Index

A acquired viral infections and, peritonsillar, 182 AAA. See Abdominal aortic 405 splenic enlargement and, 420 aneurysm body position and, 381 tubo-ovarian, 399 AAN. See American Academy cases of, 375–376 ACAS. See Asymptomatic of Neurosurgery classification of, 378–381 Carotid Atherosclerosis ABCDE mnemonic, melanoma diagnosing, 381–382 Study and, 534 disease processes with, 378 ACC/AHA. See American ABC principle. See Airway, evaluation and management College of Cardiology/ Breathing, Circulation of, algorithm for, 387 American Heart principle location of, 381 Association guideline Abdomen nonsurgical causes of, Accelerated vascular rejection, evaluation of, 556–557 404–406 kidney transplantation FAST and, 557 pathogenesis of, algorithm and, 712 Abdominal aortic aneurysm for, 379 ACE inhibitors. See (AAA), 426–427 of uncertain cause, 404 Angiotensin-converting algorithm for, 428 Abdominal sepsis, antibiotics enzyme inhibitors case study of, 431 for, 106 Acetabular wall fractures, 609 preoperative risk assessment Abdominal somatic pain, 380 Achalasia, 225–227 of, 430–431 Abdominal system-specific Achilles tendon, rupture of, surgical approach and, symptoms, pain and, 382 615, 616 430–431 Abdominal trauma Acid-base abnormalities, 62, 76 Abdominal distention, neonate diagnostic evaluation alkalinizing solutions for, 74 and, 648 methods for, comparison components of, 77 Abdominal examination, lower of, 681–682 Acid-base balance, 75 extremity swelling and, evaluation of, methods of, Acid-base status, surgery and, 512 557 80 Abdominal masses, 409–425, Abdominal wall hernias, Acidifying solutions, 75 424 494–496 Acidosis, renal failure and, 96 anatomic classification for, ABI. See Ankle brachial index Acid perfusion test, 209 411 Abscesses, 482. See also Amebic Acid reflux, peptic strictures cases referencing, 409–410 abscess; Anorectal and, 231 classification systems for, 410 abscess; Aortic root ACLS. See Advanced Cardiac etiologic classification for, 411 abscess Life Support vascular, 426–431 breast, 347 Acne, 326 workup of, algorithm for, 482 classified by location, 471 Acquired cysts, 415–416 Abdominal pain, 375–407. See draining of, 476 Acquired disease of heart also Abdominal somatic fungal, 416 valves, 265 pain liver mass and, 416 symptoms of, 265

757 758 Index

Acquired viral infections, Acute surgical abdomen, 377, Airway, Breathing, Circulation abdominal pain and, 405 389–404 (ABC) principle, 83, 136 Acral-lentiginous melanoma, Acute tubular necrosis (ATN) ATLS course and, 551 536 cadaveric donor and, 708 hemodynamically stable Acromioclavicular (AC) joint, causes of, 97 patient and, 137 injury to, 603 kidney transplantation and, trauma care and, 623 ACTH. See Plasma 713 AJCC. See American Joint adrenocorticotropic Acute variceal bleeding, 366 Committee on Cancer hormone Adenocarcinomas, 244 staging system Actinic keratoses, SCC and, esophagus and, 210 Alcohol 530, 531 Adequate tissue perfusion, cadaver donor and, 743 Activated protein C, severe criteria for, 134 cancers and, 178 sepsis and, 134 ADH. See Antidiuretic trauma and, 559–560 Activated prothrombin time hormone Alcoholic cirrhotics, bleeding (aPTT), 13 Adjuvant therapy, lung cancer in, 366 UFH and, 519 and, 255 Aldosterone suppression Acute appendicitis, CT scan of, Adnexal disease, pain and, test, Conn’s disease and, 391 382 329 Acute cellular rejection, Adrenal adenoma, Conn’s ALG. See Antilymphocyte kidney transplantation disease and, 330 globulin and, 715 Adrenal gland, Alkalinizing solutions, acid- Acute cholecystitis, 392–395, pheochromocytoma and, base abnormalities and, 394 330 74 CT scan of, 395 Adrenal vein sampling, Conn’s Alkalosis, 78 early v. delayed surgery in, disease and, 329 Alpha- and beta-blockade, 396–397, 440–441 Adult respiratory distress pheochromocytoma and, management of, 439 syndrome. See Acute 333 ultrasound of, 394 respiratory distress a-TNF. See Anti-a-tumor Acute deep vein thrombosis syndrome necrosis factor (DVT), chronic DVT v., Advanced Cardiac Life Support Altered neurologic status, 516 (ACLS), guidelines stroke and, 305 Acute dissection, CT of, 296 burn care and, 623 Alveolar-arterial (A-a) gradient, Acute diverticulitis, MODS and, 83 93 management for, Advanced Trauma Life Support Ambulatory 24-hour algorithm for, 457 (ATLS) esophageal pH Acute epididymitis, 697–698 course, ABC mnemonic and, monitoring, 209 Acute gastric dilation, 400 551 Amebic abscess, 416 Acute pancreatitis, 395 guidelines for, TBI and, 565 American Academy of Acute pericarditis, Adverse effect, intervention Neurosurgery (AAN) antiinflammatory agents and, 37 brain trauma and, 558 and, 302 AFP levels, testis cancer and, classification system for Acute pyelonephritis, 677–678 703 concussion, 559 flank pain and, 670 Afterload, 88 American Cancer Society, risk factors for, 678 Age, P Tx and, 721 screening mammogram Acute respiratory distress AIDS, abdominal pain and, 405 and, 348 syndrome (ARDS), 90 Air plethysmography (APG), American College of criteria for, 91 CVI and, 522 Cardiology/American fracture fixation and, 611 Airway. See also Advanced Heart Association Acute salpingitis, 399 Trauma Life Support (ACC/AHA) guideline, Acute scrotum, 694 burn patient and, 623 surgery and, 9 management of, 703 hemodynamically stable American College of Radiology Acute spinal cord transection, patient and, 137 Breast Imaging and neurogenic shock with, inhalation injury and, 626 Reporting Database 129 trauma and, 551 System (BIRADS), 349 Index 759

American Joint Committee lower gastrointestinal surgical site infections and, on Cancer (AJCC) bleeding and, 368 13, 15 staging system, 345, 346, stroke and, 311 vancomycin, 113 462 Angiosarcoma, 415 wounds and, 102, 112 M categories in, 346 Angiotensin-converting Anticholinergic therapy, sarcoma and, 543, 544 enzyme (ACE) hyperreflexia and, 663 T categories in, 346 inhibitors, kidney Anticoagulation therapy, 13. See Aminoglycosides, 113 transplantation and, 715 also Coumadin; Warfarin Amnionic fluid, neonate and, Ankle brachial index (ABI), emboli and, 685 649 503 Anticonvulsants, TBI and, 577 AMPLE mnemonic, trauma Ankle joint, anatomy of, 615 Antidiuretic hormone (ADH), and, 551, 552 Ankle sprains, 616 63 Amylase as marker, P Tx and, Anorectal abscess Antiinflammatory agents, acute 722 antibiotics and, 471 pericarditis and, 302 Anal canal, tumors of, 476, 477 surgical management of, Antilymphocyte globulin Anal fissure, 473–474 algorithm for, 472 (ALG), OLTX and, 737 Anastomosis. See also Primary undrained, complications of, Antimicrobial agents, activity anastomosis 472 of, 114–115 OLTX and, 746 Anoscopy, lower Antiplatelet therapy, stroke Anastrozole, breast cancer and, gastrointestinal bleeding and, 314 347 and, 368 Antireflux surgery, 221–222 Anesthesia Anterior dislocations of Antrectomy, peptic ulcer cancer examination and, 183 glenohumeral joint, disease and, 365 CEA and, 318, 319 602–603 Anus, anatomy of, 469 hernia and, 497 Anterior thoracotomy, cancer Aortic arch, contrast pheochromocytoma and, 333 staging and, 248 angiography and, 312 Aneurysm(s), 288–289. See also Anti-a-tumor necrosis factor (a- Aortic dissection, 289, 300 Visceral aneurysms TNF), Crohn’s disease Aortic insufficiency, 269–270, of carotid artery, 186 and, 451 275 gastrointestinal bleeding and, Antibiotic prophylaxis, 13, 99 Aortic root abscess, 360 clean contaminated surgery endocarditis and, 266 growth rates of, 429 and, 103, 105 Aortic stenosis, 269 Iliac, 386 secondary survey and, 555 triad of symptoms for, 269 imaging studies and, 428–429 Antibiotics. See also valve replacement and, 275 rupture, risk factors with, Cephalosporins; Aortic valve replacement, 277 430 Clindamycin; selected series of, 278, 279 surgical repair of, 429–430 Cyclosporine; Aortic valves, 265 of thoracic aorta, types of, Erythromycin; Flagyl; Aortoenteric fistula, 288 Penicillin gastrointestinal bleeding Aneurysmal disease of major abdominal pain and, 404 and, 360 arteries, 386 abdominal sepsis and, 106 APG. See Air plethysmography Angina pectoris, 286 acute epididymitis and, 698 Appendicitis, 389–391 elective surgery and, 6 anorectal abscess and, 471 Appendix epididymis, 679 Angiodysplasia, 371–372 contaminated surgery cases Appendix testis, 679 gastrointestinal bleeding and, and, 105–106 aPTT. See Activated 359 diarrhea and, 459 prothrombin time Angiography dirty surgery cases and, ARDS. See Acute respiratory AAA and, 428–429 106–107 distress syndrome abdominal masses and, 412 diverticulitis and, 456 Arsenic acute head injury and, glycopeptide, 113 sarcoma and, 541 572–573 open fractures and, 597 SCC and, 531 coarctation of aorta and, 330 OPSI and, 421 Arterial blood gas (ABG), congenital heart disease and, preoperative, 101–107 burns and, 626 261 pyelonephritis and, 677 Arterial duplex ultrasound, 505 760 Index

Arterial insufficiency, swelling Azathioprine Benign bile duct strictures, 443 and, 514 Crohn’s disease and, 451 Benign biliary obstruction, 437 Arterial vasculature, resistance OLTX and, 737 Benign breast disease, and, 88 Aztreonam, dirty cases and, 107 classification of, 340 Arteriography, gastrointestinal Benign dilatable strictures, 231 bleeding and, 364 B Benign diseases, colorectal, Arteriosclerotic renovascular Bacteremia, sepsis and, 125 471–476 hypertension, 684 Bacterial gastroenteritis, 378 Benign prostatic hyperplasia Arteriovenous malformations Bacterial infection, OLTX and, (BPH) (AVM) 748 differential diagnosis for, GI tract and, 371 Bactrim, cystitis and, 666 657–659 lower gastrointestinal Balloon angioplasty, carotid evaluation and treatment of, bleeding and, 367 stenosis with, 322 algorithm for, 658 Arthropathies, 590–592 Balloon distention tests, 209 LUTS and, 657 Ascending cholangitis, 395 congenital heart disease and, medical management drugs Ascending colon cancer, 464 262 for, 661 Aspirin Bandaging, lymphedema and, Benign stone disease, 435 mechanical valves and, 282 525 Beta blockers, ischemic heart peptic ulcer disease and, 365 Barbiturate coma, 583 disease and, 298 stroke and, 314 Barbiturates, ICP and, 583 Bicarbonate, buffer system and, Asymptomatic Carotid Barium enema 75 Atherosclerosis Study pneumaturia and, 667 Bilateral adrenal hyperplasia, (ACAS), stroke and, 312 sigmoid diverticulitis and, Conn’s disease and, 330 Atheroembolic events, carotid 393 Bile, neonate and, 648 artery and, 308 Barium esophagogram Biliary atresia, 444 Atherosclerosis, 287 esophageal motor disorders pediatric liver aneurysms and, 288 and, 229 transplantation, 751 ischemia and, 500 esophageal strictures and, Biliary disease, 210 stroke and, 308 231 Biliary obstruction, causes of, ATN. See Acute tubular necrosis Barium swallow, 210 443 Atresias, neonate intestinal achalasia and, 226 Biliary obstruction with normal obstruction and, 654–655 esophageal swallowing hepatocyte’s, 437 Atrial septal defect, 271 disorders and, 206 Biliary sepsis, 437 Atypical hyperplasia, 340, 341, Barret’s esophagus, 224–225 Bilirubin metabolism, 444 351 treatment of, medical v. jaundice classification and, future breast cancer and, 353 surgical, 220 434–435 lobular carcinoma in situ Barrier precaution, 107 Bimanual examination, oral and, 336 Basal cell carcinoma (BCC), cavity and, 183 Audit filter, alcohol and, 560 clinical subtypes of, Biochemical screening, SNS Autoimmune collagen vascular 529–530 and, 58–59 disease, abdominal pain Basal energy expenditure Bioethical principles and, 405 (BEE), 49 clinical decision making and, Autonomy, bioethics and, Base deficit, 75 149–158 152–153 Base excess, 75 summary of, 158 Avascular necrosis of femoral BCC. See Basal cell carcinoma Biofeedback, urinary head, hip dislocation Beck’s triad, 291 incontinence and, 663 and, 610 pericardial tamponade and, Biopsy. See also Core needle AVM. See Arteriovenous 126 biopsy; Vacuum assisted malformations Bed rest with elevation, CVI core biopsy; Wire Avulsion fracture, 592 and, 523 localized excisional Avulsion of biceps tendon, 604 BEE. See Basal energy biopsy Avulsions of quadriceps expenditure breast, 353 tendon, 612 Beneficence, bioethics and, techniques for, 338 Axillary dissection, 345 153–154 DCIS and, 349 Index 761

excisional, melanoma and, postoperative, 148 Body fluid(s) 535 P Tx and, 729 compartments, 64 full thickness questions addressed in, 137 electrolyte composition of, 62 melanoma and, 535 surgical, 136–148 Body water, distribution of, SCC and, 532 Bleeding time, coagulation and, normal, 66 incisional 143 Bone. See also Fracture(s) sarcoma and, 543 Bleomycin, testis cancer and, fracture patterns of, 593 skin lesions and, 529 702 gross anatomy of, 592–594 punch, skin lesions and, 529 Blindness, DM and, 720 metastases, sarcoma and, 543 skin lesions and, 180, 181, Blind segmental colectomy, 371 scan, cancer staging and, 248 529 Blood. See also Coagulation; Bone fracture. See Fracture(s) techniques, 184–185 Complete blood count Botulinum toxin, achalasia and, Biopsy prostate, serum PSA clotting, 12 227 and, 658 Blood-borne infection, 146 Bowel Biostatistical tests, 29, 30 Blood color, indications from, gastrointestinal bleeding and, Bipolar electrocoagulation 141 360 device, gastrointestinal Blood flow, lower extremity obstructed, vascular bleeding and, 362 and, 500 compromise of, 403 BIRADS. See American College Blood loss. See also Crystalloid Bowel sounds, intestinal of Radiology Breast infusion obstruction and, 401 Imaging and Reporting GI bleeding and, 373 Bowen’s disease (SCC in situ), Database System pelvis and, 610 SCC and, 532 B-lactam antibiotics, 112 Blood pressure. See also BPH. See Benign prostatic B-lactam ring, 112 Hypertension; hyperplasia Bladder Hypotension Brachial cleft cyst, 182 abnormalities of, 668 monitoring, thoracic aorta Brain, arterial anatomy of, 307 fistula on, 458 and, 300 Brain death Bladder drainage technique pheochromocytoma and, 333 cadaver donor and, 708, 743 enteral drainage technique v., Blood product infusion. See also criteria, 709 728 Crystalloid infusion TBI and, 585–586 P Tx and, 725, 727 hypovolemic shock and, 122 Brain Injury Foundation, head Bladder emptying. See Voiding pediatric patient and, 641 injury care and, 558 Bladder neck Blood products, 145, 146 Brainstem examination, 566–567 injection, hyperreflexia and, Blood tests BRCA gene, breast cancer and, 663 abdominal pain and, 384–385 352 operative suspension of, flank pain and, 689 Breast urinary incontinence Blood transfusions, 13, 136 abscess, 347 and, 663 bleeding and, 138 locally advanced breast Bladder perforation, hematuria hemorrhagic shock and, 356 cancer v., 336 and, 664 hypovolemic shock and, 122 common complaints about, Blalock-Taussig shunt, 262 secondary survey and, 555 337 Bleeding. See also Blood; surgical procedures and, 13, edema, 347, 348 Coagulation; 16 evaluation, surgeon and, 337 Diverticular bleeding Blood type, P Tx and, 721 pain, 337 colorectal malignancy and, Blood urea nitrogen (BUN), 97 reconstruction, 343 461 bleeding and, 145 secretions, 350 emergency management of, renal dysfunction and, 96 Breast cancer. See also algorithm for, 140 Blood volume Tamoxifen hemoptysis and, 236 age-based estimation of, 641 doxorubicin and, 347 minor, rectum and, 370 changes, CVI and, 522 early stage, 336, 341–347, 346 patient history and, 12–13, hypovolemic shock and, 122 locally advanced, 346 139 Bloody discharge. See also operable, inoperable v., 347 physical examination and, Nipple discharge van Nuys Prognostic Index 139 malignancy and, 350 and, 350 762 Index

