Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Adrenal Glands","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0001","url":null,"abstract":"The adrenal cortex is derived from mesoderm and the medulla, from neural crest ectoderm. An adrenal gland weighs approximately 5 g. The cortex secretes corticosteroids (cortisol), aldosterone, and sex hormones. Masses are most commonly asymptomatic. Adrenal incidentalomas are masses greater than 1 cm in diameter that are found in 2% to 4% of all CTs. Adrenalectomy is indicated for masses that are enlarging, larger than 4 to 6 cm, or functional (secreting hormone); the operation is fixated on safe transection of adrenal blood vessels. Complications are relatively uncommon with laparoscopic adrenalectomy.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115881598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Pancreas","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0012","url":null,"abstract":"The pancreas forms from the dorsal and ventral endodermal buds, which develop at the foregut-midgut junction. The head of the pancreas lies in the duodenal C-loop, anterior to the IVC and left renal vein. Islets of Langerhans carry out the endocrine function of the pancreas. Acute pancreatitis is caused by gallstones, alcohol, and trauma. CT with an IV contrast agent may be used to diagnose pancreatitis, pancreatic cancer, or complications after pancreatic surgery. Most patients with acute pancreatitis are managed conservatively. Pancreatic leaks occur in approximately 20% of operations on the pancreas.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128408840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Parathyroid Glands","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0013","url":null,"abstract":"The parathyroid glands develop from the endoderm: the superior glands from the fourth pharyngeal pouch, and the inferior glands from the third pharyngeal pouch. Parathyroid glands are usually found on the posterior surface of the thyroid gland. Chief cells secrete PTH, which has a half-life of 3 to 6 minutes. Primary HPT is most often asymptomatic and serendipitously found when the serum calcium value is increased on routine testing. The parathyroid glands can be evaluated with US, CT, MRI, or sestamibi scanning. Cervical exploration for primary HPT involves resection of a solitary adenoma in approximately 85% of patients. Injury to the RLN and superior laryngeal nerve does occur.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126470085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Rectum","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0014","url":null,"abstract":"The rectum develops from endoderm, emerging from the distal tip of the hindgut. The rectum measures 12 to 15 cm. Resting rectal pressure is approximately 10 mm Hg. Internal hemorrhoids cause painless bright-red bleeding. Surgeons evaluate the rectum mainly by performing a digital rectal examination, anoscopy, endorectal US, and MRI to determine the extent of disease. The choice between rubber band ligation and excisional hemorrhoidectomy depends on the location (internal vs external) and degree of internal hemorrhoids. Complications from excisional hemorrhoidectomy may include bleeding, urinary retention, and severe pain.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125802751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Liver","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0011","url":null,"abstract":"The liver arises from the foregut-midgut junction. It is contained in the Glisson capsule, and the falciform ligament attaches the liver to the anterior abdominal wall. Hepatocytes perform approximately 500 functions. Chronic hepatitis C, alcoholic liver disease, and nonalcoholic steatohepatitis may cause cirrhosis and give rise to liver failure and potentially HCC. MRI, CT, and US are helpful for determining the extent of cirrhosis and detecting ascites, tumors, and blood flow. Fifty percent to 80% of the liver can be resected if the remainder functions well. Liver resections may bleed, leak bile, or lead to infection.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125700034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. K. Pandian, Samuel J. Allen, D. Farley
{"title":"Esophagus","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. K. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0007","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0007","url":null,"abstract":"The esophagus is a hollow muscular tube approximately 25 cm in length, extending from the cricopharyngeus muscle to the gastroesophageal junction at the gastric cardia. It is the only organ that uses peristalsis. Achalasia is defined as failure of lower esophageal sphincter relaxation with concurrent esophageal aperistalsis. Esophageal manometry is the standard for diagnosing achalasia and DES. Achalasia is managed surgically with a Heller myotomy. Esophageal surgery may result in an iatrogenic perforation, thoracic duct injury, or anastomotic leak.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141218513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Gallbladder","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0008","url":null,"abstract":"The endodermal diverticulum of the caudal foregut develops into the GB. The GB lies between liver segments 4B and 5 and is supplied by the cystic artery. Cholecystokinin and vagal stimulation result in GB contraction, delivering bile (synthesized in the liver) into the duodenum. More than 80% of gallstones (cholelithiasis) are of the cholesterol type. Porcelain GBs can be seen on plain radiographs. Unless GB cancer is suspected preoperatively, or dense adhesions are likely, laparoscopic cholecystectomy is the operation of choice. Injury to the CBD (0.5%), duodenum, and liver parenchyma is uncommon but is a serious complication.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129635202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. K. Pandian, Samuel J. Allen, David R. Farley
{"title":"Colon","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. K. Pandian, Samuel J. Allen, David R. Farley","doi":"10.1093/med/9780190650506.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0005","url":null,"abstract":"The colon is made up of the midgut which includes the proximal two-thirds of the transverse colon, and the hindgut, which includes the distal one-third of the transverse colon. The ileocecal junction to the anus is a distance of 1.5 m. Digested food (chyme) passes into the colon and is converted to feces by bacteria. The differential diagnosis of colonic masses includes cancer, carcinoid, lipoma, diverticular disease, ulcerative colitis, polyps, and Crohn disease. Treatment of colorectal cancer and symptomatic inflammatory colon disease usually involves wide surgical resection. Complications after surgery may include postoperative bleeding, leakage, and ileus.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"119 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141217653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Appendix","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0002","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0002","url":null,"abstract":"The appendix is an antimesenteric cecal outpouching that forms in the fifth month of gestation. It is a hollow, blind-ending tube approximately 11 cm in length and less than 6 mm in diameter. Obstruction of the appendiceal lumen with a fecalith, or less commonly foreign bodies, worms, and lymphadenopathy, may result in swelling of the appendix. Patients present with periumbilical abdominal pain. Acute appendicitis is a clinical diagnosis. The majority of patients with signs and symptoms of acute appendicitis should receive prompt surgical intervention. Laparoscopic or open appendectomy can be associated with ileus, superficial or deep wound infections, GI leak, bleeding or hematoma, wound dehiscence, or hernia.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114575601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley
{"title":"Spleen","authors":"Jad M. Abdelsattar, Moustafa M. El Khatib, T. Pandian, Samuel J. Allen, D. Farley","doi":"10.1093/med/9780190650506.003.0016","DOIUrl":"https://doi.org/10.1093/med/9780190650506.003.0016","url":null,"abstract":"The spleen develops from mesoderm during the fifth week of gestation. Eighty-five percent of humans have 1 spleen, and 15% have accessory spleens. The spleen cleans the blood by trapping and breaking down dysfunctional or old red blood cells. Splenic problems most commonly arise with trauma, lymphoma, benign cysts, and hematologic disorders. Surgeons evaluate the spleen using plain radiography (CXR; kidney, ureter, bladder), CT, MRI, angiography, and nuclear studies. Open splenectomy for trauma or splenomegaly is at times dangerous and difficult with the need for speed, blood transfusion, and hemodynamic support. Potential early postoperative complications include abscess, pancreatic injury, pneumonia, and wound infection.","PeriodicalId":102588,"journal":{"name":"Mayo Clinic General Surgery","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132945521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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