society of Breast Surgeons , 256 mild acute pancreatitis , 139, 141 American urological association (AUA) , 305

T.J. Saclarides et al. (eds.), Common Surgical Diseases: An Algorithmic Approach to Problem Solving, 363 DOI 10.1007/978-1-4939-1565-1, © Springer New York 2015 364 Index

Anal adenocarcinoma , 200 initial management , 49 Anal cancer positive fl uid and solid organ injury , 50 anatomy , 197, 198 positive fl uid without solid organ injury , 50 APR , 199 Bowen’s disease , 199 Bowen’s disease , 199 Branchial cleft cysts , 271 diagnosis , 197, 199 Breast cancer inguinal lymph nodes , 199 algorithm , 263, 264 location , 199 BRCA1 and BRCA2 genes , 263 lymphoma , 200 BRCA3 gene , 263 melanoma , 200 clinical and pathologic characteristics , 263 Paget’s disease , 200 recurrence rate , 264 signs and symptoms , 197 risk factors , 264 staging , 199 Breast conserving therapy (BCT) , 262 treatment algorithm , 197, 198 Breast Imaging-Reporting and Data System (BI-RADS) , Anemia , 351 249, 253, 254 Angiotensin-converting enzyme (ACE) inhibitors , 338 Bright red blood per (BRBPR) , 205–206 Anorectal pain Budd-Chiari syndrome , 245 anal fi ssure , 201 Burn injuries anorectal infection , 202–203 primary survey hemorrhoids , 203 airway , 61 history and physical examination , 201, 202 breathing , 61 LAS , 201–202 circulation , 61 Anticoagulants secondary survey , 62–63 dabigatran , 13–15 treatment algorithm , 62 procedural bleeding risks , 13 thrombosis risks , 12–13 Carcinoid disease warfarin , 13 appendiceal carcinoids , 227 Appendiceal carcinoids , 227 diagnosis and treatment , 225, 226 Appendicitis gastric carcinoids , 225–226 diagnosis , 169–170 metastatic disease history and physical exam , 169 carcinoid heart disease , 228 management , 170–171 carcinoid syndrome , 228 Attenuated familial adenomatous polyposis (AFAP) , 190 hepatic involvement , 227 Axillary lymph node dissection (ALND) , 255, 256, 262 pulmonary carcinoid tumors , 225 rectal carcinoids , 227 Basal cell carcinoma serotonin and 5-HTP , 225 lymphoma , 200 small bowel carcinoids , 226–227 Paget’s disease , 200 Cardiac tamponade , 42, 355 Benign neoplasms , 273 Carotid bruit Benign prostatic hypertrophy (BPH) , 305 background , 17 Bilateral spontaneous discharge , 259 carotid artery stenting , 18 Bladder carotid endarterectomy , 17–18 differential diagnosis and management , 56 evaluation , 17 urologic imaging , 55 medical management , 17 Bleeding post-operative management , 18 causes , 7 Cat scratch disease , 273 lower gastrointestinal hemorrhage , 185–186 Cervix pelvic fractures , 51–52 clinical diagnosis , 320 preoperative evaluation dysmenorrhea , 321 antiplatelet agents , 7 endometritis , 321 coagulation factor defects , 9–10 leiomyomata , 321 disseminated intravascular coagulation , 9 uterine perforation , 320–321 herbs and compounds , 8 Chest pain medications , 7–8 cardiac etiology , 343–344 patient’s family history , 7 defi nition , 343, 344 platelet dysfunction , 9 gastrointestinal causes , 344–345 Blood pressure (BP) , 355 patient evaluation , 343 Blunt abdominal trauma patient history , 343 FAST examination , 49–50 pulmonary , 344 Index 365

