(BQ) Part 1 book “Surgery at a glance” has contents: Groin swellings, acute warm painful leg, urinary retention, gastrointestinal bleeding, nipple discharge, urinary retention, scrotal swellings, acute renal failure, musculoskeletal tumours, major trauma – basic principles,… and other contents.
Surgery at a Glance This new book is also available as an ebook For more details, please see www.wiley.com/buy/9781118272206 or scan this QR code: Companion website Includes a companion website at: www.testgeneralsurgery.com Featuring: – MCQs – Short answer questions Surgery at a Glance Pierce A Grace MA, MCh, FRCSI, FRCS Professor of Surgical Science Graduate Entry Medical School University Hospital Limerick Limerick, Ireland Neil R Borley FRCS, FRCS (Ed), MS Consultant Colorectal Surgeon Cheltenham General Hospital Cheltenham, UK Fifth edition A John Wiley & Sons, Ltd., Publication This edition first published 2013 © 2013 by John Wiley & Sons, Ltd Previous editions 1999, 2002, 2006, 2009 Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/ wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988 All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher Designations used by companies to distinguish their products are often claimed as trademarks All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners The publisher is not associated with any product or vendor mentioned in this book Limit of Liability/Disclaimer of Warranty: While the publisher and author(s) have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose It is sold on the understanding that the publisher is not engaged in rendering professional services and neither the publisher nor the author shall be liable for damages arising herefrom If professional advice or other expert assistance is required, the services of a competent professional should be sought Library of Congress Cataloging-in-Publication Data Grace, P.A (Pierce A.) Surgery at a glance / Pierce Grace, Neil R.Borley – 5th ed p ; cm Includes bibliographic references and index ISBN 978-1-118-27220-6 (pbk.: alk.paper) 1. Borley, Neil R 11 Title [DNLM. 1. Surgical Procedures, Operative–Handbooks. 2. Diagnostic Techniques and Procedures – Handbooks WO 39] 617'.9—dc23 2012032718 Cover image: SCIENCE PHOTO LIBRARY © MAURO FERMARIELLO Cover design by Meaden Creative A catalogue record for this book is available from the British Library Set in Times 9/11.5 pt by Toppan Best-set Premedia Limited 1 2013 Contents Preface List of abbreviations Part 1 Clinical presentations at a glance Neck lump 10 Dysphagia 12 Haemoptysis 14 Breast lump 16 Breast pain 18 Nipple discharge 20 Gastrointestinal bleeding 22 Dyspepsia 26 Vomiting 28 10 Acute abdominal pain 30 11 Chronic abdominal pain 32 12 Abdominal swellings (general) 34 13 Abdominal swellings (localized) – upper abdominal 36 14 Abdominal swellings (localized) – lower abdominal 40 15 Jaundice 42 16 Diarrhoea 44 17 Altered bowel habit/constipation 46 18 Groin swellings 48 19 Claudication 50 20 Acute warm painful leg 52 21 Acute ‘cold’ leg 54 22 Leg ulceration 56 23 Dysuria 58 24 Urinary retention 60 25 Haematuria 62 26 Scrotal swellings 64 27 Stomas and incisions 66 Part 2 Surgical diseases at a glance 28 Anaesthesia 68 29 Hypoxia 72 30 Surgical infection 74 31 Sepsis 78 32 Systemic inflammatory response syndrome 80 33 Shock 82 34 Acute renal failure 84 35 Fractures 86 36 Orthopaedics – congenital and childhood disorders 88 37 Orthopaedics – metabolic and infective disorders 90 38 Arthritis 92 39 Musculoskeletal tumours 95 40 Burns 98 41 Major trauma – basic principles 100 42 Traumatic brain injury (head injury) 102 43 Gastro-oesophageal reflux disease 106 44 Oesophageal carcinoma 108 45 Peptic ulcer disease 110 46 Gastric carcinoma 112 47 Malabsorption 114 48 Crohn’s disease 116 49 Acute appendicitis 118 50 Diverticular disease 120 51 Ulcerative colitis 122 52 Colorectal carcinoma 124 53 Benign anal and perianal disorders 126 54 Intestinal obstruction 128 55 Abdominal hernias 130 56 Gallstone disease 132 57 Pancreatitis 136 58 Pancreatic tumours 138 59 Benign breast disease 140 60 Breast cancer 142 61 Goitre 144 62 Thyroid malignancies 146 63 Parathyroid disease 148 64 Pituitary disorders 150 65 Adrenal disorders 152 66 Skin cancer 154 67 Ischaemic heart disease 157 68 Valvular heart disease 160 69 Peripheral arterial disease 162 70 The diabetic foot 164 71 Aneurysms 166 72 Extracranial arterial disease 168 73 Venous thromboembolism 170 74 Varicose veins 173 75 Lymphoedema 176 76 Postoperative pulmonary complications 178 77 Lung cancer 180 78 Urinary tract infection 182 