Breast conservation, Burn care Angiosarcoma; Breast mastectomy v., 344, 345 initial approach to, algorithm cancer; Cancer Breast disease, 335–354 for, 622 screening; Carcinoma; pathologic classification of, language of, 623–624 Chemotherapy; Duke’s 341 principles of, 623 cancer staging system; Breast self exam (BSE), 339. See Burn centers Esophageal carcinomas; also Palpable breast mass admission criteria to, 628 Lymph node(s); Primary Breathing postburn period and, 627 tumor; Staging system; hemodynamically stable Thyroid cancer; Specific patient and, 137 C cancer types hemoptysis and, 236 CABG. See Coronary artery alcohol consumption and, trauma and, 551 bypass grafting 178–180 Breslow depth, melanoma and, Cadaveric donor(s). See also ampullary, 442 536 Kidney transplantation; anal, staging for, 476 Bright red blood per rectum Organ placement in colon polyp, 465 (BRBPR), 356 organization; Organ Duke’s cancer staging Bronchial artery embolization, transplantation; system, 462 hemoptysis and, 239–240 Pancreas transplant duodenal, 442 Bronchial lavage, hemoptysis alone; Pancreas follicular, 197 and, 239 transplantation gallbladder, 439 Bronchogenic carcinomas, 234 evaluation of, OLTX and, head, sites of, 189–197 Bronchoscopes, vocal cords 742–745 liver metastases and, 413 and, 183 kidney and, 710 rectum, 465 Bronchoscopy, cancer and, liver transplant, guidelines of sigmoid colon, 464 184 acceptability as, 744 splenic flexure, 464 Bruits, 328. See also Carotid organ allocations by, 707–709 testis, 694 bruit; Cervical bruit pancreas transplants, 721 TNM staging for, 702 audible, 503 demographics of, 724 transverse colon, 464 flank pain and, 687 duct management Cancer screening, 461 BSE. See Breast self exam technique in, 726 Carbonate apatite stones, 673 Buckle fracture, pediatric era of transplant of, Carcinoma fractures and, 600 outcome by, 724 of buccal mucosa, 190 Buffer system, 75 technical failures of, 730 Crohn’s disease and, 450 Bundle of His, 266 waiting list, transplantation in situ, polypectomy and, 465 BUN. See Blood urea nitrogen and, 707 Cardiac arrhythmias, flank pain Burn(s), 621–632. See also CAGE survey, alcohol and, 560 and, 687 Fourth-degree burns; Calcaneal fractures, 616 Cardiac catheterization, 298 Full excision; Calcified cysts, 416 chest pain and, 297–297 Hypertrophic scar; Calcinurin inhibitors, kidney congenital heart disease and, Third-degree burns; transplantation and, 715 261 Total body surface area Calcium, 147 valve surgery and, 273 depth, 623 acid-base abnormalities and, Cardiac death, cadaveric donor assessment of, 624 78 and, 708 emergency department and, urinary calculi and, 672 Cardiac events, risk 627–630 Calcium oxalate, urinary tract stratification parameters first degree, 623 calculus and, 672 for, 7 inhalation injury and, 624, Calcium oxalate stones, 672–673 Cardiac examination, valve 626 Canadian repair, inguinal surgery and, 272 size calculation of, 624 hernia and, 488 Cardiac murmur. See Heart wounds, 623, 624 Cancers. See also American murmur curreri formula and, 630 Cancer Society; Cardiac output, 88 donor autograft and, 629 American Joint dobutamine and, 90 escharotomy and, 629 Committee on Cancer Cardiac Risk Index System excision, 629 staging system; (CRIS), 8 Index 763

Cardiogenic shock, 127–129, Centers for Disease Control Chest. See also Episodic chest 287 (CDC), surgical wound pain intrinsic causes of, 126, 127 infection and, 110 examination, swollen leg treatment algorithm for, 127 Central herniation, 574 and, 512 Cardiomegaly, chest X-ray and, Central parenteral nutrition, 56, injuries, trauma and, 552 273 57 pain, 228 Cardiovascular evaluation, Central pontine demyelinating differential diagnosis for, perioperative, syndrome, serum 286 noncardiac surgery and, sodium level and, 71 initial evaluation for, 9 Central venous pressure (CVP), algorithm for, 285 Cardiovascular system, MODS 87 Chest radiograph, 16 and, 86, 87–90 Cephalosporins, 113 burns and, 626 Carotid angioplasty, stenting Cerebellar herniation, 574 cancer staging and, 248 and, 322 Cerebral contusions, 571 cardiomegaly and, 273 Carotid artery Cerebral edema, 573 chest pain and, 293 atheroembolic events and, Cerebral eschemia, 317 congenital heart disease and, 308 Cerebral perfusion pressure 261 contrast angiography and, (CPP) melanoma and, 536, 540 311–312 management, ICP and, neonate intestinal obstruction Carotid bifurcation, 583 and, 652 atherosclerotic disease TBI and, 573–574 tumor and, 250 at, 322 Cerebral vascular accident Chief complaint (CC), 165, 166 Carotid body tumor, 186 (CVA). See Stroke Child abuse Carotid bruit, hemoptysis and, Cerebrospinal fluid pediatric burn patient and, 236 drainage, TBI and, 587 630, 631 Carotid duplex exam, 322 fistulas, TBI and, 585 spiral fractures and, 592 Carotid endarterectomy (CEA). intracranial volume and, Child development, See also Carotid bruit; 582 physiologic changes in, Carotid stenosis Cerebrovascular disease 642 anesthesia technique and, cervical bruit and, 309 Children. See also Child abuse; 318, 319 stroke resulting from, 323 Infants; Pediatric stroke and, 314, 315, 317 Cervical bruit, cerebrovascular bronchoscopes; Pediatric technique of disease and, 309 burn patient; Pediatric death and, 320 Cervical lymph nodes, 182, 183 end-stage liver disease restenosis and, 320 Cervical mediastinoscopy, scores; Pediatric surgical Carotid stenosis, balloon tumor and, 250 patient angioplasty for, 322 Cervical spine caloric requirements in, 637 Catheters, blood loss and, facet joint dislocations and, congestive heart failure in, 357–358 618 258–260 CAT scan, chest pain and, 296, muscle strain injury to, 618 electrolyte requirements in, 297 Charcot’s triad, 436 640 CBC. See Complete blood count Chemical adrenalectomy, head injury in, 584 CBD stones. See Common bile Conn’s disease and, 330 hydrocele in, 698 duct stones Chemistry profile, chest pain OLTX for, 751 CC. See Chief complaint and, 295 protein requirements in, 637 CDC. See Centers for Disease Chemotherapy Child-Turcotte-Pugh (CTP) Control breast cancer and, 347 classification of CEA. See Carotid colorectal cancer and, 466 hepatocellular function endarterectomy esophageal carcinomas and, in cirrhosis, 740, 741 Cecal carcinoma, 390 213 Chimerism, OLTX and, 737 Cecal volvulus, 460 sarcoma and, 544 Chloramphenicol, 113 Cecum cancer, 464 SCLC and, 255 Chlorhexidine soap, hand Cefoxitin, dirty cases and, 106 seminoma and, 702 washing and, 108, 109 Cellcept, P Tx and, 730, 732 testis cancer and, 703 Cholangiocarcinoma, 443 764 Index

Cholecystectomy, 438 Clean operative cases, Colonic disease, 450 acute cholecystitis and, 394 antibiotics and, 102 Colonic diverticula, 455 CBD stones and, 439 Clindamycin, 113 Colonic hemorrhage. See also Cholecystitis, 435 Clinical guidelines. See Practice Lower gastrointestinal Choledochal cysts, 444 guidelines bleeding Cholelithiasis, 438, 439 Clinical outcomes, nutritional management for, 368 Choriocarcinoma, 700 support and, 43 Colonic perforation, 388 TNM staging for, 702 Clonidine suppression test, Colonoscopy Chromosomal defects, neonate pheochromocytoma and, angiodyspladia and, 372 and, 650 329 Crohn’s disease and, 450 Chronic constrictive Clopidogrel (Plavix), stroke diverticulosis and, 455 pericarditis, 291 and, 314 lower gastrointestinal Chronic fissure, 473–474 Closed head injury bleeding and, 368, 369 Chronic lymphedema, sarcoma surgical indications in, 577 pneumaturia and, 667 and, 541 treatment of, 574, 575, Colorectal atresias, neonate Chronic rejection. See also 576–584 and, 645 Organ transplantation Clostridium infection, 459 Colorectal cancer, 461 kidney transplantation and, enteral feeding and, 57 metastatic, therapy for, 466 716 CO2, buffer system and, 75 preoperative Chronic stable angina pectoris, Coagulation, 12–13. See also evaluation for, 463 286 Coumadin; Heparin; staging for, 463 Chronic urinary tract infection, Warfarin recurrences, therapy for, 466 stone formation and, 674 disorders, preoperative screening for, 461 Chronic venous insufficiency management of, 14 Colorectal obstruction, 403 (CVI), 521–524 phases of, 136–137, 138 Comminution fracture, 592 treatment for, 523–524 screening tests, abnormality Common bile duct (CBD) Cigarette smoking, 11. See also causes in, 144 stones, LFT and, 439 Tobacco Coagulation cascade activation, Communication, focused Circle of Willis, stroke and, 307, coagulation and, 137 surgical examination 308 Coagulopathy, hemoptysis and, and, 168 Circulation. See also Collateral 236 Compartment pressure, burn circulation Coarctation of aorta, 328, 330 wounds and, 629 hemodynamically stable vascular etiology of, 333 Compartment syndrome, 589, patient and, 137 Colitis, infectious colitides v., 597–599 Circulatory system. See also 459 tibial fractures and, 613 Circulation Collateral circulation, circle of Complete blood count (CBC), damage to, 589 Willis and, 308 13 Cirrhosis, 737 Colles’ fracture, 608 hemoptysis and, 237 gastrointestinal bleeding and, Colloid solutions, 145, 146 hemorrhagic shock and, 356 360 postburn period and, 627 preoperative, 143 of liver, 444 Colon, 446–477 Complex congenital heart Cisplatin. See Platinol anatomy of, 447–449 disease, 328 Clark classification of tumor arterial supply to, 448 Complex lesions, 260 depth, melanoma and, functions of, 448 Compliance, ventilatory modes 536, 538 posterior aspects of, 447 and, 92 Claudication, 501, 502. See also venous drainage of, 449 Complicated gastroesophageal Intermittent Colon cancer. See also reflux (GER), treatment claudications Ascending colon cancer; algorithm for, 219 management of, algorithm Bright red blood per Compound fractures, 595 for, 504 rectum Compound nevi, 533 Clavicular fractures, 603 algorithm for, 464 Compression, CVI and, 523 Clean contaminated surgery, natural history of, 463 Compression fractures, 592 103, 105 Colonic adenomatous polyps, Compression stockings, CVI wound closure and, 111 colon cancer and, 466 and, 523, 524 Index 765

Computed tomography (CT). Congenital Meckel’s Cranberry juice, urinary tract See also Head computed diverticulum of distal infection and, 676 tomography ileum, 392 Creatinine phosphokinase AAA and, 428–429 Congestive heart failure, 257, (CPK-MB) levels, heart abdominal masses and, 412 258–260 and, 288 acute appendicitis on, 391 differential diagnosis for, Cremasteric reflex, testis brain trauma and, 558 266–271 torsion and, 679 cancer staging and, 248, 250 lower extremity swelling CRIS. See Cardiac Risk Index cervical lymph nodes and, and, 512 System 184 Conjugated bilirubin, 434 Criterion validity, 26 of chest, sarcoma and, 543 Conn’s disease, 326, 329, 330 Crohn’s colitis, classification, head injury endocrine etiology of, 328 proctocolectomy with and, 569 Construct validity, 27 ileostomy and, 452 coarctation of aorta and, Contaminated surgery cases, Crohn’s disease, 372, 450–453 330 antibiotics and, 105–106 abdominal pain and, 405 Conn’s disease and, 329 Content validity, 26 management of, algorithm Cushing’s disease, 329 Continuous veno-veno for, 451 diverticulitis and, 455, 456 hemofiltration and medical therapy for, 450–453 epidural hematoma and, 570 dialysis (CVVHD), 97, 98 surgical treatment of, flank pain and, 691 Contraction, burn wounds and, indications for, 452 hematuria and, 664 631 Cryoprecipitate, 147 hemoptysis and, 237, 238 Contrast angiography, stroke hemorrhagic shock and, 356 pancreatic tumors and, 417 and, 311–312 Cryptorchidism, 694, 695, 700 pneumaturia and, 667 Contrast enema, neonate Crystalline arthropathy, 592 pseudoachalasia and, 227 intestinal obstruction Crystalloid infusion sarcoma and, 541 and, 653 hemorrhagic shock and, 356 sepsis and, 125 Contrast esophagogram, hypovolemic shock and, 122 solitary pulmonary nodules esophageal swallowing trauma and, 562 and, 242–243 disorders and, 205–206, Crystalloid solution, 145 stroke and, 311 206 secondary survey and, 555 TBI and, checklist for, 568 Contusion, hip and, 609 synthetic colloid v., 123 trauma patient and, 556 Core body temperature, volume replacement and, 138 traumatic flank pain and, postoperative infection CSA. See Cyclosporine 680 and, 109 CT. See Computed tomography tumor and, 250 Core needle biopsy, breast and, Curreri formula, burn wounds Concussion, 576 338 and, 630 classification of, 576 Corneal reflex, TBI and, 567 Cushing’s disease, 326, 330 grades of, 559 Coronary angiography, 297–298 endocrine etiology for, 329 Conduit, occlusive disease and, Coronary artery bypass CVA. See Stroke 506 grafting (CABG), 299, CVI. See Chronic venous Confidentiality, 157, 169 300. See also Graft(s) insufficiency Congenital cysts, 416 Cortisol secreting adrenal CVP. See Central venous Congenital diaphragmatic tumors, treatment of, pressure hernias, 497 330 CVVHD. See Continuous veno- Congenital heart disease Coumadin veno hemofiltration and classification of, 258 mechanical valves and, 282 dialysis physical examination and, P143T and Cyanosis, 257, 260 260, 261 COWS acronym, TBI and, 567 Cyclophosphamide, breast treatment of, 261–262 CPK-MB. See Creatinine cancer and, 347 Congenital hernias, 497 phosphokinase levels Cyclosporine (CSA), OLTX Congenital lesions, head and CPT. See Child-Turcotte-Pugh and, 751 neck, 185–186 classification of Cyst(s). See also Acquired cysts; Congenitally deformed hepatocellular function Congenital cysts bicuspid valve, 269 in cirrhosis breast, 335, 338, 415–416 766 Index

