Monthly Archives: August 2012

Hirschsprung disease

In Hirschsprung disease Variable length of intestinal aganglionosis of the hindgut.   Rectosigmoid is the aganglionosis transition point for 80% of  Hirschsprung disease patients. Hirschsprung disease cab be Familial or sporadic. Up to 7.8% of Hirschsprung disease cases occur in patients for whom more than one family member is affected. Mutations in the RET protooncogene have […]

Ruptured abdominal aortic aneurysm

. Management of ruptured abdominal aortic aneurysm Preoperative management  of ruptured abdominal aortic aneurysm . Unstable patients with a presumed diagnosis of a ruptured aneurysm (hypotension, abdominal or back pain, and a pulsatile abdominal mass or history of aneurysmal disease) are gently resuscitated with fluids (crystalloid, colloid, or blood) to maintain organ […]

Abdominal Aortic Aneurysm

What is Abdominal Aortic Aneurysm ? How to Diagnosis? What is the management of abdominal aortic aneurysm? Endovascular management? Abdominal Aortic Aneurysm  (AAA) are the most common type of arterial aneurysm, occurring in 3% to 10% of people older than 50 years of age in the Western world (Br J […]

Abdominal Aortic Aneurysm

Thoracic Aortic Aneurysm

Thoracic Aortic Aneurysm Diagnosis Surgical management Ascending aortic arch aneurysms Transverse aortic arch aneurysms Descending Thoracic Aortic Aneurysm Thoracoabdominal aneurysms Endovascular management of thoracic aortic aneurysm Thoracic Aortic Aneurysm are primarily a disease of the elderly. Ascending and transverse arch aneurysms each comprise 25% of Thoracic Aortic Aneurysm (). The […]

Types of Grafts

A. Skin grafts Split-thickness grafts consist of epidermis and a variable thickness of dermis. Thinner grafts (<0.016 in.) have a higher rate of engraftment, whereas thicker grafts, with a greater amount of dermis, are more durable and aesthetically acceptable. Common donor sites are the thigh, buttock, and scalp. Full-thickness grafts […]

Internal Hernias

  A. Incidence of Internal Hernias Of patients who present with acute intestinal obstruction, fewer than 5% have an internal hernia. When internal hernias are complicated by intestinal volvulus, there is an 80% incidence of strangulation or gangrene. B. Etiology  of Internal Hernias Internal hernias occur within the abdominal cavity owing to congenital […]

Inguinal Hernias surgery in Bangalore & Cost

Dr Adarsh M Patil mbbs ms (mrcs) Is one of the leading GI surgeons in Bangalore .15 years of experience in eminent hospitals like Manipal Hospital, Apollo Hospitals and Narayana Hrudalaya in Bangalore. He has experience of treating numerous  Inguinal Hernia  patients in Bangalore . He believes in that Patient safety comes first […]

Phyllodes Tumor

Phyllodes Tumor account for 1% of breast neoplasms. They present as a large, smooth, lobulated mass and may be difficult to distinguish from fibroadenoma on physical exam. They can occur in women of any age, but most frequently between ages 35 and 55 years. Skin ulcerations may occur secondary to […]

Breast Anatomy

I. The Breast Breast tissue is located between the subcutaneous fat and the fascia of the pectoralis major and serratus anterior muscles. Posterior to the breast and anterior to the pectoralis fascia is the retromammary space, which contains small lymphatics and vessels. Breast tissue can extend to the clavicle, into […]

Physical Examination of breast

A. Inspect the breasts Inspect the breasts with the patient both in the upright and supine positions. With the patient in the upright position, examine with the patient’s arms relaxed and then raised, looking for shape asymmetry, deformity, and skin changes (erythema, edema, dimpling). With the patient in the supine […]

Cervical Cancer

Although detection of preinvasive disease has increased, the incidence of invasive cervical cancer has dramatically decreased in the United States due to widespread screening by cervical cytology (Papanicolaou smears). However, cervical cancer remains the leading cause of cancer related deaths among women in developing countries (National Cervical Cancer Coalition Web […]

Ovarian cancer

Ovarian cancer is the deadliest of all the gynecologic malignancies. There will be approximately 22,430 new cases diagnosed in 2007. More than two thirds of patients in whom epithelial ovarian cancer is diagnosed eventually die from this disease (15,280/year in the United States) (Cancer J Clin 2007;57:43). Besides tumors arising […]