vascular disorders , 345 Crohn’s disease vital signs , 345 diagnosis , 161–162 Chlamydia trachomatis , 327 manifestations , 161 Cholelithiasis medical treatment , 162 asymptomatic cholelithiasis , 209, 210 , 162–163 symptomatic cholelithiasis Cushing’s syndrome acute cholecystitis , 209–210 ACTH-dependent cause , 96 biliary pancreatitis , 211 diagnosis , 95–96 chronic cholecystitis , 211 inferior petrosal sinus sampling , 96 duct stones , 210–211 signs and symptoms , 95 gallstone ileus , 211 treatment , 97 Cholestatic diseases , 244 Chronic kidney disease (CKD). See Renal transplantation Dabigatran , 13–15 Chronic lower extremity ischemia DCIS. See Ductal carcinoma in situ (DCIS) angiography , 68–69 Deep venous thrombosis (DVT) prophylaxis critical limb ischemia , 67 chemical VTE prophylaxis , 20–21 functional limb ischemia , 67 contraindications , 21–22 history , 67 regimens , 20 interventions , 69 risk assessment , 19–20 medical management , 69–70 treatment algorithm , 21 noninvasive diagnostic studies , 67–68 Delayed , 210 physical exam , 67 Diabetic ketoacidosis (DKA) , 337 treatment algorithm , 68 Dialysis Chronic obstructive pulmonary disease (COPD) , 343, 352 access planning , 82–83 Chronic pancreatitis hemodialysis Beger procedure , 144 autogenous primary fi stula , 85 complications , 145 autogenous secondary fi stulas , 85 diagnosis , 143–144 non-autogenous grafts , 85–86 etiology and pathogenesis , 143 permanent catheters , 85 fi brotic gland , 145 preoperative assessment , 83–84 Frey procedure , 145 incidence , 82 localized infl ammatory process , 145 indications , 82 modifi ed , 144 pancreatic leak and pleural fi stulas , 145 catheter insertion techniques , 86–87 presentation and physical examination , 143 complications and management , 87 pseudocysts , 144 pediatric considerations , 87 puestow procedure , 145 preoperative assessment , 86 Clostridium diffi cile , 342 Diaphyseal fractures , 59 Colon cancer Diffi cult airway management postoperative period , 183 algorithm , 35 preoperative assessment , 182 cricothyrotomy , 34 screening , 181–182 defi nition , 33 surgical resection , 182–183 elective tracheostomy , 36 Colorectal cancer emergent tracheostomy , 34 AFAP , 190 Mallampati classifi cation , 33, 34 familial colorectal cancer , 191 noninvasive airway techniques , 33 FAP , 189–190 patient history , 33 Gardner’s syndrome , 191 urgent tracheostomy , 36 HCRCS, 189 videolaryngoscopy , 34 HNPCC , 191 Disseminated intravascular coagulation (DIC) , 9 Juvenile polyposis syndrome , 191 Diverticulitis MAP , 190 background , 173 Peutz-Jegher’s syndrome , 191 differential diagnosis , 173 Turcot’s syndrome , 191 fi stula , 174–175 Compartment syndrome , 57 initial evaluation , 173 Congenital neck masses , 271 mild diverticulitis , 173 Continuous positive airway pressure (CPAP) , 348 moderate to severe diverticulitis , 174 Costovertebral angle (CVA) , 306 percutaneous abscess drainage , 175 Cricothyrotomy , 34 peritonitis , 173–174 Critical limb ischemia , 67 timing of surgery , 175 366 Index

Ductal carcinoma in situ (DCIS) , 279 ALND , 262 Gastric carcinoids , 225–226 DCIS subtypes , 261 Gastrinoma diagnosis , 261 background , 111 follow-up mammography , 262 diagnosis , 111 mastectomy , 261–262 localization , 111–112 risk factors , 261 medical management , 112 SLN biopsy , 262 presentation , 111 treatment algorithm , 262 surgical treatment , 112–113 Duhamel procedure , 297 Gastroesophageal refl ux disease (GERD) , 343 Dysphagia evaluation and initial management , 137 barium swallow study , 129 incidence , 137 cancer , 131 patient presentation , 137 diverticula , 129–130 surgical management , 137–138 gastroesophageal