Surgery videos & books

2022-02-20 12:06:01 This patient has achalasia. This disorder is defined by a nonrelaxing lower esophageal sphincter (LES) and decreased peristalsis of the esophageal body. The “bird’s beak” deformity is a classic sign with a dilated esophagus which tapers to a small area at the LES. Esophagomyotomy is the treatment of choice for long-standing disease. Serial botox injections and dilations can be used early in the disease process, however their long-term results are inferior to myotomy. Proton pump inhibitors can be used for gastroesophageal reflux disease (GERD). A Nissen fundoplication is also a treatment for GERD. Calcium channel blockers are sometimes used to treat other esophageal motility disorders. Open / Comment

2022-02-19 13:44:57 Please Support me
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2022-02-19 12:05:31 Open / Comment

2022-02-19 12:04:03 43) A22-year-old male presents complaining of a 1-month history of progressive dysphagia. He reports occasional regurgitation of undigested food at night. His past medical history is noncontributory. The condition has worsened to the point that he is on a liquid diet. A contrast swallow study is shown in Figure . What is the best treatment for this patient? Open / Comment

2022-02-13 15:57:01 Dehiscence refers to a separation of the fascial layer. Evisceration is when peritoneal contents extrude through the fascial separation. Malnutrition, obesity, diabetes, uremia, malignancy, immunologic abnormalities, steroid use, infection, and coughing which increases intraabdominal pressures are all factors that increase the risk of wound dehiscence. Technical factors are also very important in preventing the dehiscence, but there is no proof that interrupted sutures are better than a running stitch for fascial closure. Open / Comment

2022-02-12 13:56:33 42) A 75-year-old man undergoes a right colectomy for stage 3 colon cancer. He has a history of emphysema requiring chronic steroid use. He also has diabetes and coronary heart disease. On postoperative day 2, the surgeon is called because the patient acutely… Open / Comment

2022-02-12 13:54:47 42) A 75-year-old man undergoes a right colectomy for stage 3 colon cancer. He has a history of emphysema requiring chronic steroid use. He also has diabetes and coronary heart disease. On postoperative day 2, the surgeon is called because the patient acutely began to have a large amount of pinkish, serous drainage from the wound. There is no evidence of infection. Which of the following factors probably contributed to this complication? Open / Comment

2022-02-11 09:22:24 Please Support me
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2022-02-10 14:59:01 Ureteral injuries are a well-known complication of pelvic surgery. The risk is greatly increased in the setting of inflammation, which can make the ureters difficult to identify. Intravenous pyelogram is a sensitive test for injury. CT scan and retrograde pyelogram are also diagnostic options. Injuries identified early are usually amenable to primary surgical repair, making early diagnosis essential. Delayed recognition usually results in a staged repair requiring urinary diversion with percutaneous nephrostomy tubes. Open / Comment

2022-02-09 10:58:29 41) A50-year-old man undergoes a sigmoid colectomy and colostomy for perforated diverticulitis of the midsigmoid colon. The surgeon reports a difficult dissection in the pelvis secondary to adhesions of the sigmoid colon to the abdominal wall. On postoperative… Open / Comment