Endometrial cancer

Endometrial cancer is the most common gynecologic malignancy in the United States. Approximately 39,080 new cases will be diagnosed in 2007. Most (approximately 90%) of these tumors are adenocarcinomas arising from the lining of the uterus. Risk factors for endometrial cancer include white race, obesity, early menarche and late menopause, […]


Galactorrhea is milky discharge unrelated to breast-feeding. Physiologic galactorrhea is the continued production of milk after lactation has ceased and menses resumed and is often caused by continued mechanical stimulation of the nipples. Drug-related galactorrhea is caused by medications that affect the hypothalamic-pituitary axis by depleting dopamine (tricyclic antidepressants, reserpine, […]

Pathologic nipple discharge

 Pathologic nipple discharge is either (1) bloody or (2) spontaneous, unilateral, and originates from a single duct. Normal physiologic discharge is usually nonbloody, from multiple ducts, can be a variety of colors (clear to yellow to green), and requires breast manipulation to produce. Pathologic discharge is serous, serosanguineous, bloody, or […]

Fibrocystic Breast Change (FBC)

Fibrocystic Breast Change (FBC) encompasses several of the following pathologic features: stromal fibrosis, macro- and microcysts, apocrine metaplasia, hyperplasia, and adenosis (which may be sclerosing, blunt-duct, or florid). FBC is common and may present as breast pain, a breast mass, nipple discharge, or abnormalities on mammography. The patient presenting with […]

Abdominal Wall Hernias

A. Incidence and etiology    Incisional hernias occur at sites of previous incisions at which there has been dehiscence of the abdominal wall. The causes are multiple and include obesity, wound infections, malnutrition, and technical wound closure factors. Hernias occur in up to 20% of patients undergoing abdominal operations and […]

Tumor Biomarkers and Prognostic Factors for Breast Cancer

Tumor Biomarkers and Prognostic Factors should be evaluated on all tumor specimens. Tumor size and grade are the most reliable pathologic predictors of outcome for patients without axillary nodal involvement. The Nottingham score combines histologic grade based on glandular differentiation, mitotic count, and nuclear grade. A higher grade is a […]

Screening for breast cancer

A. Screening for breast cancer. Screening mammogram Screening for breast cancer. Screening mammogram lowers mortality from breast cancer. It is performed in the asymptomatic patient and consists of two standard views, mediolateral oblique (MLO) and craniocaudal (CC). The current recommendation from the National Cancer Institute and American College of Surgeons […]

Neoplasms of the Head and Neck

A. Squamous cell carcinoma (SCC) Squamous cell carcinoma (SCC) arising from the aerodigestive tract is the most common neoplasm of the head and neck. SCC is strongly associated with tobacco and alcohol use. Despite advances in tumor resection, reconstruction techniques (which allow for larger surgical margins), and adjuvant treatments, the […]

Ectopic pregnancy

Ectopic pregnancy occurs when the blastocyst implants outside the uterine cavity; 97% of cases occur in a fallopian tube (tubal pregnancy). Presentation and clinical features of Ectopic pregnancy  . Although more than 90% of patients with tubal pregnancies have abdominal or pelvic pain, some may be asymptomatic. Early (unruptured) ectopic pregnancies […]

Causes of Vaginal Bleeding

 Causes of Vaginal Bleeding Differential diagnosis Laboratory data Signs and symptoms Treatment Menses CBC count, urine hCG Cyclic bleeding every 21–35 d Iron therapy if indicated Dysfunctional uterine bleeding CBC count, urine hCG, endometrial biopsy if >35 yr, duration >6 mo Noncyclic bleeding; may have associated dysmenorrhea, fatigue, or dizziness […]

Bleeding During Pregnency

Approximately 30% to 40% of all pregnancies are associated with some vaginal bleeding, and approximately half of these are spontaneously aborted. Terminology Threatened abortion: any vaginal bleeding during the first half of pregnancy, cervix closed. Missed abortion: fetal death with retention of products of conception (POC), cervix closed. Inevitable abortion: […]

Salivary Glands

A. Anatomy and physiology The major salivary glands include the parotid, submandibular, and sublingual glands. Hundreds of minor salivary glands exist in the palate, oral mucosa, and tongue. Salivary glands supply 1 to 1.5 L of saliva per day. Saliva provides lubrication during mastication, inhibits bacterial growth, helps to maintain […]