Cyst(s) (cont.) overview of, 719–720 lower gastrointestinal choledochal, 444 renal failure and, 706 bleeding and, 367 dermoid, 185 Diabetic Control and Diverticular outpouchings, epidermal inclusion, 180 Complications Trial acute surgical abdomen esophageal, 215 (DCCT), 720 and, 389 splenic enlargement and, 420 Diabetic ketoacidosis (DKA), Diverticulitis, 391–392 Cystic hygroma, 185 DM and, 720 Diverticulosis, 454–455 Cystic neoplasms, benign Diabetic nephropathy, voiding DKA. See Diabetic ketoacidosis cystadenomas and, and, 659 DM. See Diabetes mellitus 418 Diagnosis. See also Differential DNR orders. See Do-Not- Cystine stones, 673 diagnosis Resuscitate orders Cystinuria, 673 achieving, 33 Dobutamine Cystitis, 666 Diagnostic peritoneal lavage cardiac output and, 90 Cystogastrostomy, 418 (DPL), abdomen and, 556 shock state and, 133 Cystogram, hematuria and, 664 Diaphragmatic hernias, 498 Doll’s eyes. See Oculocephalic Cystoscopy Diarrhea testing abdominal masses and, 412 diagnosis and management Donor. See also Cadaveric bladder tumors and, 680 of, 470–471 donor(s) hematuria and, 664 inflammatory, 470 iliac conduit, 723 ulcerative colitis and, 453 liver, 745 D DIC. See Disseminated implantation of, 747 D5. See Dextrose intravascular uncontrolled, non-heart Daclizumab (DAC) coagulation beating, 709 islet cell transplant and, 733 Diet Donor autograft, burn wounds P Tx and, 730 abdominal pain and, 404 and, 629 DAC. See Daclizumab lung cancer and, 244 Donor duodenal anastomosis, DCCT. See Diabetic Control urinary stones and, 676 bladder drainage and Complications Trial Differential diagnosis, 33, 136 technique v., 728 DCIS. See Ductal carcinoma in bleeding and, 143 Do-Not-Resuscitate (DNR) situ Diffuse esophageal spasm orders, 157 D-dimer assay, DVT and, 517 (DES), 229 Dopamine Debridement. See Surgical Digital rectal examination shock state and, 133 debridement (DRE), prostate cancer urine output and, 96 Decompressive craniectomy, and, 658 Doppler ultrasound. See also ICP and, 583 Direct inguinal hernia, 484 Carotid duplex exam; Deep vein thrombosis (DVT). Direct pressure, bleeding and, Ultrasonography See also Acute deep vein 138 lower extremity ischemia thrombosis Dirty surgery cases and, 505 drug treatments for, 520 antibiotics and, 106–107 waveform analysis, 310 incidence rate of, 514 Flagyl and, 107 Doxorubicin, breast cancer and, Dehydration, stone formation Dirty wound, closure of, 110 347 and, 672 Disease processes, abdominal DPL. See Diagnostic peritoneal Dental work, valve surgery pain and, 407 lavage and, 272 Dissecting aortic aneurysm, 289 Drains, infections and, 112 Derived verbal score, 554 Disseminated intravascular DRE. See Digital rectal Dermoid cysts, 185 coagulation (DIC), 136, examination Detrusor hyperreflexia, 663 145 Drug(s). See also Topical drug Detrusor hyperreflexia/ Diuretics, brain volume and, therapy; Specific drugs overactive bladder, 582 i.e. Penicillin agents for, 663 Diverticular bleeding, 371 alterations of hemostasis by, Dextrose (D5), 65 Diverticular disease, 388, 141 postburn period and, 627 454–455 toxicity, kidney Diabetes mellitus (DM) gastrointestinal bleeding and, transplantation and, complications of, 719–720 359 715 Index 767

vasoactive, shock state and, Eisenmenger’s syndrome, Endocarditis, aortic root 89, 133 259–260 abscess and, 266 Drug-seeking behavior, flank Elbow, muscle strain injuries, Endocrine response pathways, pain and, 686 604–605 surgery and, 63 Ductal carcinoma in situ Elbow joint Endolarynx, 193 (DCIS), 336, 348–350 dislocations of, 605 Endometriosis, 399 biopsy and, 349 skeletal anatomy of, 604 Endoscope Duct ectasia, bloody discharge Electrocardiogram (ECG) gastrointestinal bleeding and, and, 350–351 abdominal pain and, 385 364 Duke’s cancer staging system, cardiac rhythm and, 273 ulcerative colitis and, 453 462 chest pain and, 295 Endoscopic balloon dilators, TNM system v., 462 congenital heart disease and, dysphagia and, 215 Duodenal anastomosis, P Tx 261 Endoscopic botulinum toxin and, 729, 730 Electrodesiccation and injection, achalasia and, Duodenal ulcer, 388 curettage 227 perforation, 390 BCC and, 530 Endoscopic decompression, Duodenum, gastrointestinal SCC and, 532 volvulus and, 459–460 bleeding and, 359 Electroencephalogram (EEG), Endoscopic electrocoagulation, Duplex ultrasonography (DU) stroke and, 322 angiodyspladia and, carotid artery disease and, Electrolyte(s), 64–65. See also 372 310 Fluid(s); Potassium Endoscopic sclerotherapy, CVI and, 522 abnormalities of, 77 Mallory-Weiss tear, 366 DVT and, 516 body fluids and, 62 Endoscopic sphincterotomy renal artery stenosis, 329 children and, 640 (ES), 439 DU. See Duplex distribution of, normal, 66 CBD stones and, 439 ultrasonography imbalance, 70 Endoscopic ultrasound (EUS), DVT. See Deep vein thrombosis problems of, 67, 69, 70–80 208 Dysphagia, 203, 228 maintenance requirements Endoscopy, esophageal algorithm for, 207 for, 65–66 swallowing disorders Barrett’s esophagus and, perioperative requirements and, 206–208 225 of, 66–80 End-stage renal disease (ESRD) endoscopic balloon dilators SNS and, 51 liver transplantation and, 739 and, 215 surgery and, 80 management options for, Dyspnea, 11 Elephantiasis, 524 705–706 Dyspnea on exertion, 286 Elevation, lymphedema and, orthotopic liver transplant Dysuria, 666–667 525 and, 736 Embolism, stroke v., 306 Enemas. See also Contrast E Embolization, gastrointestinal enema EBM. See Evidence-based bleeding and, 364 neonate intestinal obstruction medicine Embryonal carcinoma, 700 and, 655 Ecchymoses, bleeding and, 141 Emergency department, burns Energy, nutrition and, 49–50 ECG. See Electrocardiogram and, treatment of, Enteral drainage technique Echocardiography 627–630 bladder drainage technique chest pain and, 295 Emergency medical services v., 728 coarctation of aorta and, 330 (EMS), trauma, 551 P Tx and, 725, 727 Ectopic pregnancy, 399 management, 561, 562 Enteral feeding. See Enteral ruptured, 386 Emergent colonoscopy. See nutrition Edmonton protocol, islet cell Urgent colonoscopy Enteral formulas, 52–58 transplant and, 733 EMS. See Emergency medical categories of, 52–58 Edrophonium test, 209 services Enteral nutrition, 47 EEG. See Electroencephalogram Enbloc resection, 424 access for, 47, 48 EGD. See Endarterectomy. See also burn wounds and, 630 Esophagogastroduodeno- Eversion endarterectomy complications of, 57 scopy stroke and, 317, 321 pediatric patient and, 638 768 Index

Enterobacteriaceae bacteria, Esophagectomy with gastric Exposure, trauma and, 554 pyelonephritis and, 677 replacement, esophageal External hemorrhoids, 474–475 Ephelides. See Freckles carcinomas and, 212–213 Extraaxial hematomas, TBI and, Epidemiologic tests, 29, 30 Esophagogastroduodenoscopy 569, 570 Epidermal inclusion cysts, 180, (EGD), upper Extracellular fluid volume, 68 182 gastrointestinal bleeding Extracranial carotid stenosis, Epidermis, burns and, 623 and, 362 management of, Epidermoid carcinoma, 477 Esophagoscopy, 226. See also algorithm for, 315, 316 Epididymitis, testis torsion Flexible esophagoscope Extrinsic cardiogenic shock, and, 679 cancer and, 184 treatment of, 129 Epididymo-orchitis, 697–698 esophageal strictures and, Extrinsic pathway, PT and, 143 Epidural hematomas, 570 231 Eyeball test (eye opening), 6 Epigastric hernias, 496 Esophagus responses, trauma and, 554 Epinephrine, shock state and, cross section of, 201 TBI and, 565 133 gastrointestinal bleeding and, Eye opening test. See Eyeball Episodic chest pain, differential 359 test (eye opening) diagnosis of, 294 ESRD. See End-stage renal Erythromycin, 113 disease F Escharotomy, burn wounds ES. See Endoscopic Facet joint dislocations, cervical and, 629 sphincterotomy spine and, 618 Esophageal atresia Etoposide, testis cancer and, Factor IX concentrate, 147 neonate and, 645 702 Factor VIII concentrate, 147 neonate intestinal obstruction EUS. See Endoscopic hereditary hemorrhagic and, 651 ultrasound disorders and, 142 Esophageal carcinomas, 210 Eversion endarterectomy, Familial adenomatous management, of stage IV, 213 stroke and, 317, 321 polyposis (FAP), 466 phase III treatment trial for, Evidence Family history (FH), 5, 165 214 clinical breast disease and, 338 presenting symptoms of, 211 appraising, 24–29 neonate and, 650 resectable, management of, study designs and, 24 patient history and, 139 212 using, 23–24 FAP. See Familial adenomatous staging of, 211 Evidence-based medicine polyposis treatment of, 211–212 (EBM), 19 Fasciotomies, compartment Esophageal dilation, achalasia algorithm for, 21 syndrome and, 598 and, 227 clinical application of, 21, FAST. See Focused abdominal Esophageal diverticula, 227–228 31, 32–39 sonogram for trauma Esophageal function, brain injury and, 558 Fatty acid, lipid preparations assessment of, 206 questions and, 55 Esophageal manometry, 226, creating, 38 FDP. See Fibrin degradation 229 elements of, 29, 31, 32 products antireflux surgery and, 221 relevance of, 19–22 Fecal fat measurement, swallowing difficulty and, summary of, 39 malabsorption and, 470 208–209 websites, 40–41 Fecal peritonitis, 456 Esophageal mucosa, layers of, Evidence-based surgery Feeding catheter, SNS and, 58 202 practicing, 19–41 Femoral artery aneurysm, 482 Esophageal patency, neonate objectives in, 19 Femoral head fractures, 609 intestinal obstruction precepts of, 22–23 Femoral hernia, 480, 481, and, 651 Examinations, special 484–486 Esophageal strictures, 231 techniques, neck masses diagnosis of, 485–486 Esophageal swallowing and, 183–184 surgical treatment of, 486 disorders, diagnostic Excision, burn wounds and, 629 Fetal development, physiologic tests for, 205–210 Exercise stress testing, chest changes in, 642 Esophageal varices, pain and, 297 Fetal hypothyroidism, 188 gastrointestinal bleeding Exogenous agents, diarrhea Fever and, 360 and, 470 flank pain and, 686 Index 769

management guidelines management of, 674–667 Focused abdominal sonogram for, 675–676 musculoskeletal causes of, for trauma (FAST), postoperative, 109–110 685 abdomen and, 557 pyelonephritis and, 677 psychological causes of, 686 Focused head injury wounds and, 101 Flexible esophagoscope, 207 evaluation, 565 FFP. See Fresh frozen plasma Flexor tendon injuries, surgery Focused surgical history, FH. See Family history and, 607 165–167 Fiberoptic cystoscopy, Flow cytometric studies, kidney algorithm for, 166 hematuria and, 664 transplantation, 712 AMPLE survey and, 167 Fiberoptic laryngoscopes, 183 Fluid(s). See also Dehydration; Focused surgical physical diverticulosis and, 455 Fluid volume; Water examination, 167–170 Fibrin clot, 148 balance, surgery and, 80 Follicular lesion, 188 Fibrin degradation products hemorrhagic shock and, 356 Follow-up, 35 (FDP), 145 hydration, pyelonephritis Foot sprains, 616 Fibrinogen, 145 and, 677 4–2-1 rule, pediatric patients Fibroadenomas, 335 imbalance, 70 and, 640, 641 Fibrocystic condition, 336 problems of, 67, 69, 70–80 Fournier’s gangrene, 111 middle-aged woman and, 340 intake, urine volume and, 676 Fourth-degree burns, 624 Fibula, fractures of, 613 loss, hypovolemic shock and, Fractional inspired oxygen, 93 FIM scores. See Functional 119 Fracture(s), 592–601. See also Independence Measure management, pediatric Calcaneal fractures; scores patient and, 642 Compound fractures; Fine needle aspiration (FNA), perioperative requirements High energy fracture of 184. See also of, 66–80 pelvis; Tibial plateau Transthoracic fine-needle resuscitation fracture; Torus fracture aspiration hypovolemic shock and, ankle, 616, 617 breast and, 338 122 deformities, 599 breast mass and, 339 postburn period and, displacements, 599 melanoma and, 540 626–627 distal femur, 612 pancreatic tumors and, 417 septic shock and, 121 distal humerus, 605 sarcoma and, 543 sequestration, 66 distal radius, 608 thyroid lesions and, 184 shock and, 135 distal tibia, 616 First branchial cleft sinus, 185 status, 67, 69 elbow, 605 First-pass phenomenon, P Tx evaluating, 62 femoral shaft, 611 and, 726, 727 SNS and, 51 femur, 609, 612 Fissure, 473–474 surgical patients and, 65 fibula, 613 Fistulas TBI and, 577 of fifth metacarpal neck, 608 diverticulitis and, 456, 458 Fluid volume. See also of fifth metatarsal, 617 peritonitis and, 456 Extracellular fluid forearm, radiographs of, treatment of, 473–474 volume 606 5a-reductase inhibition, urinary depletion, diarrhea and, 471 hip, 611 flow and, 659 expanders, types of, 145 of humeral shaft, 604 Flagyl, dirty cases and, 107 overload, aortic insufficiency patella, 613 Flank pain and, 270 patterns of, 593 diagnostic studies and, resuscitation, 145 pediatric, 600 690–691 Fluoroscopy with videotape, proximal humerus, 603–604 differential diagnosis for, esophageal swallowing proximal tibia, 613 671–686 disorders and, 206 proximal ulna, 605 evaluation of, 670–691 Fluorouracil, esophageal radial head, 605 algorithm for, 672 carcinomas and, 213 of scaphoid, 608 fever with, management FNA. See Fine needle shaft of radius, 605 guidelines for, 675–676 aspiration of shaft of ulna, 605 infected urine and, 674 Focal glomerulosclerosis, supracondylar humerus, laboratory studies and, kidney transplantation radiographs of, 606 688–690 and, 713 tibial, 613 770 Index

