Jaundice
is the clinical finding of yellow discolouration of the body tissues usually observed in the skin secondary to excess bilirubin in the serum (hyperbilirubinemia). Jaundice occurs due to an imbalance between production and clearance of bilirubin; therefore, it is important to understand the pathophysiology of jaundice to understand its aetiology. Clinically a careful history, physical examination, together with appropriate urine and blood tests will guide further investigations to obtain an appropriate diagnosis. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 10, 2023 Category: Surgery Authors: Magnus Johnston, Ravi (Rajan) Ravindran Tags: Hepatobiliary Source Type: research
Secretory functions of the gastrointestinal tract
The alimentary tract is an organ of functional diversity. The absorption of water, nutrients, minerals, and vitamins is made possible through the coordinated action of the salivary glands, intestine, stomach, exocrine pancreas and hepatobiliary system. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 10, 2023 Category: Surgery Authors: Henrik Isackson, Christopher C. Ashley Tags: Basic Science Source Type: research
Overview on the management of adult urinary incontinence
Urinary incontinence is a major health issue that affects more than 300 million people worldwide. Prevalence estimates vary depending on the group investigated and how incontinence is defined. The condition is significant in terms of the distress it causes patients and the costs it incurs on healthcare systems. It is generally classified as either stress, urge or mixed incontinence. Although there is higher prevalence in women, increasing interventions for the prostate for both benign and malignant conditions, has increased the prevalence in men. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 10, 2023 Category: Surgery Authors: Mohamed Sorour, Thomas King Tags: Renal and urological surgery III Source Type: research
Pseudo-obstruction, acquired megacolon and sigmoid volvulus
In this article we present the clinical features, diagnosis and management of a group of benign lower gastrointestinal disorders that present with features of large bowel obstruction. Colonic pseudo-obstruction, acquired megacolon and sigmoid volvulus commonly affect elderly institutionalized patients with multiple comorbidities, presenting challenges in management. Identification and treatment of any underlying causative pathology, along with conservative measures, is often the mainstay of management. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 8, 2023 Category: Surgery Authors: Tabitha Gana, H.S. Narula Tags: Intestinal surgery II Source Type: research
Anatomy of the small intestine
The small intestine, comprising the duodenum, jejunum, and ileum commences at the pyloroduodenal (gastroduodenal) junction and ends at the ileocaecal junction. The principal function of the small intestine is the digestion and absorption of ingested food, electrolytes, and vitamins. As might be expected from its very active role as a secretory and absorptive viscus, the small intestine has a rich blood supply and an extensive surface area of absorptive mucosa. The blood supply is derived chiefly from the superior mesenteric artery via its inferior pancreaticoduodenal, jejunal and ileal branches. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 8, 2023 Category: Surgery Authors: Peter J. Bazira Tags: Basic science Source Type: research
Clinical, radiological and physiological assessment of anorectal function
This article details the clinical assessment of presenting patients to establish potential causes, grade the severity of the symptoms and to assess the impact on their quality of life. The appropriate specialized radiological and physiological investigations aim to evaluate the structural integrity and function of the anal sphincter, the anorectal and pelvic floor musculature and measure the transitory function of the colon. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 8, 2023 Category: Surgery Authors: Rhiannon L. Harries, Gregory Taylor Tags: Intestinal surgery – II Source Type: research
Diverticular abscess, pelvic and other intra-abdominal abscesses
Intra-abdominal abscesses are a common surgical problem, occurring primarily in association with a variety of perforating or suppurative intra-abdominal visceral diseases or secondary to postoperative complications, including anastomotic dehiscence. Early diagnosis and recognition of associated pathology, based on clinical assessment and appropriate investigation, including accurate cross-sectional imaging and interpretation, are essential for the planning of treatment and eradication of sepsis. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 7, 2023 Category: Surgery Authors: Rebecca Reid, Kathryn Boyce, Richard Guy Tags: Intestinal surgery II Source Type: research
Acute appendicitis
is inflammation of the vermiform appendix. It is the commonest general surgical emergency in children and young adults, yet its diagnosis can still confound even the most skilled surgeon due to its highly variable presentation of appendicitis, with fewer than 50% of patients exhibiting classical features. Taking a detailed history and performing a careful examination remains the cornerstone of diagnosis. Urinalysis and blood tests, particularly C-reactive protein, are useful adjuncts and are performed routinely. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 7, 2023 Category: Surgery Authors: Frances Dixon, Anjana Singh Tags: Intestinal surgery II Source Type: research
Rectal prolapse and surgery for faecal incontinence
This article highlights some of these surgical interventions to enable trainees to have discussions in outpatient settings. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 7, 2023 Category: Surgery Authors: Judith Johnston, Athur Harikrishnan Tags: Intestinal surgery II Source Type: research
Benign liver lesions
are common and can pose a diagnostic challenge due to difficulty in differentiating them from malignant hepatic lesions. Most benign liver lesions are asymptomatic and are frequently detected incidentally during investigations for other conditions. Liver function tests are usually normal or only mildly deranged. Diagnosis is principally established by abdominal ultrasound, contrast-enhanced computed tomography, and magnetic resonance imaging together with hepatobiliary contrast agents and magnetic resonance cholangiography. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 6, 2023 Category: Surgery Authors: Aki Uutela, Michael Hughes Tags: Hepatobiliary surgery Source Type: research
Portal hypertension and ascites
Portal hypertension occurs secondary to increased resistance to portal blood flow. It is a principle consequence of liver cirrhosis and leads to severe life-threatening complications, such as variceal bleeding, ascites and hepatic encephalopathy. Acute variceal bleeding is a medical and surgical emergency requiring a multidisciplinary management approach. Prompt resuscitation along with pharmacotherapy agents (terlipressin or somatostatin analogues) followed by early endoscopic variceal banding is the cornerstone of effective treatment. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 5, 2023 Category: Surgery Authors: Manoj Thillai, Gabriel C. Oniscu Tags: Hepatobiliary surgery Source Type: research
Management of recurrent urinary tract infections in adults
Recurrent urinary tract infection (rUTI) is defined as two or more episodes in a six-month period or, three or more, in one year. Urinary tract infections are more common in women than men at all stages except for the first year of life. rUTIs represent a significant burden on healthcare and account for many lost days of work. The traditional mainstay of acute treatment was with antibiotics, however with increasing resistance patterns, the overuse/misuse of antibiotics, and a shift towards antimicrobial stewardship, we are now leaning more heavily on non-antibiotic and prophylactic strategies. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 4, 2023 Category: Surgery Authors: Jean O'Riordan, Jeremy Ockrim Tags: Renal & urology III Source Type: research
Contents
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 1, 2023 Category: Surgery Source Type: research
Editorial Board
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 1, 2023 Category: Surgery Source Type: research
Malignant tumours of the liver
can either be primary (arising from the liver) or secondary (metastasis from a distant primary tumour). Clinical symptoms are non-specific and tumours are diagnosed incidentally or during surveillance imaging. Contrast-enhanced CT and MRI with hepatobiliary contrast are both excellent imaging modalities used for evaluation of these tumours. Hepatocellular carcinoma (HCC) is the most common primary tumour and often presents on a background of liver cirrhosis. Tumour size, degree of liver cirrhosis and patient performance status dictate management pathways. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 31, 2023 Category: Surgery Authors: Manoj Thillai, Andrew J. Healey Tags: Hepatobiliary surgery Source Type: research