refl ux , 131 Gastrointestinal (GI) tract , 283 history and physical exam , 129 Genitourinary (GU) tract , 283 obstruction , 130–131 Glanzmann thrombasthenia , 9 primary motility disorders , 129 Gonadotropin-releasing hormone (GnRH) , 322 Graves disease , 101 Electrocardiographic (ECG) , 73–74 Gustilo-Anderson classifi cation system , 58 Endometriosis , 321, 322 Endometritis , 321 HD. See Hirschsprung’s disease (HD) Endoscopic (ERCP) , 214 Head trauma Endoscopic retrograde cholangiopancreatography air sinus fractures , 31 (ERCP) , 211, 281 blunt head trauma , 30 Endoscopic therapy , 223 CSF fi stula , 31 Endoscopic ultrasound (EUS) , 210, 214 laboratory evaluation , 29 Endovascular AAA repair (EVAR) , 80 neurological evaluation , 29 Esophageal atresia (EA) nonoperative management , 31–32 clinical presentation , 287 penetrating injuries , 30 complications , 289 radiographic evaluation , 29 diagnosis , 287 skull base fractures , 31 medical management , 287–288 skull fractures , 31 outcomes , 289 surgical management , 30–31 surgical management , 288–289 treatment algorithm , 32 treatment algorithm , 287, 288 Helicobacter pylori . See Peptic ulcer disease (PUD) VACTERL association , 287 Hemangiomas , 271 Esophageal cancer Hematuria diagnosis , 133 cystoscopy , 306, 307 epidemiology , 133 cytology , 306 patient follow-up , 135 diagnostic evaluation , 305, 306 presentation , 133 differential diagnosis and management , 55–56 surgical resection , 135 history , 53, 305–306 TNM stages , 133, 134 imaging studies , 306–307 treatment , 133, 135 lab tests , 53 Extremity fractures non-traumatic hematuria workup , 305, 306 closed fractures , 59 physical examination , 53, 305–306 initial evaluation, 57 risk factors , 305, 306 open fractures , 57–59 urinalysis and urine dipstick , 306 urologic disease , 305 Familial adenomatous polyposis (FAP) , urologic imaging 189–190 bladder , 55 Familial hypocalciuric hypercalcemia (FHH) , 105 kidney , 54 test (FOBT) , 205 ureter , 54–55 Fine needle aspiration (FNA) , 92, 261 urethra , 55 Focal nodular hyperplasia (FNH) , 218 Hemorrhoids , 206–207 Focal segmental glomerulosclerosis (FSGS) , 239 Hemothorax , 42

Fraction of inspired oxygen (FIO2 ) , 347–348 Hepatobiliary iminodiacetic acid (HIDA) , 279 Fulminant hepatic failure (FHF) , 243 Hepatoblastoma (HB) , 284 Functional limb ischemia , 67 Hepatocellular carcinoma (HCC) , 219, 284 Index 367

Hereditary colorectal cancer syndrome (HCRCS) , 189 tension pneumothorax , 355 Hereditary nonpolyposis colon cancer (HNPCC) , 191 Hypoxemia , 351 . See Abdominal wall defects Hypoxia Herpes simplex virus type 1 (HSV-1) , 319 anemia , 351 High power fi eld (HPF) , 305 decreased blood circulation , 351 Hirschsprung’s disease (HD) hypoxemia , 351 clinical presentation , 295–296 increased oxygen affi nity , 352 complications , 297–298 pneumonia , 352 defi nition , 295 signs and symptoms , 352 diagnostic evaluation , 296–297 treatment , 353 dysganglionosis , 295 neural crest cells , 295 Implantable cardiac defi brillators (ICDs) , 5 operative therapy , 297 Incidentalomas pathologic characteristics , 295 hyperaldosteronism , 119 RET gene , 295 hypercortisolism , 119 HPS. See Hypertrophic pyloric stenosis (HPS) pheochromocytoma , 119–120 Human epidermal growth factor receptor 2 (HER2) , 256 Inferior petrosal sinus sampling (IPSS) , 96 Human immunodefi ciency virus (HIV) , 327 I n fl ammatory breast