FRC. See Functional residual Gastrointestinal bleeding, Gluteus maximus, contusion of, capacity 355–373, 373. See also 609 Freckles (ephelides), nevi v., Lower gastrointestinal Goiter, thyroid gland and, 182 532 bleeding; Upper Goodsall’s rule, 473 Fresh frozen plasma (FFP), 146 gastrointestinal bleeding Gout, 592 Full excision, burn wounds bleeding site in, 361–362 uric acid stones and, 673 and, 629 differential diagnosis for, 359 Graft(s) Fulminant colitis, 453 initial management of, endovascular stent, AAA Functional independence 356–359 and, 428–429, 430 Measure (FIM) scores, management of, algorithm infrapopliteal, 508 559 for, 357 prosthetic, renal artery Functional residual capacity patient evaluation in, stenosis and, 333 (FRC), 93 359–361 split-thickness skin, burn Fungal infection, OLTX and, upper gastrointestinal wounds and, 629 748 bleeding, 362 systemic, OLTX and, 737 Furosamide, urine output and, Gastrointestinal fluid Graft survival 96 hypokalemia and, 78 deceased donor liver loss, 67 transplants and, 754 G volume and composition living donor liver transplants Gag reflex, TBI and, 567 of, 67 and, 754, 755 Gallbladder Gastrointestinal obstruction, P Tx and, 730 disease, 381 400–403 Grave’s disease, 188 dysfunction, 392–395 Gastrointestinal perforation, 388 Greater saphenous vein (GSV), Gallstone disease, 437 Gastrointestinal tract, occlusive disease and, Gallstone ileus, 385 hypovolemic shock and, 506 Gallstone-induced pancreatitis, 119 Greenstick fracture, pediatric 398 Gaucher’s disease, spleen and, fractures and, 600 Gangrene, volvulus and, 460 420 Groin, anatomy of, 482–484 Gastrectomy, 365–366 GCS. See Glasgow Coma Scale Groin hernias, 479–497, Gastric carcinoma, 365–366 Genital tract 484–494 Gastric content, assessment of, examination of, flank pain Nyhus classification of, 34 209 and, 688 Groin masses Gastric motility, evaluation of, female, hemorrhagic differential diagnosis of, 33, 210 conditions of, 390 480–482 Gastric outlet obstruction, 400 Genitourinary tract, acute workup for, algorithm for, Gastric ulcers, 365–366, 388 surgical abdomen and, 482 Gastritis, abdominal pain and, 389 GSV. See Greater saphenous 405 GERD. See Gastroesophageal vein Gastroduodenal obstruction, reflux disease Guidelines for Management neonate and, 645 GER. See Gastroesophageal of Severe Head Injury, Gastroduodenal ulcer disease, reflux 579 abdominal pain and, 405 Glasgow Coma Scale (GCS), Guidelines. See Practice Gastroenteritis, 402 552, 554, 565 guidelines Gastroesophageal reflux (GER), Glasgow Outcome Scale, TBI Gynecologic pelvic disorders, 209. See also Complicated and, 586 399–400 gastroesophageal reflux Glenohumeral joint Barrett’s esophagus and, 224 dislocation of, 602 H gastrointestinal bleeding and, radiographs of, 602 Halo nevus, 533 359 Gloves, OR and, 107–108 Hand washing, wound treatment of, 217–218 Glucose infection and, 108 Gastroesophageal reflux as marker, P Tx and, 721 Harm, determining, 37–38 disease (GERD), 216–222 nutrition and, 50 Harris-Benedict equation, burn Gastrografin, neonate intestinal serum osmolarity and, 69 wounds and, 630 obstruction and, 653 SNS and, 59 Hashimoto’s thyroiditis, 187 Index 771

HAT. See Hepatic arterial Helical computed tomography, Heparin-induced thrombosis embolism and, 518 thrombocytopenia (HIT), Hazard ratios, CABG and, 303 Heliobacter pylori, peptic ulcer 519 HCV. See Hepatitis C virus disease and, 365 Hepatectomy, 443 Head Hemangioma, 413 Hepatic adenomas, 413 circumference, pediatric Hematemesis, 356, 361 Hepatic arterial thrombosis surgical patient and, 635 Hematochezia, 356 (HAT), OLTX and, 746 elevation, TBI and, 577 Hematogenous infection, Hepatic flexurecancer, 464 examination, lesions and, pyelonephritis and, 677 Hepatic jaundice, 435, 444 180–185 Hematologic disorders, 382 Hepatitis, 444 lesions, 177–198 abdominal pain and, 405 abdominal pain and, 405 Head computed tomography, Hematology, surgical Hepatitis C virus (HCV), OLTX TBI and, 586–587 evaluation and, 12–13 and, 738 Head injury. See also Focused Hematoma, bleeding and, 141 Hepatocellular carcinoma, 414 head injury evaluation; Hematuria, 664–665 Hepatologist, pediatric, liver Guidelines for Hemodialysis transplantation and, 752 Management of Severe ESRD and, 705, 706 Hepatoma, 414 Head Injury; Penetrating renal failure and, 97 Hereditary nonpolyposis coli head injury; Traumatic Hemodynamic instability, 382 syndromes (HNPCC), brain injury Hemodynamic monitoring, 87 466 CT classification of, 569 Hemodynamic parameters, Hernia, 35, 480. See also Head of metacarpal, laceration shock states and, Abdominal wall hernias; of, 608–609 differential diagnosis of, Groin hernias; Hiatal Healthcare staff, secondary 131 hernias; Inguinal hernia survey and, 555 Hemolysis, jaundice and, 435 incisional, 495, 496 Heart, compressive cardiogenic Hemoptysis, 233, 234–240 indirect inguinal, 484 shock and, 127 causes of, 234 parastomal, 496 Heart chamber enlargement, diagnostic evaluation for, 236 pelvic floor, 496 chest X-ray and, 273 management of, 238–240 syndromes, 574 Heart murmur, 257–282. See summary of, 256 TBI and, 574 also Heart valve(s); Hemorrhage, 137, 306. See also types of, 222, 223, 497 Intermittent mitral Acute variceal bleeding; umbilical, 494 stenosis murmur Gastrointestinal bleeding ventral, 494 acquired, 264–282 diverticulosis and, 455 ventral incisional, 494 adults with, diagnostic hypovolemic shock and, 119 Hesselbach’s triangle, 484 algorithm for, 267 secondary survey and, 555 Hetastarch, 123 diagnosis and treatment of, trauma and, 551 Hexachlorophene soap, hand algorithm for, 259 Hemorrhagic disorders, washing and, 108, 109 diagnostic methods for, hereditary, factor VIII Hiatal hernias 272–274 and, 142 treatment for, 224 hemoptysis and, 236 Hemorrhagic/hypovolemic types of, 222–223 Heart valve(s). See also shock, 87 High dose dexamethasone Acquired disease of Hemorrhagic pancreatitis, 386 suppression test, heart valves; Hemorrhagic shock, physical Cushing’s disease, 329 Congenitally deformed findings in, 121, 356 High energy fracture of pelvis, bicuspid valve Hemorrhoids, 474–475 610 anatomy of, 265–266 differential diagnosis for, 474 High energy lateral competency, acute changes management of, algorithm compression injuries, 611 in, 271 for, 475 Hip joint, 609 prosthesis, types of, 277 Hemostasis, 136–148, 148 dislocations of, 609 replacement, aortic stenosis Heparin, 13. See also Hirschsprung’s disease, and, 275 Unfractionated heparin neonate and, 645 Heater probe, gastrointestinal pulmonary embolism and, intestinal obstruction in, 654 bleeding and, 362 303 Hirsutism, 326 772 Index

History of present illness (HPI), Hypertension, 325, 333–334 Ileal pouch-anal anastomosis, 165, 166 diagnosis and treatment for, 454 History. See Patient history algorithm for, 327 Ileocolic stenotic disease, HIT. See Heparin-induced medications for, 330 primary anastomosis thrombocytopenia Hypertensive LES, 230 and, 451 HIV. See Human Hyperthermic isolated limb Iliac aneurysms, 386 immunodeficiency perfusion, sarcoma and, Imaging studies. See also virus 544, 547 Computed tomography; HLA. See Human leukocyte Hyperthyroidism, 187–188 Duplex ultrasonography; antigen Hypertonic saline, hypovolemic Positron emission HNPCC. See Hereditary shock and, 122, 123 tomography scan; nonpolyposis coli Hypertrophic scar, burn Radiographic studies; syndromes wounds and, 631 Ultrasonography; Horner’s syndrome, 566 Hyperventilation Ultrasound examination; Hospital admission, flank pain brain trauma and, 558 Upper gastrointestinal and, 674 TBI and, 581 contrast studies; Upper Host, infection in, 100 Hypocalcemia, 78 tract imaging; Upper Human chorionic Hypoglycemia, DM and, 720 urinary tract imaging; X- gonadotropin, testis Hypokalemia, gastrointestinal ray examination cancer and, 700 fluids and, 78 abdominal pain and, 384–385 Human genomics, surgery and, Hypomagnesemia, 80 aneurysms and, 428–429 150 Hypo-osmolar hyponatremia, solitary pulmonary nodules Human immunodeficiency 69 and, 242–243 virus (HIV) infection, Hypoperfusion, 135 surgery and, 16 444. See also AIDS occlusive disease and, 308 Immunosuppressants secondary survey and, 556 Hypopharynx, 191 kidney transplantation and, Human leukocyte antigen cancer of, 192 706, 707, 713 (HLA) Hypophosphatemia, 80 OLTX and, 748, 750 kidney transplantation and, Hypotension, 72, 87 organ donation and, 709 706, 707 head injury and, 576 P Tx and, 729, 730–732 organ donation and, 709 secondary survey and, 555 renal function and, 716 Hydrocele, 482, 698–699 Hypothalamus-pituitary-gonad Immunosuppression Hydrocephalus, TBI and, 585 axis, 694 islet cell transplantation and, Hydrochloric acid infusions, Hypothermia 734 metabolic alkalosis and, cerebral metabolism and, 583 outcomes according to, P Tx 77 postburn period and, 627 and, 732 Hydronephrosis, flank pain Hypothyroidism, 187 peritonitis and, 456 and, 671 Hypovolemia, 119, 121, protocols, OLTX and, 748, 751 Hyperacute rejection, kidney 356–357 SCC and, 531 transplantation, 712 treatment of, 145 Immunotherapies, Crohn’s Hyperbaric oxygen treatment, Hypovolemic shock, 119–123 disease and, 451 inhalation injury and, algorithm for treating, 120 Imuran, P Tx and, 732 626 treatment of, 122 Incisional hernias, 495, 496 Hypercalcemia, 78 Hypoxia Incontinence. See Urinary Hypercalcinuria, 674 head injury and, 576 incontinence Hyperkalemia, 67, 78 secondary survey and, 555 Indirect inguinal hernia, 484, renal failure and, 96 485 treatment of, 79 I Induction therapy, OLTX and, Hypermagnesemia, 80 IABP. See Intraaortic balloon 748 Hypermetabolism, SNS and, pump Infants 45 ICP. See Intracranial pressure caloric requirements in, 637 Hyperparathyroidism, ICU. See Surgical intensive care congenital hernias and, 497 hypercalcemia and, 78 unit congestive heart failure in, Hyperphosphatemia, 80 Ileal atresias, neonate and, 645 258–262 Index 773

electrolyte requirements in, Informed consent, 17. See also International normalized ratio 640 Informed refusal of care (INR), 143 maintenance fluid rates in, bioethical principles and, 150 VTE and, 519 640 principles of, 155 International Pancreas protein requirements in, 637 Informed refusal of care, 156 Transplant Registry Infection(s). See also Abdominal Inguinal canal, 483, 484 (IPTR), number of sepsis; Bacteremia; Inguinal hernia, 480, 481, transplants reported, Bacterial infection; 486–487 719 Hematogenous infection; decision tree for, 487 Intestinal obstruction, 401. See Postoperative infection; laparoscopic repair of, 489 also Neonate intestinal Remote site infection; surgical treatment of, obstruction Wound sepsis 487–489 Intestinal tubes, small bowel acute surgical abdomen and, complications of, 488 obstruction and, 402 389 Inguinal pain, decision tree for, Intraabdominal pathology, children and, 186 487 flank pain and, 685 in host, 100 Inhalation injury, burns and, Intraaortic balloon pump inflammatory diarrhea and, 624, 626 (IABP), intrinsic 470 Initial assessment, abdominal cardiogenic shock and, kidney transplantation and, pain and, 386 129 713 Initial diagnosis, abdominal Intraaxial hematomas, TBI and, lymphedema and, 525 pain and, 385–386 569, 570 OLTX and, 746, 748 Initial stabilization, head injury Intracranial compliance, TBI open fractures and, 597 and, 577 and, 579 postoperative Injury. See also Traumatic injury Intracranial components, core body temperature descriptions, compartment volume of, 573 and, 109 syndrome and, 598 Intracranial hemorrhages, TBI wound surveillance physiologic response to, 63 and, 569, 570 protocol for, 102–103 Injury analysis, pattern of, PE Intracranial hypertension, preoperative components of, v. control in, 515 treatment pathway for, 100 Inotropes, shock and, 132–134 581 principles of, 99–117 Inotropy, 90 Intracranial infections, TBI and, risk factors for, algorithm in, INR. See International 585 101 normalized ratio Intracranial pressure (ICP) SNS and, 59 Inspection, lesions and, 180, control techniques for, 581 surgical, antibiotic therapy 181, 182–183 monitoring, indications for, and, 13, 15 Insulin, pancreas and, 725 578, 579 Infection stones, 673 Intensive care unit (ICU) TBI and, 573 Infectious colitides, 459 hemodialysis, 97 treatment of, 578, 579–583 Inferior cava filtration device, renal dysfunction and, 96 Intradermal nevi, 533 521 Intercompartmental pressure Intrahepatic Infertility, acute epididymitis monitoring, cholangiocarcinoma, and, 698 compartment syndrome 415 Inflammation of rotator cuff, and, 598 Intraoperative fluid loss, 67 601 Interferon-alpha 2b, melanoma Intraoral lesion, biopsy of, 184 Inflammatory arthropathy, 592 and, 540 Intraparenchymal hematomas, Inflammatory bowel disease, Intermittent claudications, 570–571 372 vascular disease and, Intraparenchymal gastrointestinal bleeding and, 502 hemorrhages, 571 360 Intermittent mitral stenosis Intraparenchymal ICP UC and, 453 murmur, 271 monitors, TBI and, 577 urinary calculi and, 673 Internal carotid arteries, stroke Intraperitoneal neoplasms, Inflammatory diarrhea, 470 and, 307 400 Inflow, occlusive disease and, Internal hemorrhoids, 474 Intravenous lipid preparations, 506 Internal hernia, 480 fatty acid content of, 55 774 Index

