1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103–2899 ABERNATHY’S SURGICAL SECRETS, SIXTH EDITION ISBN: 978-0-323-05711-0 Copyright Q 2009, 2005, 2003, 2000, 1996, 1991, 1986 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (þ1) 215 239 3804 (US) or (þ44) 1865 843830 (UK); fax: (þ44) 1865 853333; e-mail: [email protected]. You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions. NOTICE Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editor assumes any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. The Publisher Library of Congress Cataloging-in-Publication Data Abernathy’s surgical secrets. – 6th ed. / [edited by] Alden H. Harken, Ernest E. Moore. p. ; cm. – (The secrets series) Includes bibliographical references and index. ISBN 978-0-323-05711-0 1. Surgery–Examinations, questions, etc. I. Abernathy, Charles. II. Harken, Alden H. III. Moore, Ernest Eugene. IV. Title: Surgical secrets. V. Series. [DNLM: 1. Surgical Procedures, Operative–Examination Questions. WO 18.2 A146 2009] RD37.2.S975 2009 617.0076–dc22 2008031054 Acquisitions Editor: Jim Merritt Developmental Editor: Christine Abshire Project Manager: Mary Stermel Marketing Manager: Alyson Sherby Printed in China DEDICATION Charles M. Abernathy, M.D. 1941–1994 v CONTRIBUTORS Brett B. Abernathy, MD Clinical Instructor, Division of Urology, Department of Surgery, University of Colorado Health Sciences Center, Denver, Colorado; The Urology Center of Colorado, Denver, Colorado Jason Q. Alexander, MD Chief, Vascular Surgery, Kaiser Oakland Medical Center, Oakland, California; General Surgery Residency Site Director, Division of Vascular and Endovascular Therapy, University of California, San Francisco–East Bay, Oakland, California David Altman, MD, MBA Chief Medical Officer, Alameda County Medical Center, Oakland, California Nancy C. Andersen, MD Resident, Department of General Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina Benjamin O. Anderson, MD Director, Breast Health Center, Professor, Department of Surgery, University of Washington School of Medicine, Seattle, Washington Ashok N. Babu, MD General Surgery Resident, Department of Surgery, University of Colorado, Denver, Colorado Thomas E. Bak, MD Department of Transplant Surgery, University of Colorado Denver, Aurora, Colorado; University of Colorado Hospital, Denver, Colorado Carlton C. Barnett, Jr., MD Assistant Professor, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas Joel Baumgartner, MD Surgery Resident, Department of Surgery, University of Colorado, Denver, Colorado Bernard Timothy Baxter, MD Professor, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska; Staff Surgeon, Department of Surgery, Methodist Hospital, Omaha, Nebraska Kathryn Beauchamp, MD Assistant Professor, Department of Neurosurgery, University of Colorado at Denver, Denver, Colorado; Neurosurgeon, Department of Neurosurgery, Denver Health Medical Center, Denver, Colorado Allen T. Belshaw, MD Assistant Clinical Professor, Department of Surgery, University of Colorado Health Sciences Center, Denver, Colorado; General Surgeon, Yampa Valley Medical Center, Steamboat Springs, Colorado Denis D. Bensard, MD Professor of Surgery, Department of Pediatric Surgery, University of Cincinnati and The Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Director, Department of Pediatric Surgery, The Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, Indiana xv xvi CONTRIBUTORS Walter L. Biffl, MD, FACS Assistant Professor of Surgery, Department of Surgery, University of Colorado Denver School of Medicine, Denver, Colorado; Acute Care Surgeon, Assistant Director of Patient Quality and Safety, Department of Surgery, Denver Health Medical Center, Denver, Colorado Natasha D. Bir, MD, MHS Resident, Department of Surgery, University of California, San Francisco–East Bay, Oakland, California Elizabeth C. Brew, MD Private Practice, General Surgery, Wheat Ridge, Colorado Laurence H. Brinckerhoff, MD Chief, General Thoracic Surgery, Assistant Professor, Department of Surgery, Tufts Medical Center, Boston, Massachusetts Jamie M. Brown, MD Associate Professor of Surgery, Department of Surgery, University of Maryland, Baltimore, Maryland; Associate Professor of Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland Mark P. Cain, MD Professor, Department of Urology, Indiana University, Indianapolis, Indiana; Riley Hospital for Children, Indianapolis, Indiana Kristine E. Calhoun, MD Assistant Professor, Department of Surgery, University of Washington School of Medicine, Seattle, Washington Brian P. Callahan, MD Chief Resident, Department of Neurosurgery, University of Colorado Health Sciences Center, Denver, Colorado Jeffrey Campsen, MD Surgical Transplant Fellow, Department of Transplantation, University of Colorado Health Sciences Center, Aurora, Colorado Anne Cannon, RN, BSN Ventricular Assist Device Coordinator, Department of Cardiothoracic Surgery, University of Colorado Hospital, Aurora, Colorado Mario F. Chammas, Jr., MD Urologist, Department of Urology, University of Colorado Denver, Aurora, Colorado; Urologist, Department of Urology, Denver Health Medical Center, Denver, Colorado David J. Ciesla, MD, MS Associate Professor, Department of Surgery, University of South Florida, Tampa, Florida; Director of Trauma and Surgical Critical Care, Department of Surgery, Tampa General Hospital, Tampa, Florida Joseph C. Cleveland, Jr., MD Associate Professor of Surgery, Surgical Director, Cardiac Transplant and MCS, Department of Surgery, University of Colorado at Denver, Aurora, Colorado; Associate Professor, Department of Surgery, University of Colorado Hospital, Aurora, Colorado; Chief, CT Surgery, Department of Surgery, Denver Veterans Affairs Medical Center, Denver, Colorado C. Clay Cothren, MD Assistant Professor, Department of Surgery, University of Colorado School of Medicine, Denver, Colorado; Program Director, Surgical Critical Care & TACS Fellowships, Department of Surgery, Denver Health Medical Center, Denver, Colorado Paul R. Crisostomo, MD Research Fellow, Department of Surgery, Indiana University, Indianapolis, Indiana; Resident in Surgery, Department of Surgery, Indiana University, Indianapolis, Indiana CONTRIBUTORS xvii Elizabeth L. Cureton, MD Resident in General Surgery, Department of Surgery, University of California, San Francisco–East Bay, Alameda County Medical Center, Oakland, California Laura DiMatteo, MD Orthopaedic Surgery Resident, Department of Orthopaedics, University of Colorado Health Sciences Center, Denver, Colorado Alexander Q. Ereso, MD Chief Resident, Department of Surgery, University of California, San Francisco–East Bay, Alameda County Medical Center, Oakland, California Michael E. Fenoglio, MD General Surgeon, Department of General Surgery, Presbyterian St. Luke’s Hospital, Denver, Colorado; General Surgeon, Department of General Surgery, St. Joseph’s Hospital, Denver, Colorado; General Surgeon, Department of General Surgery, University of Colorado Health Sciences Center, Denver, Colorado Christina A. Finlayson, MD Associate Professor, Department of Surgery, University of Colorado Denver, Aurora, Colorado; Director, Diane O’Connor Thompson Breast Center, University of Colorado Hospital, Aurora, Colorado David A. Fullerton, MD Professor and Division Head, Department of Cardiothoracic Surgery, University of Colorado Denver, Aurora, Colorado; Faculty Surgeon, Department of Surgery, Division of Cardiothoracic Surgery, University Hospital, Aurora, Colorado; Faculty Surgeon, Department of Cardiothoracic Surgery, The Children’s Hospital, Aurora, Colorado; Faculty Surgeon, Department of Cardiothoracic Surgery, Veterans Administration Medical Center, Denver, Colorado Glenn W. Geelhoed, MD, MPH, MA, DTMH, ScD (Hon), MA, MPhil, EdD, FACS Professor of Surgery, International Medical Education, Microbiology, Immunology, and Tropical Medicine, Departments of Surgery and Microbiology, Immunology, and Tropical Medicine, Office of the Dean, George Washington University Medical Center, Washington, DC; Distinguished Global Professor of International Medicine, Center for Creative Learning, University of Toledo Medical Sciences Center, Toledo, Ohio; Distinguished Professor of Obstetrics