cancer , 257 Human leukocyte antigen (HLA) I n fl ammatory neck masses ABO blood group , 241 actinomyces , 272–273 crossmatch , 241 acute bacterial lymphadenitis , 272 matching , 241 cat scratch disease , 273 Hydrocele , 315 Ludwig’s angina , 272 5-hydroxytryptophan (5-HTP) , 225 scrofula , 273 Hyperaldosteronism , 119 sialadenitis , 273 Hypercalcemia viral reactive lymphadenopathy , 272 biology , 103 Inguinal hernia clinical presentation , 103 bilateral hernia , 230–231 elevated parathyroid hormone history , 229 familial hypocalciuric hypercalcemia , 105 persistent pain , 231 primary hyperparathyroidism , 105 physical examination , 229, 230 hypercalcemic crisis , 103–104 recurrent hernia , 229–230 laboratory investigations , 103 unilateral hernia , 229–231 suppressed parathyroid hormone , 105 Insulinoma Hypercortisolism , 119 diagnosis , 107 Hyperthyroidism incidence , 107 diagnosis , 100–101 laparoscopic management , 107 history , 98 localization , 107 physical examination malignancy and metastatic disease , 109 diffuse enlargement , 98 medical treatment , 108–109 nodular enlargement , 98 surgical treatment , 109 toxic adenomas (Plummer’s disease) , 99–100 Intussusception treatment diagnostic evaluation , 291–292 Graves disease , 101 incidence , 291 toxic adenoma , 102 intraluminal/intramural anatomic abnormality , 291 toxic multinodular goiter , 101 ischemia progresses , 291 Hypertrophic pyloric stenosis (HPS) nonoperative therapy clinical presentation , 277, 278 enema reduction , 293 etiology/pathophysiology , 277 hydrostatic reduction , 292–293 evaluation , 277 pneumatic reduction , 293 postoperative management , 278 radiographic reduction , 293 treatment , 277–278 operative therapy , 293 Hypoglycemia , 16 Peyer’s patch , 291 Hypotension recurrence risk , 293–294 cardiac tamponade , 355 treatment algorithm , 291, 292 decreased afterload BP , 356 Invasive breast cancer decreased preload BP , 355 ACOSOG Z-0011 trial , 256 evaluation , 355, 356 adjuvant therapy , 257 intrinsic pump failure , 356 ALND , 255, 256 laboratory assessment , 355 HER2 receptor , 256 368 Index

Invasive breast cancer (cont.) solid lesions incidence , 255 FNH , 218 infl ammatory disease , 257 HCC , 219 radiation , 256–257 hemangioma , 217–218 sentinel lymph node biopsy , 255 hepatic adenoma, 218–219 stages , 255, 257 symptoms , 217, 218 treatment algorithm , 255, 256 Ischemic bowel evaluation , 244, 245 acute mesenteric arterial occlusion , 157–158 indications chronic mesenteric ischemia , 159 alcoholic liver disease , 244 clinical presentation , 157 Budd-Chiari syndrome , 245 laboratory fi nding , 157 cholestatic diseases , 244 mesenteric venous thrombosis , 159 hepatitis B and hepatitis C virus , 245 nonocclusive mesenteric insuffi ciency , 158–159 malignant tumors , 244 metabolic diseases , 245 Jaundice NASH , 244 conjugated hyperbilirubinemia , 213 MELD score , 243 indirect and direct bilirubin , 213 UNOS system , 243 obstructive jaundice Liver tumors , 284 endobiliary stent placement , 215 Lower gastrointestinal hemorrhage evaluation , 214–215 bleeding pattern and severity , 185–186 head/uncinate process , 214 defi nition , 184 hepatic veno-occlusive disease , 214 initial assessment and resuscitation , 184–185 traumatic stricture , 214 stable patient treatment , 186–187 in pediatric patient surgery , 187 , 280–281 unstable patient treatment , 186 choledochal cyst , 281 Low molecular