Intravenous pyelography (IVP) LFTs, evaluation of, 438 Lacunar ligament, 485 abdominal masses and, 412 malignancy and, 442 Ladd’s bands, neonate bladder tumors and, 680 Jaw pain, 286 intestinal obstruction hematuria and, 664 Jejunal atresia, neonate and, 654 Intravenous urography intestinal obstruction Laparoscopic excision ureteral injuries and, 684 and, 652, 653 Cushing’s disease and, 330 ureteral injury and, 665 Joint spleen and, 420 Intraventricular hemorrhages, dislocations, 599–600 Laparoscopic gallbladder 571, 572 injuries, 590–592 removal, 445 Intrinsic cardiogenic shock, Joint capsule, sprain and, Laparoscopic hernia surgery, theraputive objective for, 590–591 open hernia repair v., 128 Justice, 154 490–495 Intrinsic pathway, 143 bioethics and, 152 Laparoscopic incision, Conn’s PTT and, 143 disease and, 330 Intrinsic renal allograft disease, K Laparoscopic Nissen kidney transplantation Kasai procedure, 444 fundoplicaton, 221, 222 and, 715 Kegel exercises, urinary Laparoscopic surgery, open Invasive monitoring, 87 incontinence and, 663 splenectomy v., 422 indications for, 132 Keratoacanthoma, SCC and, Laparoscopy Invasive venous sampling (for 532 abdomen trauma and, 557 ACTH), Cushing’s Kidneys laparotomy v., disease, 329 cadaveric donor v. live donor appendectomy and, 392 Involuntary guarding, and, 710–711 Laparotomy abdominal pain and, 383 flank pain and, 671 GI bleeding and, 357 Iodophor-based soap, hand organ donation and, 708 laparoscopy v., washing and, 108, 109 prerenal profusion and, 96 appendectomy and, 392 IPTR. See International Kidney transplantation, Laplace’s law, 303 Pancreas Transplant 705–716 aneurysm and, 429 Registry candidate criteria for, ischemic heart disease and, Irradiation, sarcoma and, 541 705–707 298 Irrigation, open fractures and, contraindications for, 706, Large bladder 597 707 rhabdomyosarcoma, Ischemia, lower extremity, ESRD and, 705 urinary tract obstruction atherosclerotic disease intermediate period of, 715 and, 688 and, 500 late period of, 715–716 Large bowel disease, initial Ischemic colitis, 372 post-transplant period of, work-up for, algorithm Ischemic heart disease, 711–716 for, 449 286–288, 298–300 P Tx and, 721 Large-bowel malignancy, signs Islet cell transplant, 732–733 Knee, anatomy of, 611 and symptoms of, 461 IV catheter site, bleeding and, Knee joint, dislocations of, 612 Large-cell carcinomas, 244 141 Laryngeal nerve, surgery and, IVP. See Intravenous L 198 pyelography Laboratory studies Larynx, 193 abdominal pain and, 384–385 cancers of, 192 J acute epididymitis and, 698 parts of, 192 Jaundice, 433–445. See also bleeding and, 143 Laser therapy, dysphagia and, Hepatic jaundice; chest pain and, 295 215 Hepatitis surgery and, 13, 16 Lawn-mower injuries, foot and, acute cholecystitis and, 394 Laboratory testing, pulmonary 617 case studies of, 433–434 problems and, 9 LCIS. See Lobular carcinoma in classification and causes of, Lactate dehydrogenase, situ 437 melanoma and, 536, 540 LDLT. See Living donor liver evaluation of, algorithm for, Lactated Ringer’s solution, 145 transplant 436 Lacunar infarctions, 306 Left heart catheterization, 273 Index 775

Left inguinal canal, 484 indications for, 738 management of, algorithm Left lower quadrant pain, induction and, for, 368 differential diagnosis for, immunosuppression for, massive hemorrhage and, 390 750 370–371 Left upper quadrant abdominal patient listing for, 740 Lower urinary tract disorders, pain, differential pediatric 656–669 diagnosis of, 400 adult OLTX v., 751 case studies of, 656–657 Leg swelling, 511–526, 526 indications for, 752 pain and, 382 management of, algorithm postoperative monitoring in, Lower urinary tract symptoms for, 513 algorithm for, 749 (LUTS), 657–664 unilateral, hemoptysis and, routine clinical studies for, Low molecular weight 236 740 heparins (LMWHs), VTE Leiomyomas, 215 Liver tumor, evaluation and and, 520, 521 Lentigo maligna melanoma, treatment of, algorithm Ludwig’s angina, 186 536 for, 414 Lumbar burst fracture, Lesions. See also Specfic types of Living donor liver transplant radiograph of, 619 lesions (LDLT), 755 Lumbar hernia, 496 neck, examination algorithm pediatric population and, 751 Lumbar spine, muscle strain for, 181 Living donor organ injury to, 618 LES. See Lower esophageal transplantation Lumbar spine injury, 616 sphincter adult v. pediatrics, 753 Lumpectomy, 349 Leukoplakia, 181 evaluation, 710 Lumpectomy with radiation, Levels of evidence, 24, 25. See after implantation, 753 survival and, 343 also Study designs issues arising with, 709 Lund-Browder chart, burns LFTs. See Liver function tests kidney and, 711 and, 624, 625 Ligament of Treitz, bleeding LMWHs. See Low molecular Lung biopsy, solitary site and, 361 weight heparins pulmonary nodules and, Lipase as marker, P Tx and, 721 Lobular carcinoma in situ 243, 244 Lipid peroxidation inhibitor, (LCIS), 351 Lung cancer SCI and, 559 Localized excisional biopsy, epidemiology of, 244 Lipid preparations, fatty acid 349 initial symptoms of, 248 content of, 55 Long bone, gross anatomy of, neoadjuvant therapy and, Lipodermatosclerosis, CVI and, 594 255 521 Long-term care, valve repair paraneoplastic syndromes in, Liver and, 277 249 coagulation factors and, Lower endoscopy, Crohn’s patient history and, 241 144–145 disease and, 450 preoperative pulmonary hemoptysis and, 236 Lower esophageal sphincter evaluation, 253, 254 procurement process of, 743 (LES) prevention of, 244 SNS and, 60 factors affecting, 203 surgical resection of, 255 Liver disease, end-stage swallowing and, 202, 203 survival by tumor size in, complications of, Lower extremity, ischemic, 254 737–739 499–509 TNM descriptors for, 252 Liver failure, 444 Lower extremity duplex scan, Lung neoplasms. See Lung cirrhosis and, 737 lymphedema and, 524 cancer Liver function tests (LFTs) Lower extremity ischemia, Lung resection surgery, bleeding and, 144–145 treatment of, 505–509 pulmonary function jaundice and, 438 Lower extremity venous examination, 8 Liver masses, 412–413 duplex scan, embolism Lungs. See also Lung biopsy; Liver transplantation, 735–755 and, 517 Lung cancer contraindications to, 742, 743 Lower gastrointestinal soft tissue sarcoma evaluation for, 739 bleeding, 367–373 metastasis and, 546 historic perspective of, case investigation of, LUTS. See Lower urinary tract 735–737 372–373 symptoms 776 Index

Lymphedema, 512, 524–525. Maldigestive steatorrhea, 470 Mean arterial pressure (MAP), See also Chronic Malignancy. See also Melanoma shock and, 87 lymphedema; bloody discharge and, 350 Mechanical obstruction, 402, Elephantiasis; Pneumatic hypercalcemia and, 78 403 compression garments jaundice and, 442 Mechanical valve, 277 treatment for, 525 microcalcifications and, 348, Mechanical ventilation Lymph node(s). See also 349 discontinuation of, 95 Regional lymph nodes neck mass and, 186 pulmonary management hemoptysis and, 236 nevi and, 533 and, 92 lung cancer and, 241 papilloma v., 336, 350–351 weaning from, clinical trials mapping, 345 Malignant cystic tumors of and, 95 mass, 481 pancreas, resection and, Meckel’s diverticulum, 367 melanoma and, 540 418 Meconium ileus, neonate metastases, staging and, 345 Malignant diseases, 461–467 intestinal obstruction Lymphocytic crossmatch, Malignant epithelial lung and, 654 kidney transplantation tumors, classification of, Meconium plug syndrome, and, 712 245 neonate intestinal Lymphoscintigraphy, Malignant soft tissue lesion. See obstruction and, 653, 654 lymphedema and, 525 Sarcoma Meconium stool, neonate and, Malignant thyroid lesion, oral 649 M thyroid hormone and, Mediastinoscopy, cancer Macrodantin, cystitis and, 666 188 staging and, 248 Macrolide antibiotics, 113 Mallory-Weiss tear, 366 Medical condition, kidney Mafenide acetate (Sulfamylon), gastrointestinal bleeding and, transplantation and, 706 burn wounds and, 628 360 Medical evaluation, surgical Magnesium, 80 Malnutrition, 44 evaluation v., 4 Magnesium ammonium SNS and, 45, 46 Medical history. See also Past phosphate stones, 673 Mammogram medical history Magnetic resonance abnormal, 337, 338 pediatric surgical patient angiography (MRA) diagnostic, 349 and, 635 coarctation of aorta and, 330 screening, death and, 348 trauma and, 551 embolism and, 518 trials, 342 Medical management, valvular lower extremity ischemia Mammotome, biopsy v., 349 heart disease, 274–275 and, 505 Mandatory breaths, 92 Medical therapy, type B aortic renal artery stenosis, 329 Mannitol, brain volume and, dissections and, 301–302 stroke and, 311, 312 582, 583 Medications Magnetic resonance imaging Manual detorsion, testis torsion medical conditions and, 6 (MRI) and, 679 patient history and, 139 acute head injury and, 572 Manual lymph drainage, pediatric patient and, 642 chest pain and, 297 lymphedema and, 525 urinary stones and, 676 Conn’s disease and, 329 MAP. See Mean arterial Medullary thyroid cancer, 197 lymphedema and, 524 pressure Melanocytic nevocellular nevi, neck lesions and, 184 Marfan’s syndrome, 288 532 sarcoma and, 541 Marijuana, 179 Melanoma, 189, 534–541 stroke and, 311 Masses, palpation and, 384 ABCDE mnemonic of, 534 TBI and, 587 Mastectomy, 343, 349. See also atypical nevi and, 534 Maintenance fluid Axillary dissection; disease staging of, 536 calculation of, 641 Breast cancer, early stage evaluation of, 534 estimating, pediatric patient breast conservation v., 344, excision margins for, current and, 640 345 recommendations of, 539 Major intraabdominal bleeding, MAST. See Military anti-shock management of, algorithm 386 garment suit for, 545 Malabsorption, fecal fat Maternal history, neonate and, stage groupings for, 538 measurement and, 470 650 treatment of, 536–538, 540 Index 777

MELD score. See Model for Microbial factors, infections MRSA. See Methicillin-resistant end-stage liver disease and, 100 Staphylococcus aureus scores Microcalcifications, Multinodular goiter, 183 Melena, 356 mammography and, 348, Multiple endocrine neoplasia MEN IIa. See Multiple 349 syndrome (MEN IIa), endocrine neoplasia Micronutrients, SNS and, 51 328 syndrome Mild head injuries, 576 Multiple organ dysfunction Menstrual history, breast and, Military anti-shock garment system (MODS), 98 337, 338 (MAST) suit, 562 cardiovascular system Mental rehabilitation, burn Minute ventilation, 95 dysfunction and, 86, wounds and, 631 MI. See Myocardial infarction 87–90 Mesalamine, Crohn’s disease Mitral insufficiency, 266, diagnostics of, 85–98 and, 451 270–271 management of, 85–98 Mesenteric arteries, surgery for, 276 pulmonary system thromboembolic Mitral insufficiency murmur, dysfunction and, 90–95 occlusion of, 388 273 shock and, 134 Mesenteric lymphadenitis, Mitral stenosis, 234, 272, 276 surgical critical care and, 83 abdominal pain and, 405 rheumatic valvular disease Munchausen syndrome, flank Mesh repair, inguinal hernia and, 270 pain and, 686 and, 488 Mitral valve repair, 280 Murmur of postinfarction Meta-analysis, review article Mitral valves, 265 ventricular septal defect, and, 26 Mittelschmerz, 399 271 Metabolic acidosis, 77 Mixed teratocarcinoma, 700 Muscle contusion, 589 Metabolic alkalosis, 77 MMF. See Mycophenolate knee joint and, 612 Metabolic therapies, ICP and, mofetil Muscle lacerations, 589 583 Model for end-stage liver Muscle strain injuries Metaiodobenzylguanidine disease (MELD) scores, ankle, 615 (MIBG) scanning, 741 musculotendinous junction pheochromocytoma and, Moderate head injury, and, 589 329 treatment, 576–584 Musculoskeletal injuries, Metal stents, dysphagia and, Modified fluoroscopic barium 588–619, 619 215 study, esophageal by body region, 601–619 Metanephrines, swallowing disorders Musculoskeletal system, pheochromocytoma and, and, 206 components of, 589 329 MODS. See Multiple organ Musculotendinous junction, Metastatic tumors, 246. See also dysfunction system muscle strain injuries Systemic metastases Moles. See Nevi and, 589–590 breast cancer and, 341 Monro-Kellie doctrine, TBI and, Mycophenolate mofetil (MMF), clinical presentation of, 573, 579 OLTX and, 751 247–248 Monteggia fracture, 605 Myocardial infarction (MI), 287, to lung, 240 Mortality 305 Methicillin, 112 aortic valve replacement and, elective surgery and, 6 Methicillin-resistant 277 Myocardium, preload on, 87 Staphylococcus aureus inhalation injury and, 624, (MRSA), 112 626 N Methotrexate, Crohn’s disease severe sepsis and, 124 NASCIS. See National Acute and, 451 Motor examination, TBI and, Spinal Cord Injury Methylprednisolone, SCI and, 567 Study 559 Motor response test, TBI and, Nasogastric tube (NGT), Metronidazole, 113 565 bleeding site and, 361 MIBG scanning. See MRA. See Magnetic resonance Nasopharyngeal lesions, Metaiodobenzylguanidine angiography gastrointestinal bleeding scanning MRI. SEe Magnetic resonance and, 359 Microbes, OR and, 115 imaging Nasopharynx, 191 778 Index

National Acute Spinal Cord Neurologic assessment prescription for, defining, Injury Study (NASCIS), head injury and, 577 49–58 558, 559 TBI and, 565 surgery and, 11–12 National Surgical Adjuvant Neurologic disorders, surgery patient and, 42–61 Breast and Bowel Project urodynamic findings in, objectives for, 42 (NSABP), 351 660 Nutritional history, pediatric Neck cancer, sites of, 189–197 Neurologic status, stroke and, surgical patient and, 635 Neck examination, lesions and, 309–310 Nutritional status. See 180–185 Nevi (moles), 532–534 Specialized nutrition Neck lesions, 177–198 atypical, 533–534 support algorithm approach for, 178 dysplastic, 533–534 Nutritional supplementation Neck lymph nodes, 183 types of, 533 monitoring, 638 Neck mass, older patient with, New-onset angina, 286 pediatric surgical patient 185 New York Heart Association and, 636 Necrotizing fasciitis, 111 functional classification Nutritional support Necrotizing hemorrhagic of angina, 287 monitoring components of, pancreatitis, 395 NGT. See Nasogastric tube pediatric patient and, Necrotizing infection, wounds Nipple discharge, 337, 351 639 and, 111 Nitrogen load, SNS and, 59 pediatric patient and, Necrotizing soft tissue Nodular melanoma, 536 algorithm for, 637 infections, 111 Non maleficence, 154 standard orders for, 56 Needle core biopsy, 185 bioethics and, 152 Nyhus classification, groin Negative outcome, intervention Nonobstructive jaundice, 444 hernias and, 34 and, 37 Nonproliferative lesions, 340, Neoadjuvant therapy 341 O breast cancer and, 348 Non-Q-wave myocardial Obesity, lower extremity lung cancer and, 255 infarction, 286 swelling and, 512 Neonate intestinal obstruction Non-small-cell lung cancer, Obstructing adhesive band, diagnostic studies and, radiograph of, 237 surgical scar and, 401 652–654 Non-small-cell lung cancer Obstruction of alimentary tract, differential diagnosis of, 654 (NSCLC), 245 400 etiology of, algorithm of, 644, staging of, 250, 251 Obstructive jaundice, 435–439, 645 surgical management of, 442–444 physical examination and, 251–254 Obstructive lesions, congestive 650–652 Nonsteroidal antiinflammatory heart failure and, 258 potential cause of, 646–648 drugs (NSAIDs) Occlusive disease, presentation of, 645–650 gastrointestinal bleeding and, hypoperfusion and, 308 treatment of, 654–655 359 Occult blood Neonates, coarctation of aorta peptic ulcer disease and, 365 anemia and, 356 and, 330 Norepinephrine, shock state lower extremity swelling Neoplasia, pancreatic tumors and, 132, 134 and, 512 and, 417 NSABP. See National Surgical Octreotide, bleeding and, 366 Neoplasms. See also Cystic Adjuvant Breast and Ocular movement examination, neoplasms Bowel Project TBI and, 566 anal canal and, 476–477 NSAIDs. See Nonsteroidal Oculocephalic testing (doll’s Neoplastic lesions, rupture of, antiinflammatory drugs eyes), TBI and, 566 386 NSCLC. See Non-small-cell Oculovestibular testing, 566 Nervous system, damage to, lung cancer gaze centers and, 567 589 Nutcracker esophagus, 229–230 Odynophagia, 203 Neurogenic pain, abdominal Nutrition. See also Nutritional Oligomenorrhea, 326 pain and, 405 supplementation; OLTX. See Orthotopic liver Neurogenic shock, 121 Nutritional support transplant spinal shock v., 129 perioperative studies of, 46, Open-book pelvis injury, treatment algorithm for, 130 47 radiograph of, 610 Index 779