79 Benign prostatic hypertrophy 184 80 Renal (urinary) calculi 186 81 Renal cell carcinoma 188 82 Carcinoma of the bladder 190 83 Carcinoma of the prostate 192 84 Testicular cancer 194 85 Urinary incontinence 196 86 Solid organ transplantation 198 87 Paediatric ‘general’ surgery 200 Index 204 Companion website Includes a companion website at: www.testgeneralsurgery.com Featuring: – MCQs – Short answer questions Contents Preface Surgery at a Glance continues to be a very popular text with medical students and others who study surgery In full colour, the book, in keeping with the At a Glance series in general, has a very user-friendly layout and is easy to read A key feature of Surgery at a Glance is its division into clinical presentations and surgical diseases Thus, in one volume is combined the ways that patients present with surgical problems and the surgical diseases that underlie those presentations Fourteen years on we are delighted to present the revised and updated fifth edition of Surgery at a Glance The new edition contains some additions In response to feedback from medical students we have added four new chapters on orthopaedics as well as updating the text and illustrations throughout the book The book retains its colour profile and beautiful illustrations We have had lots of help and suggestions 6 Preface from several people in putting this book together We would like to thank the many medical students and colleagues who have read the book and given us good advice Students seem to like this book particularly for revision in preparation for exams We especially thank the publishing team and illustrators at Wiley-Blackwell for their hard work in bringing this beautifully presented book to completion We believe that the fifth edition of Surgery at a Glance is an excellent book and we hope that this text will continue to help students understand surgery Pierce A Grace Neil R Borley 2013 List of abbreviations AAA AAT ABI Abs ACE Ach ACN ACS ACTH ADH AF AFP Ag AJCC AKI Alb ALI ALND ANCA ANDI AP AP APACHE APTT ARB ARDS ARF ASA ASCA ATN AV BCC BCG b.d BDM BE BEP BMI BP BPH BS bx C&S CABG CAD cAMP CA-MRSA CAS CBD CCF CD CDH CDI abdominal aortic aneurysm aspartate amino transferase ankle–brachial pressure index antibiotics angiotensin converting enzyme acetylcholine acute cortical necrosis acute coronary syndrome adrenocorticotrophic hormone antidiuretic hormone atrial fibrillation α-fetoprotein antigen American Joint Committee on Cancer acute kidney injury albumin acute lung injury axillary lymph node dissection antineutrophil cytoplasmic antibody abnormalities of the normal development and involution (of the breast) angina pectoris anteroposterior acute physiology and chronic health evaluation activated partial thromboplastin time angiotensin receptor blocker adult/acute respiratory distress syndrome acute renal failure American Society of Anesthesiologists anti-Saccharomyces cerevisiae antibodies acute tubular necrosis arteriovenous basal cell carcinoma bacillus Calmette–Guérin twice daily bone mineral density base excess bleomycin, etoposide, cisplatin body mass index blood pressure benign prostatic hypertrophy breath sounds biopsy culture and sensitivity coronary artery bypass graft coronary artery disease cyclic adenosine monophosphate community-associated methicillin-resistant Staphylococcus aureus carotid angioplasty and stent common bile duct congestive cardiac failure Clostridium difficile congenital dysplaia of the hip central diabetes insipidus CEA CEA cfu CgA CK CLO CMV CMV CNS COCP COPD COX CPK-MB CRC CRF CRP CSF CT CTA CTCV CVA CVI CVP CVS CXR D2 DCIS DDAVP DDH DHEA DIC DM DMARDs DMSA DU DVT Dx DXA DXT EAS EBV ECG EMLA ER ERCP ESR ESWL EUA EUS FAP FBC FCD FFP FHx carcinoembryonic antigen carotid endarterectomy colony forming units chromogranin A creatinine kinase Campylobacter-like organism cisplatin, methotrexate, vinblastine cytomegalovirus central nervous system combined oral contraceptive pill chronic obstructive pulmonary disease cyclo-oxygenase creatine phosphokinase (cardiac type) colorectal carcinoma chronic renal failure C-reactive protein cerebrospinal fluid computed tomography computed tomographic angiogram congenital talipes calcaneo valgus cerebrovascular accident chronic venous insufficiency central venous pressure cardiovascular system chest X-ray type dopaminergic receptors ductal carcinoma in situ 1-desamino-8-arginine vasopressin (desmopressin) developmental dysplaia of the hip dihydroepiandrosterone disseminated intravascular coagulation diabetes mellitus disease-modifying antirheumatic