weight heparin (LMWH) , 353 direct hyperbilirubinemia , 279–280 Ludwig’s angina , 272 stone disease , 281 Lymphatic drainage , 273 treatment algorithm , 279, 280 Lymphatic malformation , 271 treatment algorithm , 213, 214 Lymphomas , 273 unconjugated hyperbilirubinemia , 213 Juvenile polyposis syndrome , 191 Magnetic resonance cholangiopancreatography (MRCP) , 210, 214 Magnetic resonance imaging (MRI) , 193 Kasai hepatoportoenterostomy, 280 Malignancy-associated hypercalcemia (MAH) , 105 Kidney Malignant pediatric liver lesions differential diagnosis and management , 55 hepatoblastoma (HB) , 284 urologic imaging , 54 hepatocellular carcinoma (HCC) , 284 Kidney paired donation (KPD) , 239 Mallampati classifi cation , 33, 34 Killian’s triangle, 130 Mammography , 249, 251 biopsy , 253–254 Large bowel obstruction defi nitive surgery , 254 diagnostic imaging , 178–179 diagnostic modalities , 253 history and physical exam , 177 MRI , 253 left-sided obstruction management, 179 screening , 253, 254 peritonitis , 177 Medication management pseudo-obstruction , 179 anticoagulants resuscitation , 177 dabigatran , 13–15 right-sided obstruction management , 179 procedural bleeding risks , 13 Leiomyomata , 321 thrombosis risks , 12–13 Lentigo maligna melanomas , 266 warfarin , 13 Levator ani syndrome (LAS) , 201–202 beta blockers , 12 Liver function tests (LFT) , 213 diabetes Liver mass diet , 15 computed tomography , 217 oral hypoglycemic agents/noninsulin injectables , 15–16 cystic lesion , 219–220 preoperative evaluation , 15 history and physical examination , 217 type 1/insulin-dependent type 2 diabetes , 16 image-guided fi ne needle aspiration , 217 hypoglycemia , 16 magnetic resonance imaging , 217 nonsteroidal anti-infl ammatory drugs , 11–12 metastatic lesions , 220 principles , 11 Index 369

Melanoma diagnosis , 358–359 acral lentiginous , 266 imaging techniques , 358 biopsy , 265 LRINEC score , 358 clinical presentation , 265, 266 monomicrobial infections , 357 epidemiology , 265 polymicrobial infections , 357 lentigo maligna , 266 treatment algorithm , 357, 358 nodular melanoma , 266 Neisseria gonorrhoeae , 327, 329 pathology report , 265 Nipple discharge physical examination , 266 bilateral spontaneous discharge , 259 prognostic factor , 265 history , 259 SNLB , 267 nonspontaneous discharge , 260 superfi cial spreading melanoma , 266 physical examination , 259 treatment , 266–267 systemic approach , 259, 260 Mesenteric ischemia. See Ischemic bowel unilateral spontaneous discharge , 259–260 Metastatic disease Nodular melanomas , 266 carcinoid heart disease , 228 Nonalcoholic steatotic hepatitis (NASH) , 244 Carcinoid syndrome , 228 Noncardiac surgery hepatic involvement , 227 diagnostics , 4 Model for end-stage liver disease (MELS) score , 243 elective surgery , 3 Multicenter selective lymphadenectomy trial emergency surgery , 3 (MSLT-1) , 267 operation, day of , 5 Multinodular toxic goiters (MNGs) , 98 preoperative optimization , 4–5 Multiple organ dysfunction syndrome (MODS) , 361 risk factor , 3–4 MYH-associated polyposis (MAP) , 190 urgent surgery , 3 Myocardial infarction , 343 Nonspontaneous nipple discharge , 260 diagnosis , 73–74 Nonsteroidal anti-infl ammatory drugs (NSAIDS) fi brinolytics , 75 and ACE inhibitors , 338 immediate therapy , 74–75 medication management , 11–12 PCI , 75–76 Nutcracker , 129 prognosis , 76 Oliguria Nasopharyngeal carcinoma and