General surgery Archive

Surgery is a team sport

Surgery is a team sport. Yet as a new surgical intern, you may feel that you are not a crucial part of the team. Even if you are incredibly smart, you are unlikely to be making critical

Spontaneous “perforation” of the liver

62 y. o. f. patient admitted for obstructing jaundice. 2 days after ERCP, the day before planned surgery sudden bout of intense pain relieved by common analgesics. No decline in general status, but slight increase of jaundice

“Spilled” gallstones and gallstone ileus

A cannibalized “spilled” stone causing gallstone-ileus following laparoscopic cholecystectomy.

Examining for a hernia

How do others examine for a hernia? Do you just look at and palpate with the patient standing up? Do you also invaginate the scrotum with the little fingerinserted up through the external inguinal ring?

Fecal impaction

Fecal impaction causing mega-rectum – a cause of colorectal catastrophes.

Laparoscopic hernia repair

Last week I had a case of a 54-year-old obese woman who went to the Emergency Room with right lower quadrant/groin pain. She is a medical biller who used to work in my office. She thought she

Sclerosing peritonitis

Is sclerosing peritonitis a foreign body response? This week I (plus two colleagues) operated a case of sclerosing peritonitis. It is an unusual entity of which I have previously operated 3 or 4 cases. Viewing it as

Рatient declining operation

I would like to share with you rather an incredible experience I had during my last on-call weekend and would like to invite some comments on ethical issues regarding the case.

Best method of diagnosing appendicitis

Appendicitis is many diseases: recent posts on one best method of diagnosing appendicitis ignore something basic, which applies to surgical conditions generally. Here are some varieties of appendicitis which I hope others will recognise. [Level 5 or

Complicated hepatectomies

I crossed the East River and went to Sloan Kettring to see how Dr. Blumgart does “complicated hepatectomies”. A few of you may be interested in the following: