Surgery videos & books

2022-06-16 11:46:44 62) A 46-year-old female presents to your office with rectal bleeding, itching, and irritation. On examination, a 3-cm ulcerating lesion is seen in the anal canal. Biopsy of the lesion reveals squamous cell carcinoma (SCC). Which of the following is the most appropriate treatment? Open / Comment

2022-06-14 21:43:56 Sabiston Textbook of Surgery
21st Edition

@mmedicalbookss Open / Comment

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2022-06-09 12:08:01 Ulcerative colitis is a diffuse inflammatory disease of the colon and rectum with unknown etiology. Unlike Crohn’s disease, surgical removal of the entire colon and rectum provides a complete cure. Nonetheless, many patients are treated successfully with medical therapy including corticosteroids and can avoid the potential complications of surgery and lifelong ileostomy. Ulcerative colitis usually presents as bloody diarrhea, fever, and abdominal pain. The disease process begins in the rectum, advances proximally in a contiguous fashion, and affects the superficial layers of the colon wall. Crohn’s disease is located anywhere from the mouth to anus, has skip lesions, and is transmural in nature. Histologically, superficial inflammation with crypt abscesses is most indicative of ulcerative colitis, whereas deeper involvement with granulomas and fissures are most characteristic of Crohn’s disease. Both diseases may present with extraintestinal manifestations such as arthritis, skin lesions, and hepatic dysfunction, but perianal disease with fistula formation is characteristic of Crohn’s disease. Patients with ulcerative colitis have a 10–20% risk of developing colon cancer within 20 years after diagnosis. The incidence is also increased in those with Crohn’s disease but to a lesser extent. Surveillance colonoscopy is essential in patients with long-standing disease. Open / Comment

2022-06-08 12:07:09 61) A 26-year-old male presents with abdominal pain and bloody diarrhea. On examination, he has a low-grade fever and mildly tender abdomen. Lower endoscopy is performed which reveals edematous mucosa with contiguous involvement from the rectum to the left… Open / Comment

2022-06-08 12:06:08 61) A 26-year-old male presents with abdominal pain and bloody diarrhea. On examination, he has a low-grade fever and mildly tender abdomen. Lower endoscopy is performed which reveals edematous mucosa with contiguous involvement from the rectum to the left colon. Random biopsies are performed which reveals acute and chronic inflammation of the mucosa and submucosa with multiple crypt abscesses. There are no granulomas seen. What can you tell this patient about his condition? Open / Comment

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2022-06-01 06:55:00 Internal hemorrhoids are highly vascularized submucosal cushions located in the anal canal. They are classified as first degree if no prolapse is present; second degree if prolapse occurs with spontaneous reduction; third degree if they require manual reduction; and fourth degree if they are irreducible. Treatment is based on the symptoms and degree of prolapse.Nearly all patients with first- and seconddegree hemorrhoids should initially be placed on a trial of conservative measures including a bowel management program with high fiber diet to avoid straining and constipation, frequent warm baths, and an anti-inflammatory topical cream. If symptoms continue, both rubber band ligation (a small rubber band is placed at the neck of the hemorrhoid resulting in eventual death and detachment of tissue) and infrared coagulation (controlled burn of the vessels at the neck of the hemorrhoid) are good alternatives to surgical therapy. For refractory first- and second-degree hemorrhoids, most third-degree and all fourth-degree hemorrhoids, surgical hemorrhoidectomy is the treatment of choice. A thrombosed external hemorrhoid is a blood clot resulting in painful swelling of the tightly held anoderm. In most cases conservative management is indicated. Excision is reserved for patients with debilitating pain or signs of necrosis. Open / Comment

2022-05-31 06:54:07 60) A 48-year-old male truck driver presents for evaluation of bright red rectal bleeding with bowel movements. He also has the feeling that something protrudes through his anus while he strains to move his bowels but that it withdraws into the bowel when… Open / Comment