melanoma , 273 defi nition , 337, 338 NEC. See Necrotizing enterocolitis (NEC) postrenal causes , 339 Neck mass prerenal causes congenital neck masses , 271 abnormal vital signs , 337–338 history and physical exam , 271, 272 ACE inhibitors , 338 infl ammatory neck masses assessment , 337 actinomyces , 272 cardiac dysfunction , 338 acute bacterial lymphadenitis , 272 DKA/nonketotic hyperosmolar states , 337 cat scratch disease , 273 initial evaluation , 337 Ludwig’s angina , 272 invasive monitoring and vasopressor , 338 scrofula , 273 isotonic fl uid replacement , 337 sialadenitis , 273 laboratory tests , 337 viral reactive lymphadenopathy , 272 NSAIDS , 338 neoplastic neck masses , 273 Swan-Ganz catheter , 338 Necrotizing enterocolitis (NEC) treatment , 338 clinical presentation , 299 renal causes incidence , 299 acute interstitial nephritis and glomerulonephritis , 339 laboratory tests , 299 acute tubular necrosis , 339 medical management , 300 glomerular diseases , 339 occurrence , 299 laboratory studies , 338–339 outcomes , 301 Open pneumothorax , 41 pathophysiology , 299, 300 Ovarian tumors, 284–285 radiographic studies , 299–300 Ovary surgical management , 300–301 endometriosis , 321–322 Necrotizing soft tissue infections (NSTIs) Mittelschmerz , 321 adjuvant therapy , 359 ovarian torsion , 321 aggressive surgical debridement , 359 PID/TOA , 321 antibiotic therapy , 359 ruptured ovarian cyst , 322 clinical manifestations , 358 Oxygen affi nity , 352 370 Index

Paget’s disease , 200 Peptic ulcer disease (PUD) , 343 Palpable breast mass complicated patient , 154–155 diagnostic evaluation , 249 gastric outlet obstruction , 155 fi broad-enoma/cyst , 250, 251 incidence , 153 history , 249, 250 physical examination , 153 physical examination , 249 signs and symptoms , 153 postmenopausal age , 250, 251 uncomplicated patient , 153–154 premenopausal age , 250, 251 Peutz-Jegher’s syndrome , 191 Pancreatic cancer , 147 Pheochromocytoma , 119–120 diagnostic evaluation , 147–148 PID. See Pelvic infl ammatory disease (PID) epidemiology , 147 Platelet dysfunction , 9 history and physical exam , 147 Polytetrafl uoroethylene (PTFE) , 236 treatment , 148–149 Pediatric abdominal masses causes of , 221, 222 GI tract , 283 clinical manifestations , 221–223 GU tract , 283 defi nition , 221 history and physical examination , 283, 284 diagnosis , 221 liver tumors , 284 recurrent bleeding/chronic treatment , 223–224 neuroblastoma , 283–284 treatment ovarian tumors , 284–285 acute bleeding , 222–223 Wilms tumor , 284 ascites , 221–222 Pelvic fractures encephalopathy , 222 bleeding , 51–52 venous collaterals , 221, 222 fracture classifi cation , 51 Positive end-expiratory pressure (PEEP) , 347–348 initial management , 51 Positron emission tomography (PET) , 194 Pelvic infl ammatory disease (PID) , 321 Postoperative fever diagnosis , 327 acute period , 341–342 differential diagnosis , 327 defi nition , 342 incidence , 327 delayed period , 342 intravenous antibiotic therapy , 328 immediate period , 341 outpatient therapy , 328–329 subacute period , 342 polymicrobial disorder , 327 treatment algorithm , 341, 342 risk factors , 327 5 Ws , 341 treatment algorithm , 327, 328 Posttransplant lymphoproliferative disorder (PTLD) , 242 triage , 327 Primary biliary cirrhosis (PBC) , 244 Penetrating abdominal trauma Primary peritoneal drainage , 301 anterior abdominal injury , 46–47 Primary sclerosing