Open fractures Orthophosphates, urinary Pain syndrome, associated classification of, 597 stones and, 676 symptoms of, 382 grades of, 595, 596, 597 Orthotopic liver transplant Palliation, esophageal Open hernia repair, (OLTX), 755 carcinomas and, 213 laparoscopic surgery v., contraindications for, 742 Palliative radiation therapy, 490–494 ESLD and, 736 esophageal carcinomas Open splenectomy, postoperative complications and, 213 laparoscopic surgery v., in, 746–748 Palpable abdominal masses, 422 surgical technical issues in, 424 Open surgical excision, 745 Palpable breast mass, 337 Cushing’s disease and, Osmolarity, 64, 65 management of, algorithm 330 Osteoarthritis, 591–592 for, 352 Open tibia fracture, radiograph Osteomyelitis, open fractures middle-age woman with, of, 614, 615 and, 614 340–341 Operating room (OR) Outflow, occlusive disease and, in younger women, 338–340 cadaver donor in, 506 Palpation preparation of, Ovarian cyst, 399 neck masses and, 183 743–744 Overcirculation of lungs, organomegaly and, 384 conduct in, 107–109 congestive heart failure Pancreas, function of, 725 Operative environment, and, 258 Pancreas transplant alone infections and, 100 Overwhelming (PTA), 725 Operative history, patient postsplenectomy Pancreas transplantation (P Tx), history and, 139 infection (OPSI), 718–736. See also OPO. See Organ Placement splenectomy and, 421 Cellcept; Kidney Organization Oxygen transplantation OPSI. See Overwhelming blood loss and, 357 case study of, 718 postsplenectomy respiratory system and, 92 contraindications for, 721 infection Oxygenation, 90 donor selection, 721–723 Oral cavity respiratory system and, 91 enteric conversion in, 729 bimanual examination, 183 evaluation, 721 cancer in, 190–191 P historical perspective of, 719 Oral contraceptives, hepatic P-1 Breast Cancer Prevention immunosuppression adenomas and, 413 Trial medications and, Oral thyroid hormone, tamoxifen and, 351 730–732 malignant thyroid lesion Packed red blood cells islet cell transplantation and, and, 188 (PRBCs), 146 734 Oral tongue cancers, 191 pediatric patient and, 641, postoperative complications Organ dysfunction. See also 642 with, 729–730 Multiple organ Paclitaxel, breast cancer and, 347 postoperative monitoring in, dysfunction system Pain. See also Abdominal pain; algorithm for, 731 nutrition and, 51–52 Right lower quadrant surgical techniques in, Organomegaly, palpation and, pain; Right upper 725–729 384 quadrant abdominal three options for, 723–725 Organ Placement Organization pain; Specific type pain Pancreatic adenocarcinoma, 442 (OPO), 708 i.e. Breast pain, Flank Pancreatic cancer, 418 Organ specific symptoms, pain pain Pancreatic mass, 416 and, 382 dissecting aortic aneurysm evaluation and treatment of, Organ transplantation, post- and, 289 algorithm for, 417 transplant period of, patient history and, 180 Pancreatic pseudocysts, 418 711–716 PPQRSTA mnemonic and, Pancreatitis, 395–399 Oropharyngeal lesions, 198 166, 167 CT scan of, 399 Oropharynx, 191 swallowing, 203–204 Pantaloon hernia, 484 cancer of, 192 visceral, abdominal pain and, PAOP. See Pulmonary artery OR. See Operating room 378 occlusion pressure 780 Index

Papillary carcinoma of thyroid, congenital heart disease and, Penicillin, 112 197 260 dirty cases and, 107 Papilloma, malignancy v., 336, documentation in, 86 Penicillin allergy, dirty cases 350–351 flank pain and, 686–687 and, 106 Paraesophageal hernias. See fracture and, 594–595 Penile meatus, hematuria and, Type 2 hiatal hernias gastrointestinal bleeding and, 664 Paralysis, thoracic aorta 359 Pentastarch, 123. See also surgery and, 302 head mass and, 180 Hetastarch Paralytic ileus, 402 heart murmurs, 272 Peptic ulcer disease, 365 Paraneoplastic syndromes, 248 hemoptysis and, 235 Peptic ulcer rebleeding, Parastomal hernias, 496 lung cancer and, 241 predictors of, 364 Parathyroid lesions, 187, 198 lymphedema and, 524 Percussion of abdomen, 384 Parenteral amino acid melanoma and, 534 Percutaneous needle biopsy solutions, 55 MODS and, 83, 84 pancreatic cancer and, 418 Parenteral feeding, pulmonary function and, 8 sarcoma and, 543 complications of, 57–58 skin lesions and, 529 Percutaneous transhepatic Parenteral fluids stroke and, 309–310 cholangiography (PTC), composition of, 74 surgical evaluation and, 4, 17 443 Parenteral nutrition (PN). See surgical hypertension and, Percutaneous transluminal also Central parenteral 326 coronary angioplasty nutrition; Enteral swallowing difficulty and, (PTCA), 509 nutrition 201, 203–205 ischemic heart disease and, access for, 48 swollen leg and, 512–514 298, 299 electrolyte concentrations in, Patient outcome, 37, 38 renal artery stenosis and, 333 51 PCS. See Postconcussive Perforation, colorectal formulas, 57–58 syndrome malignancy and, 461 pediatric patient and, 638 PCWP. See Pulmonary capillary Periampullary cancer, 442 Parietal pain, 380 wedge pressure Perianal conditions, 468–477 Parietal peritoneal irritation, Pediatric bronchoscopes, vocal cases histories and, 468–469 involuntary guarding cords and, 183 initial workup for, algorithm and, 384 Pediatric burn patient, adult for, 468–477 Parkland formula, postburn burn patient v., 630 Perianal Crohn’s disease, 452 period and, 627 Pediatric end-stage liver Pericardial disease, 290–291, Partial thromboplastin time disease (PELD) scores, 302–303 (PTT), 143, 144 741, 751 Pericardial effusion, renal PA. See Pulmonary Pediatric inguinal hernia, 480 failure and, 96 angiography Pediatric surgical patient Pericardial friction rub, 291 Past medical history (PMH), nutritional assessment in, Pericardial tamponade, Beck’s 165, 166 635 triad and, 126 pain and, 382–383 perioperative care in, Perilunate dislocation, patient history and, 139 principles of, 633–643 radiographs of, 607 Patch closure, arteriotomy and, principles for approaching, Perineal sepsis, 472 317 634 Perineum, neonate intestinal Patency. See Vessel patency PEEP, 93 obstruction and, 651 Patient care, care provider PELD score. See Pediatric end- Perioperative care beliefs and, 157 stage liver disease scores informed consent and, 17 Patient history, 4–6. See also Pelvic floor hernias, 496 nutrition with, 11 Past medical history Pelvic inflammatory diseases, objectives in, 3 abdominal masses and, 399 of surgery patient, 3–17 411–412 Pelvic pain, 399 Peripheral aneurysms, AAA abdominal pain and, 381 Pelvis, anatomy of, 609 and, 427 algorithm for, 5 Penetrating head injury, Peripheral arterial disease, bleeding and, 139 treatment of, 574, 575, lower leg ischemia and, chest pain and, 292–293 584 509 Index 781

Peripheral parenteral formula, ischemic extremity and, 502, Platelet concentrates, 146–147 57 503 Platelet count, 13, 143 Peripheral pulses lower urinary tract disorders Platelet dysfunction, renal compartment syndrome and, and, 657 failure and, 96 598 lung cancer and, 241 Platinol (Cisplatin) fracture and, 595 lymphedema and, 524 esophageal carcinomas and, Peritoneal dialysis, ESRD and, melanoma in, evaluation of, 213 705 535 testis cancer and, 702 Peritoneal signs, 380 MODS and, 83, 84–85 Pleomorphic adenoma, 189 Peritonitis. See also Fecal neonate intestinal obstruction PMH. See Past medical peritonitis and, 650–652 history diverticulitis and, 455 pulmonary function and, 8 Pneumatic compression hypovolemic shock and, 120 sarcoma and, 541 garments, lymphedema purulent, 456 stroke and, 309–310 and, 525 Peritonsillar abscess, 182 surgical evaluation and, 4 Pneumaturia, 667 PET scan. See Positron emission surgical hypertension and, Pneumoperitoneum, X-ray of, tomography scan 326 389 Peurtz-Jeghers syndrome, 182 swallowing difficulty and, PNI. See Prognostic nutritional Pharmacotherapy, achalasia 201, 203–205 index (PNI) and, 227 swollen leg and, 512–514 PN. See Parenteral nutrition Pharyngeal swallowing, 228 urinary incontinence and, Polypectomy, carcinoma in situ classification of, 228 662–664 and, 465 Pharynx, view of, 191 varicocele and, 699–700 Polyposis coli syndromes, Pheochromocytoma, 328, 329, Physiologic PEEP, 93 466 330, 333 PICO, EBM questions and, 31, Polyps Phlebography, 516 33 cancer in, 465 Phosphate, 80 Pilonidal abscesses, draining esophageal, 215 Photodynamic therapy, of, 476 Popliteal artery aneurysm, dysphagia and, 215 Pilonidal disease, 475–476 AAA and, 427 pHPT. See Primary PIOPED. See Prospective Porphyria, abdominal pain hyperparathyroidism Investigation of and, 405 Physical examination, 4–6. See Pulmonary Embolism Portal drainage technique, P Tx also Abdominal Diagnosis and, 725, 726, 727 examination; Bimanual Pitressin infusion, bowel Portal hypertension, cirrhosis examination; Cardiac bleeding and, 369 and, 737 examination PIVOT study group, P Tx and, Portal vein, pancreas and, 725 abdominal masses and, 412 730 Portocaval shunting, bleeding abdominal pain and, 383–384 Plain chest X-rays, esophageal and, 366 algorithm for, 5 swallowing disorders Positron emission tomography BCC and, 530 and, 205–206 (PET) scan bleeding and, 139, 141 Plain film abdominal series, cancer staging and, 248 breast and, 338 diverticulitis and, 455 solitary pulmonary nodules cardiogenic shock and, 128 Plasma adrenocorticotropic and, 242–243 chest pain and, 292–293 hormone (ACTH), stroke and, 313 congenital heart disease and, Cushing’s disease, 329 tumor and, 250 260, 261 Plasma catecholamines, Postconcussive syndrome CVI and, 522 pheochromocytoma and, (PCS), 576 documentation in, 86 329 Posterior glenohumeral flank pain and, 687–688 Plasma renin, Conn’s disease dislocations, 602 fracture and, 594–595 and, 328 Posthepatocyte obstruction, gastrointestinal bleeding and, Plasma volume, postburn jaundice and, 435 360–361 period and, 627 Postoperative care, 109–110 heart murmurs, 272 Platelet aggregation, Postoperative infection, hemoptysis and, 235–236 coagulation and, 137 components of, 114 782 Index

Post-renal transplant, rising Primary tumor, clinical Psychosocial issues, OLTX and, serum creatinine, presentation of, 247 742 differential for, 712 Primary urinary tract etiology, PTA. See Pancreas transplant Posttraumatic seizures, TBI 657 alone and, 585 Proctocolectomy with PTCA. See Percutaneous Potassium ileostomy, Crohn’s colitis transluminal coronary abnormal concentrations of, and, 452 angioplasty 77, 78 Prognosis, estimating, 34–35 PTC. See Percutaneous electrolytes and, 66 Prognostic nutritional index transhepatic PPQRSTA mnemonic, pain and, (PNI), 12 cholangiography 166, 167 Prograf (tacrolimus) PT. See Prothrombin time Practice guidelines, 27, 28 islet cell transplant and, 733 P Tx. See Pancreas assessment of, 28 OLTX and, 737, 751 transplantation validity and, 29 P Tx and, 730, 731 Pubovaginal sling procedure, PRBCs. See Packed red blood Proliferative without atypia urinary incontinence cells lesions, 340, 341 and, 663 Prednisone, P Tx and, 730 Proscar, BPH and, 661 Pulmonary angiography (PA), Pregnancy. See also Ectopic Prospective Investigation of embolism and, 517 pregnancy Pulmonary Embolism Pulmonary artery catheter flank pain and, 688 Diagnosis (PIOPED), 517 (PAC), shock state and, pain and, 382 interpretation categories and 129–131 trauma in, 561 criteria in, 518 Pulmonary artery occlusion Prehepatic jaundice, 435 Prostaglandin, fetal circulation pressure (PAOP), 87 Preload, myocardium and, 87 and, 261 Pulmonary capillary wedge Premenopausal women, Prostate cancer, 657 pressure (PCWP), 91 palpable breast mass watchful waiting series for, Pulmonary congestion, chest X- and, 352 659 ray and, 273 Preoperative shower, wound Prostate gland, enlargement of, Pulmonary disease, risk infection and, 108 657 assessment for, 8–11 Preoperative SNS, 454 Prostate Symptom Pulmonary dysfunction Prerenal azotemia, 72 Questionnaire, voiding causes of, 91 Prerenal failure, 96 dysfunction and, 657, etiology of, 90–91 Prerenal profusion, kidneys 658 treatment for, 91–93 and, 96 Protein levels Pulmonary edema, 286, 328 Pressors, shock and, 132–134 postoperative complications Pulmonary embolism (PE), Primary anastomosis, ileocolic and, 43 291–292, 303, 515, stenotic disease and, 451 SNS and, 50–51 517–521 Primary arthropathy, joints Prothrombin time (PT), 13, 143, Pulmonary examination, valve and, 591 144 surgery and, 272 Primary closure, arteriotomy hemoptysis and, 237 Pulmonary failure, 90 and, 317 Proximal biceps tendon Pulmonary infection, kidney Primary esophageal motor rupture, 601 transplantation and, 713 disorders, 228 Proximal great vessels, contrast Pulmonary injury, burns and, Primary hyperparathyroidism angiography and, 312 626 (pHPT), 187 Proximal tibiofibular joint, Pulmonary insufficiency, 90 Primary hypersplenism, 419 dislocations of, 612 Pulmonary nodule, 233 Primary lymphedema, 524 PSA. See Serum prostate- Pulmonary system, MODS and, Primary malignant liver specific antigen 86, 90–95 tumors, 414 Pseudoachalasia, 226 Pulmonary toilet procedures, Primary peritonitis, abdominal Pseudocysts, 418 11 pain and, 404 Pseudogout, 592 Pulmonary vascular disease Primary survey Pseudomonas aeruginosa, dirty (PVD), 507 elements of, 84 cases and, 107 Pulmonary vascular resistance, trauma and, 552, 553 Psoas muscle abscess, 482 congestive heart failure algorithm for, 553 Psoriatic arthritis, 592 and, 259, 260 Index 783

