General surgery Archive

Drainage of a Pancreatic Abscess

Operative Indications Pancreatic abscess and/or sepsis is the major cause of morbidity and mortality in acute pancreatitis. Early diagnosis is essential if pancreatic debridement and drainage is to be performed early enough to prevent life-threatening morbidity. With

Diverticularization of the Duodenum and Pancreatic Drainage for Combined Duodenal and Pancreatic Trauma

Operative Indications The surgical management of combined pancreatic and duodenal trauma can be very challenging to the trauma surgeon. These combined injuries carry a high morbidity and significant mortality. Operative Technique Virtually all patients with blunt or

Pyloric Exclusion and Pancreatic Drainage for Combined Duodenal and Pancreatic Trauma

Operative Indications Operative Techniquen some instances of combined duodenal and pancreatic trauma, the injury may not be extensive enough to warrant a hemigastrectomy and diverticularization of the duodenum. In addition, the patient may be unstable, and the


The term amputation in medical language means the removal of a part or the whole of an extremity. Such may be necessary in many con­ditions.

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