cholangitis (PSC) , 244 back/fl ank injury , 47 Pulmonary carcinoid tumors , 225 hemodynamically stable patients , 45 Pulmonary embolism (PE) hemodynamically unstable patients , 45 anticoagulation , 353 operating room , 47 DVT , 352 primary survey , 45 Homan’s sign , 352 secondary survey , 45 indications , 353 thoracoabdominal injury , 47 mechanical thrombectomy , 353 Penetrating chest trauma oxygen saturation and serum bicarbonate level , 353 cardiac tamponade , 42 Pulmonary embolus (PE) , 344 hemothorax , 42 , 277–278 open pneumothorax , 41 resuscitative thoracotomy , 42–43 Ranson’s criteria , 139, 140 secondary survey , 43 Rapid-shallow breathing index (RSBI) , 348–349 tension pneumothorax , 41 Rectal bleeding tracheobronchial injury , 41 , 205 Penetrating neck trauma FOBT , 205 angiogram , 39 hemorrhoids , 206–207 anterior triangle , 37–38 , 205 evaluation , 37 , 206 explore wound , 37 treatment algorithm , 205, 206 mortality , 37 Rectal cancer unstable patient , 37 clinical staging , 193–194 vascular and esophageal injuries , 39 endorectal stents , 195 Index 371

epidemiology , 193 SIRS. See Systemic infl ammatory response FOLFOX , 194 syndrome (SIRS) history and physical examination , 193, 194 Small bowel carcinoids , 226–227 LAR and APR , 195 Small bowel obstruction patient factors , 195 etiology , 151 tumor location and features , 195 initial evaluation , 151 workup evaluation , 193 nonoperative management , 151 Rectal carcinoids , 227 operative management , 152 Red blood cells (RBCs) , 305 Soave procedure , 297 Renal transplantation Society of surgical oncology (SSO) , 262 acute rejection , 242 Solitary pulmonary nodules (SPN) algorithm , 239, 240 biopsy and surgery , 269–270 cadaveric donors , 239, 241 differential diagnosis , 269 chronic rejection , 242 Fleischner criteria , 269 complications , 239, 241 high-risk characteristics , 269 contraindications , 241 low-risk characteristics , 269 etiology , 239, 241 treatment algorithm , 269, 270 hemodialysis/peritoneal dialysis , 239 video-assisted thoracoscopic surgery (VATS) , history and physical examination , 239 269–270 HLA matching and crossmatch , 241 Spontaneous breathing trial (SBT) , 348 hyperacute rejection , 242 Squamous cell carcinoma (SCC) immunosuppression , 242 APR , 199 infections and malignancy , 242 inguinal lymph nodes , 199 KPD , 239 location , 199 living donors , 239 staging , 199 pretransplant testing and management. , 239, 241 Superfi cial spreading melanoma , 266 SLE , 239 Surgical hypertension treatment , 242 aorta coarctation , 115–116 Resuscitative thoracotomy , 42–43 pheochromocytoma , 117 primary hyperaldosteronism , 116–117 Sclerotherapy , 223 renal renovascular disease , 115 Scrofula , 273 signs and symptoms , 115 Scrotum Surviving Sepsis Campaign (SSC) , 362 differential diagnosis , 313 Swenson procedure , 297 epididymitis and orchitis , 314 Systemic infl ammatory response syndrome (SIRS) Fournier’s gangrene , 315 acute lung injury , 362 history and physical examination , 313, 314 acute respiratory distress syndrome , 362 hydroceles , 315 broad-spectrum antibiotics , 362 incarcerated inguinal hernia , 315 clinical presentation , 361 laboratory tests , 313 colloid/crystalloid fl uids , 362 radiography , 313 diagnosis , 361–362 testicular torsion , 315 operative therapy , 362 varicocele , 315 resuscitation , 362 Sentinel lymph node (SLN) , 262 treatment algorithm , 361, 362 