Pulsatile abdominal mass, 427 RDA. See Recommended daily Renal transplantation. See AAA and, 428 allowances Kidney transplantation Pulse pressure, 137 a-receptor blockade, urinary Renal tumors, CT of, 678, 679 Pulses, ischemia and, 502 flow and, 659 Renal ultrasound, hematuria Pulse volume recordings Recommended daily and, 664 (PVRs), 504 allowances (RDA), Renal vein samples, renal Pulsus paradoxus, 126 formula for, 637 artery stenosis, 329 Pupillary examination, TBI Rectal examination. See also Renovascular hypertension, and, 566 Digital rectal surgery and, 33 Purulent peritonitis, 456 examination Resection. See Surgical Pus, postoperative flank pain and, 688 resection management and, 110 Rectum, 446–477. See also Resistance, arterial vasculature PVD. See Pulmonary vascular Cancers and, 88 disease anatomy of, 447–449 Respiratory acidosis, 75, 76 Pyogenic bacterial abscess, 416 arterial supply to, 448 Response rate, breast cancer venous drainage of, 449 and, 348 Q Rectus sheath hematoma, Rest angina, 287 Quinolones, 113 abdominal pain and, 405 Restenosis, 317 Quinupristine-dalfopristine, 5a-reductase inhibition, urinary Resting metabolic expenditure 113 flow and, 659 (RME), calculating, 49 Q-wave myocardial infarction, Refractory hypertension, 328 Resuscitation 287 Regional lymph nodes, blood loss and, 357 Q waves, chest pain and, 295 melanoma and, 535 head injury and, 576 Regurgitation, achalasia and, hemorrhagic shock and, R 226 356–357 Radiation exposure, common Rehabilitation, burn wounds lower gastrointestinal studies and, 561 and, 631 bleeding and, 367 Radiation therapy Reliability, 27 primary survey and, 554 BCC and, 530 Remote site infection, wound Retention with urinary cancers and, 180 infection and, 108 overflow incontinence, DCIS and, 349, 350 Renal artery, flank pain and, 687 663 lymphedema and, 524 Renal artery emboli, 683–685 Retrograde urethrogram Radical orchiectomy, testis causes of, 683, 684 bladder tumors and, 680 cancer and, 701 Renal artery stenosis, 328 penile meatus, 664 Radiographic studies. See also vascular etiology of, 329–330, Retroperitoneal lymph node Plain chest X-rays 333 dissection, testis cancer abdominal, neonate Renal calculus disease and, 702 intestinal obstruction abdominal plain film Retroperitoneal lymphoma, 423 and, 652, 653 showing, 690 Retroperitoneal masses, abdominal masses and, 412 flank pain and, 670 421–424 compartment syndrome and, Renal capsule, flank pain and, algorithm for, 423 598 671 Retroperitoneal sarcomas, 546 esophageal swallowing Renal colic, flank pain and, 671 Reversible ischemic neurologic disorders and, 205–206 Renal dysfunction, ICU and, 96 deficits (RINDS), 306 TBI and, 568 Renal failure Review article, meta-analysis Radioisotope scanning, neck hypertension and, 706 and, 26 lesions and, 184 signs of, 96 Review of systems (ROS), 165, Radionuclide scanning, lower Renal function 167 gastrointestinal bleeding P Tx and, 721 patient history and, 139 and, 369 transplantation and, 716 Reynolds’ pentad, 436 Radiotherapy, sarcoma and, Renal infarction, trauma and, Rheumatic valvular disease, 544, 545 680 mitral stenosis and, 270 Ranula, 182 Renal masses, 424 Rheumatoid arthritis, 592 Rapid bowel cleansing, Renal parenchymal failure, 97 Richter’s hernia, 480 colonoscopy and, 369 Renal system, MODS and, 86 Right heart catheterization, 273 784 Index

Right hemicolectomy, hepatic Sclerosing cholangitis, 443 Septic shock, 87, 88, 121 flexure lesions and, 464 Screening mammogram. See treatment algorithm for, 124 Right lower quadrant pain, Mammogram, screening treatment for, 125–126 differential diagnosis for, Screening maneuvers, neonate Serology, P Tx and, 721 390 intestinal obstruction Seroma, 482 Right upper quadrant and, 651 Serum alkaline phosphatase, abdominal pain, Screening tests, alcohol and, melanoma and, 540 differential diagnosis of, 560 Serum bilirubin, wound 398 Scrofula, 182 infection and, 103 Rigid bronchoscopy, Scrotal masses, causes of, 703 Serum creatine, rising, kidney hemoptysis and, 237 Scrotal pain, 696–698 transplantation and, 713 Rigid esophagoscopy, 208 differential diagnosis for, 696 algorithm for, 714 Rigid sigmoidoscopy Scrotal ultrasonography, testis Serum electrolytes, 13 lower gastrointestinal cancer and, 701 data for, 64 bleeding and, 367–368 Scrotum, benign lesions of, Serum prostate-specific antigen volvulus and, 459 698–700 (PSA), prostate cancer RINDS. See Reversible ischemic Sebaceous cysts, 182 and, 658 neurologic deficits Seborrheic keratoses, 182, 189 Serum sodium level, 69, 71 Risk assessment Secondary hypersplenism, 419 Serum thyroglobulin levels, acute surgical abdomen and, Secondary hypertension, 326 thyroid cancers and, 198 377 Secondary lymphedema, 524 Serum tumor markers, testis cardiac events and, 6–8, 7 Secondary survey, trauma and, cancer and, 700 pulmonary disease, 8–11 555–556 Sestamibi scan, 184 Risk management, lower Secondary urinary tract Severe head injury, treatment, extremity ischemia and, etiology, 657 576–584 505 Second branchial cleft cyst, 185 Sexual history, masses and, 180 RME. See Resting metabolic Second-degree burns, Sexually transmitted diseases, expenditure superficial dermis and, acute epididymitis and, ROS. See Review of systems 624 698 Rotator cuff strains, 601 Secretory diarrhea, 470–471 Shaving, wound infection and, Rotator cuff tears, Securing airway, mechanical 108 supraspinatus tendon ventilation and, 92 Shock. See also Cardiogenic and, 601 Sedation, TBI and, 577 shock Rule of nines, burn size and, Segmental pressure types of, 119–129 624 measurement, 504 Shock state, 87, 118–135 Seminoma tumors, 700 dopamine and, 133 S Sengstaken-Blakemore tube, GI vasoactive drugs and, 89, 133 Salicylates, acute pericarditis, bleeding and, 366 Shoe covers, 107 302 Sensory examination, TBI and, Short Michigan Alcohol Salter-Harris fracture 567 Screening Test (SMAST), classification, 600 Sentinel node biopsy (SNB), 560 Saphenous vein, renal artery melanoma and, 538 Shoulder, skeletal anatomy of, stenosis and, 333 Sepsis. See also Abdominal 601 Sarcoma, 541–546 sepsis; Biliary sepsis; Shoulder separation, 603 anatomic distribution of, 542 Perineal sepsis; Septic SH. See Social history Sartorius muscle, avulsion of, shock; Wound sepsis Shunt, carotid clamping and, 609 pancreatic necrosis and, 399 322 Scalp examination, 189 postoperative, 111 SIADH. See Syndrome of Scapula fractures, 603 symptoms of, 125 inappropriate ADH SCC. See Squamous cell wounds and, 101 Sickle cell anemia, abdominal carcinomas SEPS. See Subfascial endoscopic pain and, 405 SCI. See Spinal cord injury perforator vein surgery Sigmoid diverticulitis, 390 Scleroderma, esophageal Septic arthritis, 592 barium enema of, 393 manifestations of, 230 Septic decompensation, 125 CT scan of, 393 Index 785

Sigmoidoscopy Small intestinal disease, 451 Somatic pain minor rectal bleeding and, Small intestinal diverticuli, abdominal pain and, 378 370 392 algorithm for, 379 ulcerative colitis and, 453 Small left colon syndrome, Spastic motor disorders of Sigmoid volvulus, 459–460 neonate intestinal esophagus, manometric Silver sulfadiazine, burn obstruction and, 655 criteria for, 229 wounds and, 628 SMAST. See Short Michigan Specialized nutrition support Sinuses, cancers of, 192 Alcohol Screening Test (SNS), 56 Sirolimus, islet cell transplant SMLC. See Small-cell lung algorithm for, 44 and, 733 carcinoma assessing, 43–45 SIRS, 90–91 Smoking. See Tobacco defining route of, 47–49 Sitz baths, fissures and, 474 Snake bite, abdominal pain formulations for, 52–58 Skeletally immature bone, and, 405 monitoring complications of, skeletally mature bone SNB. See Sentinel node biopsy 58–60 v., 592–593 SNS. See Specialized nutrition monitoring progress of, Skeletally mature bone, support 58–60 skeletally immature SOAP approach, abdominal non-protein calories for, 50 bone v., 592–593 pain and, 386 prescription definition for Skin, 527–548 Social history, 5 basic formulations for, zones of, 623 gastrointestinal bleeding and, 51–58 Skin biopsy, BCC and, 530 360 basic requirements in, Skin cancer, 189 tobacco use and, 178–180 49–51 benign v. malignant, 546–548 Social history (SH), 165 organ dysfunction and, SCC and, 531 Sodium. See also Serum sodium 51–52 Skin cancer, nonmelanoma, level termination of, 60 management of, electrolytes and, 66 Speed reading skills algorithm for, 546 Sodium concentration mnemonic for, 162 Skin care, lymphedema and, abnormal, 73 surgery clerkship and, 525 changes in, 72–74 160–164 Skin lesion, 527–541 Sodium deficit, 72, 74 Spermatic cord, 483 case studies of, 527–528 Sodium excess, 69 Spermatocele, 699 evaluation of, 529 stress response and, 72 Spider bite, abdominal pain ulcerated, 180, 181 Sodium level. See Serum and, 405 Skin meshing, burn wounds sodium level Spigelian hernia, 496 and, 629 Soft tissue injury Spinal column, fractures of, Skin screening examinations, open fractures and, 595 618–619 533 wrist and, 607 Spinal cord injury (SCI), Skin yellowing, bilirubin Soft tissue lesion, biopsy of, 558–559 metabolism and, 434 indications for, 542 shock and, 129 Skull fractures, TBI and, 569 Soft tissues, 527–548 Spinal shock, neurogenic shock Sliding hernia. See Type 1 hiatal Soft tissue sarcoma, initial v., 129 hernia management of, 547 Spine, motion and, 617–618 Sliding hiatal hernia, 497 Soft tissue sarcoma metastasis, Spine injury, trauma and, 554 Small bowel, intraoperative surgical resection of Spiral fractures, child abuse endoscopic exploration, pulmonary lesions in, and, 592 364 546 Spiral fractures of humeral Small bowel obstruction, 403 Solid mass, breast, 338, 339 shaft, 604 intestinal tubes and, 402 Solitary pulmonary nodules, Spiral oblique fractures, 592 X-ray of, 401 240–244 Spirometry, 11 Small bowel perforation, 388 algorithm for, 242 Spleen, spontaneous rupture of, Small bowel tumors, 424 evaluation of, 240–241 386 Small-cell lung carcinoma histologic diagnosis of, Splenectomy, 420–421 (SMLC), 244, 245 243–244 indications for, 421 management of, 255 Solitary thyroid nodule, 188 Splenic disorders, 382 786 Index

Splenic enlargement, cysts and, Stool Surgery. See also Cardiac 420 abdominal pain and, catheterization; Clean Splenomegaly, 418–420 384–385 operative cases; causes of, 419 lower extremity swelling Contaminated surgery Splinting, fracture and, 595 and, 512 cases; Dirty surgery Spontaneous abortion, 399 Stool softeners, fissures and, cases; Electrolyte(s); Sprain 474 Evidence-based surgery; grades of, 591 Streptokinase catheter Fluid; Focused surgical joint capsule and, 590–591 embolectomy, emboli history; Lung resection Sputum culture, hemoptysis and, 685 surgery; Postoperative and, 237 Stress fracture, 592 care; Postoperative Squamous cell carcinoma in Stress response, 63 infection; Preoperative situ. See Bowen’s sodium excess and, 72 shower disease Stress ulcers, 365 acute cholecystitis and, Squamous cell carcinomas Stress urinary incontinence, 663 396–397 (SCC), 244, 530–532 Stroke, 305–324. See also antireflux, 221–222 anal margin and, 476–477 Transient ischemic bioethics and, 151 esophagus and, 210 attack BPH and, 661 features of, metastases and, epidemiology of, 308–309 cardiac, pediatric, 262 531 pathophysiology of, 306–309 carotid artery, stroke and, Squamous cell carcinomas of prevention of, 315 314, 315 lip, 190 treatment and, 313–315 clerkship, skill in, 159–160 Squamous cell carcinomas of vascular etiology of, 328 coronary bypass, ischemic tongue, 182 ST segments, chest pain and, heart disease and, 298 Staghorn calculus, 673 295 CVI and, 523 Staging system. See also Study designs. See also Levels diverticulitis and, 456 American Joint of evidence elective Committee on Cancer hierarchy of, 24, 25 MI and, 6 staging system Subacute thyroiditis, 187 unstable angina and, 6 colorectal malignancy and, Subarachnoid hemorrhages, emboli and, 685 462–463 571, 572 emergent scrotal exploration, lymph node metastases and, Subdural hematomas, 570 testis torsion and, 679 345 Subfalcine herniation, 574 energy needs for, 49–50 Standardized clinical Subfascial endoscopic ethical issues in, 155–157 examinations, 164–170 perforator vein surgery femoral artery aneurysm Standardized written (SEPS), leg ulcers and, and, 482 examinations, 170–174 523 fluid balance, summary of, 80 Staphylococcus aureus, 103 Submandibular gland, mouth fluid status after, pediatric Stem cells, islet cell cancer and, 189 patient and, 642 transplantation and, 734 Sulfamylon. See Mafenide GER and, 220 Stented tissue valves, 277 acetate hemorrhoids and, 475 Stenting Sulfasalazine laboratory studies and, 13, 16 carotid angioplasty and, Crohn’s disease and, 451 lymphedema and, 524, 525 322 ulcerative colitis, 453–454 neonate intestinal obstruction renal artery stenosis and, 333 Sulfonamide drugs, 112 and, 655 Stereotactic biopsy with large- Sun, SCC and, 531 patient, nutrition support in, bore needles, 349 Superficial dermis, second- 42–61 Steroid therapy degree burns and, 624 peptic ulcer disease and, 365 acute pericarditis, 302 Superficial spreading physiologic response to, 63 inhalation injury and, 626 melanoma, 535 protein needs for, 50–51 OLTX and, 737, 751 Superior sulcus tumor, 248 SNS and, 60–61 SCI and, 558 Supported breaths, 92 solitary pulmonary nodules Stomach, gastrointestinal Supraspinatus tendon, rotator and, 243 bleeding and, 359 cuff tears and, 601 thyroid cancers and, 198 Index 787

Surgical abdominal Survival Tamoxifen emergencies, 386–389 breast cancer and, 348 breast cancer and, 347 Surgical airway, inhalation P Tx and, 730 DCIS and, 349, 350 injury and, 626 SVR. See Systemic vascular P-1 Breast Cancer Prevention Surgical bleeding. See Bleeding, resistance Trial and, 351 surgical Swallowing Tamponade, 291 Surgical bypass, peripheral difficulty in, 200–231 Tangential excision, burn aneurysm and, 427 disordered motor function wounds and, 629 Surgical critical care, 82–98 in, 228 TBI. See Traumatic brain objectives for, 82 etiologies associated with, injury Surgical debridement 205 TBSA. See Total body surface burn wounds and, 628 physiology of, 203 area necrotizing wounds and, 111 Swan-Ganz catheter, TBW. See Total body water open fractures and, 597 hemoptysis and, 234 Technetium bone scanning, penetrating head injury, 584 Swelling, unilateral, 513. See sarcoma and, 543, 544 Surgical evaluation, 3–4 also Compression TEE. See Transesophageal cardiac conditions and, 6 stockings echocardiography hematologic considerations Syndrome of inappropriate Teicoplanin, 113 in, 12–13 ADH (SIADH), 71 Tenderness nutritional status and, 11–12 water deficit caused by, 71 abdominal pain and, 383 pulmonary considerations water excess caused by, 71 flank pain and, 688 and, 8–11 Synthetic colloid. See also Tendinopathies, 590 Surgical excision, melanoma Hetastarch Tendon avulsions, 590 and, 537 crystalloid solution v., 123 Tendon lacerations, 590 Surgical exclusion, peripheral Systematic reviews. See also Tendonosis, 590 aneurysm and, 427 Review article Teratoma, 700 Surgical extirpation, clinical studies and, 25, 26 Tertiary survey, trauma and, pheochromocytoma and, guidelines for, 26 556 330 validity and, 27, 28 Testicle, 694 Surgical history, pain and, 382 Systemic adjuvant therapy, Testis Surgical hypertension, 325–334 breast cancer and, 347 masses, 698, 699 common causes of, Systemic anticoagulation, torsion, 696–697 frequencies of, 326 stroke and, 314 tumors, 700–703 differential diagnosis for, 326 Systemic drainage technique, workup algorithm for, 701 Surgical intensive care unit P Tx and, 725, 726 Test taking skills, 170 (ICU), ARDS and, 90 Systemic inflammatory Tetanus Surgical myotomy, achalasia response prophylaxis and, 227 pain and, 382 open fractures and, 597 Surgical orchiopexy, 695 shock and, 121 postburn period and, 627 Surgical resection Systemic metabolic disorders, secondary survey and, 555 bowel cancers and, 467 abdominal pain and, 405 Tetralogy of Fallot, 260 hemoptysis and, 240 Systemic metastases, breast Therapy, deciding on, 35–37 malignant cystic tumors of cancer death and, 343 Thermal injury. See Burn(s) pancreas and, 418 Systemic therapy, breast cancer Third-degree burns, 624 of pulmonary lesions, soft and, 343 Third space fluid loss, tissue sarcoma Systemic vascular resistance hypovolemic shock and, metastasis and, 546 (SVR), 88 119–120 Surgical scar, obstructing Thoracic aorta, diseases of, 288, adhesive band and, T 300–302 401 Tachycardia, 137 Thoracic injuries, trauma and, Surgical site infection. See Tachypnea, 92 552 Wound sepsis Tacrolimus. See Prograf Thoracic pain, abdominal pain Surgical wound infection. See Talar neck, displaced fractures and, 405 Wound sepsis of, 617 Throat pain, 286 788 Index

Thrombolytic therapy. See Topical drug therapy, burn Transverse fracture, 592 also Anticoagulation wounds and, 628 Trauma. See also Abdominal therapy Tortuous innominate artery, 186 trauma; Closed head embolism and, 519 Torus fracture, pediatric injury; Traumatic brain peripheral aneurysm and, fractures and, 600 injury 427 Total body surface area (TBSA), alcohol and, 559–560 stroke and, 313 burns and, 623, 624 burn care as, 623–624 Thrombosis, 148 Total body water (TBW), 64 burn injury and, 631–632 Thrombosis of vascular Total esophagectomy, chest injuries and, 552 anastomoses, P Tx and, esophageal carcinomas DVT and, 515 729 and, 213 fundamentals of, 549–562 Thyroglossal duct cysts, 182, Total fluid requirement, shock hematuria and, 664 185 and management, 550 Thyroid cancer Total intracranial volume, brain mortality, trimodal pattern total thyroidectomy and, component of, 582 of, 550 195–196 Total thyroidectomy, 197 renal infarction from, 680 treatment of, algorithm for, proponents supporting less splenic, 420 194 than, 195–196 venous thromboembolism Thyroid gland Toupet fundoplication, 222 and, risk factors for, 515 goiter and, 182 Toxicity, drug, dirty cases and, Trauma center, 556 neck lumps and, 198 106 Trauma survey, 551–556 palpation of, 183 Toxic megacolon, 453 Traumatic brain injury (TBI)

Thyroiditis, 187 Transcutaneous O2 diagnostic evaluation for, Thyroid mass, 187–189 measurement, 505 567–574 Thyroid nodule, 188 Transesophageal evaluation of, 564–587 evaluation of, algorithm for, echocardiography (TEE), management of, 558, 564–587 179 290 neurologic complications in, palpation and, 183 chest pain and, 295–296 584–586 Thyroid storm, 188 thoracic aorta and, 300 pathophysiology of, TIA. See Transient ischemic Transient ischemic attack (TIA), 573–574 attack 306 treatment of, 574, 575 Tibia, fractures of, 613 Transjugular portasystemic Traumatic cysts, 416 Tibial plateau fracture, 613 shunts (TIPS), bleeding Traumatic flank pain, 680, 683 radiographs of, 613 and, 366 Traumatic hernia, 497 Ticarcillin-clavulinic acid, dirty Transplantation. See Cadaveric Traumatic injury cases and, 106 donor(s); Donor; Kidney gastrointestinal bleeding and, Ticlopidine (Ticlid), stroke and, transplantation; Liver 359 314 transplantation; Organ shock following, 121 Tidal volumes, 93 transplantation; Traumatic shock, 121 Timed barium esophagogram, Pancreas transplantation Trauma triage, 550–551 esophageal swallowing Transsphenoidal resection of Triage of resources, 156 disorders and, 206 pituitary gland, Trials, clinical. See Study TIPS. See Transjugular Cushing’s disease and, designs portasystemic shunts 330 Triceps avulsions from Tirilazad, SCI and, 559 Transtentorial herniation, 574 olecranon, 605 Tissue edema, 66 Transthoracic fine-needle Tricuspid insufficiency, 266 Tissue injury, shock and, 121 aspiration (FNA), Tricuspid regurgitation, 271 TNM classification. See Tumor/ solitary pulmonary Triple test, breast and, 340 node/metastasis nodules and, 243, 244 Trisomy 21, neonate intestinal classification Transurethral electrosurgical obstruction and, 650 Tobacco, 11 resection, BPH and, 661 Troponin levels, 288 cancers and, 178–180 Transurethral resection of chest pain and, 295 flank pain and, 687 prostate (TURP), voiding Truncal vagotomy, peptic ulcer Tonsillar herniation, 574 and, 659 disease and, 365 Index 789

Tuberculous peritonitis, TWEAK, alcohol screening Ultrasound examination abdominal pain and, 404 and, 560 abdomen and, 557 Tubo-ovarian abscess, 399 Tympanitic gas, 384 biliary stone disease and, 445 Tumor cells of lower Type 1 diabetes mellitus, 720 breast mass and, 339 esophagus, 202–203 Type 1 hiatal hernia (sliding maternal, neonate and, 648 Tumor/node/metastasis hernia), 222, 223 pancreatic tumors and, 417 (TNM) classification, 462 paraesophageal hernias v., Umbilical hernias, 494 Duke’s cancer staging system 223 Undescended testis, 703 v., 462 Type 2 diabetes mellitus, 720 Unfractionated heparin (UFH), lung cancer and, 250, 252 Type 2 hiatal hernias embolism and, 519, 520, melanoma and, 536, 537 (paraesophageal 521 sarcoma and, 543 hernias), 497 United System for Organ Tumors, 421, 423–424. See also Type 2 hiatal hernias Sharing (UNOS) cadaver Abdominal masses; (paraesophageal kidney allocation Cancers; Clark hernias), 222, 223 system, 707 classification of tumor Type A aortic dissections, 289, Universal precautions, depth; Malignant cystic 301 secondary survey and, tumors of pancreas; Type B aortic dissections, 289, 555 Malignant epithelial 290 Unna’s boot, CVI and, 523 lung tumors; Metastatic medical therapy and, UNOS. See United System for tumors; Primary 301–302 Organ Sharing cadaver malignant liver tumors; Type III hiatal hernias, 223 kidney allocation system Primary tumor; Staging Type IV hiatal hernias, 223 Unstable angina, 286 system; Testis; Tumor/ Upper esophageal endoscopy, node/metastasis U 210 classification; Urinary UC. See Ulcerative colitis Crohn’s disease and, 450 tract UFH. See Unfractionated upper gastrointestinal benign, 245 heparin bleeding and, 362 of head and neck, 185–189 Ulcer(s). See also Peptic ulcer Upper gastrointestinal benign esophageal, 215–216 disease; Stress ulcers; bleeding, management bladder, 678, 679 Unna’s boot of, 362 bronchial gland, 246 duodenal, 388 algorithm for, 363 colon, 424 gastric, 365 Upper gastrointestinal contrast cystic, 418 gastroduodenal, abdominal studies, neonate germ cell, 421, 423 pain and, 405 intestinal obstruction liver, classification of, 413 gastrointestinal bleeding and, and, 652 malignant esophageal, 359 Upper tract imaging, children 210–215 leg, 523 and, trauma in, 680 mediastinum, 246–247 SCC and, 531 Upper urinary tract imaging, nonsenoma, 700 venous, treatments for, 523 hematuria and, 664 pancreatic, 417–418 Ulcerative colitis (UC), 372, Urea splitting bacteria, stones, parotid, 189, 192 453 673 primary germ cell, 421 abdominal pain and, 405 Ureteral calculus, salivary gland, 186, 189, 192 Crohn’s disease v., 450 pyelonephritis and, 677 seminoma, 700 extraintestinal manifestations Ureteral injuries small bowel, 424 of, 453 diagnosis of, 684 spermatic cord, 482 management of, algorithm mechanism and site of, 683 stomach, 424 for, 454 Urethra, abnormalities of, 668 swallowing difficulty and, medical therapy for, 453–454 Urgency urinary incontinence, 210–215 Ultrasonography. See also 663 testicular, 421 Duplex ultrasonography Urgent colonoscopy, lower urologic, 679 abdominal, AAA and, 428 gastrointestinal bleeding TURP. See Transurethral acute epididymitis and, 698 and, 368–370 resection of prostate testis torsion and, 679 Uric acid stones, 673 790 Index

Urinalysis V Ventricular septal defect, flank pain and, 689 Vacuum assisted core biopsy, congenital heart disease ureteral injury and, 665, 684 349 and, 261 Urinary calculi, 690 Valve. See Heart valve Ventriculostomy, TBI and, 577 flank pain and, 672 Valvular heart disease Verbal response test, TBI and, risk factors for, 673–674 etiologies of, 268 565 types of, 672–673 summary of diagnosis of, 281 Vesicourethral reflux, Urinary catecholamines, 330 surgery and, 274–275 pyelonephritis and, 677 pheochromocytoma and, Vancomycin, 113 Vessel patency, 507 329 Vancomycin-resistant Vigorous achalasia, 226 Urinary flow rates, drugs for, enterococcus (VRE), Vincent’s angina, 186 659 wound infection and, 103 Viral gastroenteritis, pain and, Urinary free cortisol levels, Vanillylmandelic acid, 378 Cushing’s disease, 329 pheochromocytoma and, Viral infection, OLTX and, 748 Urinary frequency, 658 329 Virchow’s triad, DVT and, 514 flank pain and, 686 Van Nuys Prognostic Index, Visceral aneurysms, 386 Urinary incontinence, 662–664. breast cancer and, 350 Visceral angiography, AVM See also Voiding Varicocele, 482, 699–700 and, 371 classification of, 662 Vascular abdominal masses, Visceral pain female patient and, 662–663 431–432 abdominal pain and, 378 male patient with, 663–664 Vascular disease, intermittent algorithm for, 380 TURP and, 659 claudications and, 502 Visceral receptors, 379 Urinary tract. See also Urinary Vascular injuries, TBI and, 585 Vital signs calculi; Urinary Vascular lesions, 186 flank pain and, 687 incontinence; Urinary Vascular thrombosis hemodynamically stable tract infection; Voiding kidney transplantation and, patient and, 137 cystitis and, 666 713 Voiding, 658, 659 flank pain and, 671 P Tx and, 729 lower urinary tract disorders hypovolemic shock and, 119 Vasculitis, abdominal pain and, and, 657 lower quadrant pan and, 390 405 Prostate Symptom obstruction Vasoconstriction, coagulation Questionnaire and, 657, large bladder and, 137 658 rhabdomyosarcoma and, Venipuncture site, bleeding Voiding cystourethrogram, 688 and, 141 reflux in, 677 pyelonephritis and, 677 Venography, DVT and, 516 Volume of platelet transfusion, tumors, flank pain and, Venous thromboembolism pediatric patient and, 678–680 (VTE), 514 641 Urinary tract infection. See also risk factors for, 515 Voluntary guarding, abdominal Chronic urinary tract trauma and, 515 pain and, 383 infection Venovenous bypass, OLTX and, Volvulus, 459–460 kidney transplantation and, 736, 745, 746 Vomiting. See also 713 Ventilation, 90 Regurgitation Urine respiratory system and, 91, bilious, neonate and, 648 bilirubin metabolism and, 92 flank pain and, 686 434 Ventilation/perfusion scan gastrointestinal bleeding and, leaks, kidney transplantation (V/Q), embolism and, 360 and, 713 517 intestinal obstruction and, output, renal dysfunction Ventilator modes, 92, 93 401 and, 96 conventional, 94 V/Q. See Ventilation/perfusion water deficit and, 72 Ventilator. See Mechanical scan Urodynamic testing, bladder ventilation VRE. See Vancomycin-resistant function and, 658 Ventilatory support, 93 enterococcus Urologist, flank pain and, 691 Ventral hernias, 494 VTE. See Venous Uterine disease, pain and, 382 Ventral incisional hernias, 494 thromboembolism Index 791

W testis torsion and, 679 Wound infection. See Wound Warfarin, 13 wound infection and, 103 sepsis emboli and, 519, 520 wounds and, 101 Wound sepsis Watchful waiting, hernias and, Whole blood, 146 kidney transplantation and, 489 Whole organ pancreas 713 Water. See also Total body transplantation, postoperative fever and, 110 water technique for, 727 prevention guidelines for, 15 deficit, SIADH and, 71 WHO. See World Health signs of, 110 electrolytes and, 66 Organization surgical site and excess, 69 Wire localized excisional CDC and, 110 SIADH and, 71 biopsy, 349 evidence based guidelines, WBCs. See White blood cells World Health Organization 104 Wedge pressure, 88 (WHO), alcohol and, WBC and, 102 Weight 560 Wound surveillance protocol, initial assessment of, Wound(s). See also Burn(s); infections and, 102–103 pediatric patient and, Dirty wound; Wound Wrist 640 sepsis; Wound dislocation, 607 pediatric patient and, 638 surveillance protocol soft tissue injury around, 607 P Tx and, 721 burn, 623, 627 Wrist joint, composition of, Weight loss closure, methods of, 629 606–607 esophageal carcinomas, 211 infection and, 101, 102 gastrointestinal bleeding and, non-healing, SCC and, 531 X 360 Wound classification system X-ray examination. See also malignancy and, 442 infection risk in, surgery and, Chest radiograph; Plain SNS and, 44 102 chest X-rays White blood cells (WBCs) postoperative management bleeding and, 364 pyelonephritis and, 677 and, 110 TBI and, 568