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 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 […]
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 […]
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 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 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 […]
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: […]
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 […]
ddf
A. Incidence Femoral hernias constitute up to 2% to 4% of all groin hernias; 70% occur in women. Approximately 25% of femoral hernias become incarcerated or strangulated, and a similar number are missed or diagnosed late. B. Anatomy The abdominal viscera and peritoneum protrude through the femoral canal into the […]
Hip Replacement
Disorder Your Score Major Depression: Moderate Dysthymia: Slight Bipolar Disorder: Extremely High Cyclothymia: Very High Seasonal Affective Disorder: Slight Postpartum Depression: N/A Take the Depression Test
A. Epidemiology The peak incidence of urinary calculi is in the third to fifth decades. Stones are more prevalent in men than in women. Stone incidence is increased during the late summer months. Dietary factors leading to stone formation include low water intake and high protein or oxalate (leafy green […]
Hepatic Cysts can be divided into nonparasitic cysts and echinococcal cysts. A. Nonparasitic cysts Nonparasitic cysts generally are benign. They can be solitary or multiple and often are identified incidentally on imaging for other symptoms. Asymptomatic cysts require no treatment regardless of size. Large cysts may be symptomatic because of […]
Amebic abscess should be considered in every case of solitary hepatic abscess. Amebiasis is caused by the protozoan Entamoeba histolytica. This parasite exists in two forms: an infective cyst stage and a trophozoite stage, which is the form that causes invasive disease. Amebic liver abscess is the most common extraintestinal […]
Pyogenic abscesses in the liver occur secondary to other sources of bacterial sepsis. Up to 60% of cases arise from direct spread of bacteria from biliary infections such as empyema of the gallbladder or cholangitis. Ruptured appendicitis or diverticulitis are other potential sources for bacterial seeding to the liver. Pathogenesis. […]
The annual incidence of Hepatocellular carcinoma in the United States is approximately 2.4/100,000. The incidence is rising rapidly due in large part to the hepatitis C epidemic. There is a 2 to 3:1 male-to-female predominance. The incidence in African American men is almost twice that in white men. HCC is diagnosed mainly in […]
Focal nodular hyperplasia (FNH) is the second-most-common benign hepatic tumor, constituting about 8% of cases. The pathogenesis of FNH is a matter of debate. In the past, it was thought to be either a hamartoma or a neoplasm. Currently, it is thought to represent a nonneoplastic, hyperplastic response to a […]
Hemangioma is the most common benign liver tumor, with the prevalence (estimated from autopsy series) ranging from 3% to 20%. The majority are diagnosed in middle-aged women, and there is a female-to-male ratio of 5 to 6:1. The pathogenesis of hemangiomas is poorly understood. They are thought to represent hamartomatous […]
Chronic Pancreatitis is caused by alcohol abuse in the majority of patients. Other etiologies include idiopathic or metabolic (hypercalcemia, hypertriglyceridemia, hypercholesterolemia, hyperparathyroidism, cystic fibrosis) factors, drugs, trauma, and congenital abnormalities
What is Acute Pancreatitis? Acute Pancreatitis is an inflammatory process of variable severity. Most episodes of acute pancreatitis are self-limiting and associated with mild transitory symptoms that remit within 3 to 5 days. . The exact mechanism by which various etiologic factors induce acute pancreatitis and with such variable severity is […]
1 Risk factors for Pancreatic Cancer An increased risk of pancreatic cancer has been associated with smoking, alcoholism, hereditary disorders [familial adenomatous polyposis (FAP), van Hippel-Lindau disease (VHL), hereditary breast cancer, Gardner syndrome], and chronic pancreatitis. The association with alcohol-induced pancreatitis is related to concurrent chronic pancreatitis and the […]
Types- Squamous cell carcinoma behaves like cutaneous squamous cell carcinoma, is well differentiated and keratinizing, and is treated with wide local excision and chemoradiation if large. Basal cell carcinoma is a rare, male-predominant cancer and is treated with local excision. Bowen disease is intraepidermal squamous cell carcinoma. It is rare […]
The colostomy construction technique depends on whether the goal is decompression or diversion. Ongoing surveillance of the remaining colon is necessary but often overlooked in patients with colostomies