Sentinel lymph node biopsy (SNLB) , 267 vasopressors , 362 Sepsis acute lung injury , 362 Technetium-labeled dye (Tc-99) , 267 acute respiratory distress syndrome , 362 Tension pneumothorax , 41, 355 broad-spectrum antibiotics , 362 Testicular mass clinical presentation , 361 cancer , 310–311 colloid/crystalloid fl uids , 362 differential diagnosis , 309, 310 defi nition , 361 history , 309 diagnosis , 361–362 orchiectomy , 310 operative therapy , 362 physical examination , 309 resuscitation , 362 ultrasound evaluation , 309–310 treatment algorithm , 361, 362 The Laboratory Risk Indicator for Necrotizing Fasciitis vasopressors , 362 (LRINEC) score, 358 Sexually transmitted infections (STI) , 319 Thyroglossal duct cysts , 271 Sialadenitis , 273 Thyroid , 273 Sigmoidoscopy , 206 Thyroid malignancies , 93 372 Index

Thyroid nodules Mallory-Weiss tear , 127 evaluation , 91, 92 neoplasms , 127 fi ne-needle aspiration , 92 treatment algorithm , 126 investigation , 91–92 vascular malformations , 127 prevalence , 91 visceral arterial aneurysms and pseudoaneurysms , 128 treatment , 92–93 Ureter Total parental nutrition (TPN) , 287 differential diagnosis and management , 55–56 Toxic adenoma , 102 urologic imaging , 54–55 Toxic multinodular goiter , 101 Urethra Tracheobronchial injury , 41 differential diagnosis and management , 56 Tracheoesophageal fi stula (TEF). See Esophageal atresia (EA) urologic imaging , 55 Transanal endoscopic microsurgery (TEM) , 195 Urgent cholecystectomy , 210 Transjugular intrahepatic portocaval shunt (TIPS) , 223 Urinary tract infections (UTIs) , 279, 320 Transrectal ultrasound (TRUS) , 193–194 Uterine perforation , 320, 321 Trauma Uterus blunt abdominal trauma (see Blunt abdominal trauma) clinical diagnosis , 320 diffi cult airway (see Diffi cult airway management) dysmenorrhea , 321 head trauma (see Head trauma) endometritis , 321 hematuria , 53–56 leiomyomata , 321 initial assessment and resuscitation uterine perforation , 320–321 adjuncts , 28 breathing , 25–27 Vagina circulation , 27 diagnosis , 319 disability , 27 foreign bodies , 320 exposure , 27 laceration , 319 patient airway , 25 vaginal cuff dehiscence , 320 preparations , 25 Varicocele , 315 secondary survey , 28 Venous thromboembolism (VTE) pelvic trauma , 51–52 complications , 19 penetrating abdominal trauma (see Penetrating abdominal incidence , 19 trauma) patient’s risk factor , 19 penetrating chest trauma (see Penetrating chest trauma) risk assessment , 21 penetrating neck trauma (see Penetrating neck trauma) Ventilator management Tubo-ovarian abscess (TOA) , 321 CPAP , 348 defi ntion , 347

Ulcerative colitis FIO2 , 347–348 clinical presentation , 165 indications , 347, 348 diagnosis , 165–166 PEEP , 347–348 treatment , 166–167 respiratory failure , 347 Unfractionated heparin (UFH) , 5 RSBI , 348–349 Unilateral spontaneous discharge, 259–260 VicrylT mesh , 236 United Network for Organ Sharing (UNOS) , 243 Video-assisted thoracoscopic surgery (VATS) , 269–270 Upper gastrointestinal hemorrhage Videolaryngoscopy , 34 aortoduodenal fi stula , 128 Von Willebrand disease (VWD) , 9 duodenal diverticula , 127 duodenal ulcer , 127 Waardenburg syndrome , 296 esophageal varices , 125 Warfarin , 13 esophagitis , 127 Wilms tumor , 284 gastric ulcer , 127 Women’s Health Initiative Study , 255 gastritis and duodenitis , 127 hemobilia and hemosuccus pancreaticus , 128 Zenker’s diverticula , 129