Liver trauma

Based on the mechanism of injury, liver trauma is classified as penetrating or blunt. Penetrating wounds, constituting more than half of cases, are typically due to projectiles (such as bullets or shrapnel) or knives. In civilian practice,

Mortality peaks after trauma

In general, the only effective interventions for this primary peak in injury-induced mortality are aggressive prevention strategies, either devices, such as automobile restraints and bicycle helmets, that prevent or lessen injury, or laws, such as drinking and

Intra-operative peritoneal lavage (IOPL)

  I have been unable to find scientific evidence in the literature that irrigation of the abdominal cavity with antibiotics has any additional benefit than irrigation with saline alone. In fact, antibiotic irrigation may be harmful in

About complicated ulcers

The comments by many surgeons are an important reminder, at the time when the bacterial (helicobacter) etiology of ulcers is (over) emphasized, that ulcers are the result of mulifaceted etiology, especially the socio-economic one.

Examination of the scrotum, external genitalia

In surgical practice examination of theexternal genitalia is usually confined to examination of the male genitalia, since females with disorders of this region are managed by gynaecologists. The examination is best performed with the sick man in

Examination of the abdomen

An abdominal examination consists of several parts: examination of the abdomen, of the inguinal region, examination of the scrotum, testes, and rectal examination.

Examination of the breasts

The common breast complaints in females are discovery of a lump (benign or malignant), pain (mastalgia) and nipple discharge. In males, the most common ailment is unilateral or bilateral hypertrophy (gynaecomastia), which may be idiopathic (postpubertal), drug

Examination of the neck and head

Examination of the neck and head begins with inspection.

Causes of cervical lymphadenopathy

Main causes of cervical lymphadenopathy are an infection or neoplastic infiltration. The latter may consist of secondary deposits from a primary tumour elsewhere in the body or be primary in nature, i.e. lymphoma.

Examination of a swelling

A swelling may be visible on inspection or not be detected until palpation is carried out. The lump may be discrete and localized or be diffuse, when it is more properly desig­nated a swelling. The important features