drugs dimercaptosuccinic acid duodenal ulcer deep venous thrombosis diagnosis dual energy X-ray absorptiometry deep X-ray therapy external anal sphincter Epstein–Barr virus electrocardiogram Eutetic Mixture of Local Anaesthetic oestrogen receptor endoscopic retrograde cholangio-pancreatograph erythrocyte sedimentation rate extracorporeal shock-wave lithotripsy examination under anaesthesia endoscopic ultrasound familial polyposis coli full blood count fibrocystic disease fresh frozen plasma family history List of abbreviations FNAC FSH 5-FU gFOBT γ-GT GA GC GCS GFR GH GI GIST Gm+, Gm– GORD GSF GTN GU GU GVHD HALO Hb HCG β-HCG Hct HCT HDL HDU HER2/neu HIDA HLA HNPCC HoLEP hPTH HRT HVA Hx I&D IBS ICP ICS ICU IFN-γ Ig IGF IL iNOS INR IPPV IV IVC IVU JGA JVP KUB LA LAD LATS LBO fine-needle aspiration cytology follicle-stimulating hormone 5-fluorouracil guaiac faecal occult blood test gamma glutamyl transpeptidase general anaesthetic gemcitabine, cisplatin Glasgow Coma Scale glomerular filtration rate growth hormone gastrointestinal gastrointestinal stromal tumour Gram-positive, Gram-negative gastro-oesophageal reflux disease greater sciatica foramen glyceryl trinitrate gastric ulcer genito-urinary graft-versus-host disease haemorrhoidal artery ligation operation haemoglobin human chorionic gonadotrophin beta-human chorionic gonadotrophin haematocrit hematopoietic cell transplantation high density lipoprotein high-dependency unit human epidermal growth factor receptor hepatabiliary imido-diacetic acid human leucocyte antigen hereditary non-polyposis colorectal cancer (Lynch syndrome) holium laser enucleation of prostate human parathyroid hormone hormone replacement therapy homovanillic acid history incision and drainage irritable bowel syndrome intracranial pressure intercostal space intensive care unit interferon gamma immunoglobulin insulin-like growth factor interleukin inducible nitric oxide synthetase international normalized ratio intermittent positive pressure ventilation intravenous inferior vena cava intravenous urogram juxtaglomerular apparatus jugular venous pulse kidney, ureter, bladder local anaesthetic left anterior descending long-acting thyroid stimulating (factor) large bowel obstruction 8 List of abbreviations LCA LDH LDL LDUH LFT LH LHRH LIF LMWH LOC LOS LPS LRD LSE LSF LSV LUQ LURD LUTS LV LVF MAG3 MAP MCP MC+S MDRO MDT MEAC MEN MI MIBG MM MND MODS MRA MRCP MRI MRSA MS MSH MSU MT mTOR MTP MUGA MVAC N&V NAdr NDI NF-κB NG NK NPO NSAID NSGCT NSTEMI NSU OA left coronary artery lactate dehydrogenase low density lipoprotein low dose unfractionated heparin liver function test luteinizing hormone LH-releasing hormone left iliac fossa low molecular weight heparin loss of consciousness lower oesophageal sphincter lipopolysaccharide living related donor left sternal edge lesser sciatica foramen long saphenous vein left upper quadrant living unrelated donor lower urinary tract symptoms left ventricle left ventricular failure mercapto acetyl triglycine mean arterial pressure metacarpophalangeal microscopy cultures and sensitivity multidrug-resistant organisms multidisciplinary team minimum effective analgesic concentration multiple endocrine neoplasia myocardial infarction meta-iodo-benzyl guanidine malignant melanoma motor neurone disease multiple organ dysfunction syndrome magnetic resonance angiography magnetic resonance cholangio-pancreatography magnetic resonance imaging methicillin-resistant Staphylococcus aureus multiple sclerosis melanocyte-stimulating hormone mid-stream urine major trauma mammalian target of rapamycin metatarsophalangeal multiple uptake gated analysis methotrexate, vinblastine, doxorubicin (Adriamycin), cisplatin nausea and vomiting noradrenaline/norepinephrine nephrogenic diabetes insipidus nuclear factor-κB nasogastric natural killer nil per oram (nil by mouth) non-steroidal anti-inflammatory drug non-seminomatous germ cell tumour non-ST elevation myocardial infarction non-specific urethritis osteoarthritis ... understand surgery Pierce A Grace Neil R Borley 2 013 List of abbreviations AAA AAT ABI Abs ACE Ach ACN ACS ACTH ADH AF AFP Ag AJCC AKI Alb ALI ALND ANCA ANDI AP AP APACHE APTT ARB ARDS ARF ASA ASCA... pupillary dilatation, contralateral paresis or paralysis) Treatment is by evacuation of haematoma via burr holes • Acute subdural haemorrhage: tearing of veins between arachnoid and dura mater Usually... Premedia Limited 1 2 013 Contents Preface List of abbreviations Part 1 Clinical presentations at a glance Neck lump 10 Dysphagia 12 Haemoptysis 14 Breast lump 16 Breast pain 18 Nipple discharge