Churchill's Pocketbook of Surgery

 
 
Elsevier HealthScience EN (Verlag)
  • 5. Auflage
  • |
  • erschienen am 24. Februar 2016
  • |
  • 544 Seiten
 
E-Book | ePUB mit Adobe-DRM | Systemvoraussetzungen
E-Book | PDF mit Adobe-DRM | Systemvoraussetzungen
978-0-7020-6310-7 (ISBN)
 

The Fifth Edition of this highly-praised and bestselling pocketbook continues to deliver a concise and didactic account of the essential features of all common surgical disorders. The book covers fundamental principles as well as providing basic information on aetiology, diagnosis and management, including pre-operative and post-operative care. The text includes an overview of history-taking, relevant physical signs, differential diagnosis, investigations and practical treatment.

The book provides comprehensive coverage of general surgery but in addition covers the basic needs of the medical student and those in the early years of postgraduate training as far as the surgical specialities are concerned.

      • Presented in portable small format in two colours with line drawings and radiological images. The text is succinct and clearly structured with extensive use of headings to guide the reader.
        • Covers all the major surgical specialties.
          • Contains outlines of common operations such as appendicectomy and thyroidectomy.
            • Contains an introductory chapter on consent, medicolegal issues, statistics and clinical audit.
              • Contains a checklist of emergency situations for quick reference.
                    • The text has been extensively re-written by a team of senior specialist surgical registrars or newly appointed consultants.
                      • Over 50 new illustrations of line drawings are included as well as updated radiological images.
                        • New hints and tips sections have been added.
                          5. Auflage
                          • Englisch
                          • Saintt Louis
                          • |
                          • Großbritannien
                          Approx. 115 illustrations (60 in color)
                          • 9,09 MB
                          978-0-7020-6310-7 (9780702063107)
                          weitere Ausgaben werden ermittelt
                          • Front Cover
                          • Inside Front Cover
                          • Churchill's Pocketbook of Surgery
                          • Copyright Page
                          • Table Of Contents
                          • Preface
                          • Acknowledgements
                          • Contributors
                          • Abbreviations
                          • Terms and Definitions
                          • Terms
                          • Some Important Definitions
                          • Biochemical Values
                          • Venous Blood: Adult Reference Values
                          • Haematological Values
                          • Emergencies
                          • 1 Introduction to Surgery
                          • Chapter Outline
                          • Approach to the Patient
                          • Taking a History
                          • History of Pain
                          • Examination of a Lump
                          • History
                          • Examination
                          • Consistency.
                          • Fluctuation.
                          • Fluid Thrill.
                          • Translucency.
                          • Resonance.
                          • Pulsatility.
                          • Compressibility.
                          • Bruit.
                          • Reducibility.
                          • Relation to Surrounding Structures.
                          • Regional Lymph Nodes.
                          • Surrounding Tissues and Extremities.
                          • General Examination
                          • Examination of an Ulcer
                          • Definition
                          • History
                          • Examination
                          • Base.
                          • Edge.
                          • Depth.
                          • Discharge.
                          • Surrounding Tissues.
                          • Examine the Local Lymph Nodes
                          • Classification of Disease
                          • Evidence-Based Medicine
                          • Clinical Governance in Surgical Practice
                          • Clinical Audit
                          • Medicolegal Issues
                          • Consent
                          • Breaking Bad News
                          • Death and the Certification of Death
                          • Bereavement Counselling
                          • 2 An Introduction to Surgical Techniques and Practical Procedures
                          • Chapter Outline
                          • Surgical Incisions
                          • Sutures
                          • Absorbable
                          • Nonabsorbable
                          • Natural Sutures
                          • Synthetic Sutures
                          • Monofilament
                          • Braided (Polyfilament)
                          • Wire
                          • Gauge
                          • Needles
                          • Methods of Suturing
                          • Removal of Sutures
                          • Alternatives to Sutures
                          • Drains
                          • Open Drainage
                          • Closed Drainage
                          • Suction Drains
                          • Nonsuction Drains
                          • Complications of Drains
                          • Stomas (-Ostomies)
                          • Colostomy
                          • Ileostomy
                          • Urostomy (Ileal Bladder)
                          • Mucous Fistula
                          • Local Anaesthesia
                          • Types of Local Anaesthetic
                          • Lidocaine.
                          • Bupivacaine.
                          • Prilocaine.
                          • Complications
                          • Toxicity
                          • Tourniquets
                          • Diathermy
                          • Laser
                          • Laparoscopic Surgery
                          • Diagnostic Laparoscopy.
                          • Therapeutic Laparoscopy.
                          • Technique
                          • Complications
                          • Venous Access
                          • Central Venous Catheterization - Internal Jugular Vein
                          • Blood Gas Sampling
                          • Urinary Catheterization (Male)
                          • 3 Investigative Procedures
                          • Chapter Outline
                          • Conventional Radiology
                          • Plain Films
                          • Chest X-ray (CXR)
                          • Abdominal X-ray (AXR)
                          • Contrast Studies
                          • Gastrointestinal Tract
                          • Barium Meal.
                          • Barium Enema.
                          • Barium Follow-Through or Small Bowel Enema.
                          • Biliary Tree
                          • Ultrasound.
                          • Magnetic Resonance Cholangiopancreatography (MRCP).
                          • Endoscopic Retrograde Cholangiopancreatography (ERCP).
                          • Percutaneous Transhepatic Cholangiography (PTC).
                          • Operative Cholangiogram.
                          • T-Tube Cholangiogram.
                          • Urinary Tract
                          • Intravenous Urography (IVU).
                          • Cystography.
                          • Urethrography.
                          • Retrograde Pyelography.
                          • Antegrade Pyelography.
                          • Vascular System
                          • Arteriography.
                          • Digital Subtraction Angiography (DSA).
                          • Venography.
                          • Ultrasonography
                          • Advantages
                          • Disadvantages
                          • Doppler Ultrasound
                          • Uses of Doppler Ultrasound
                          • Measurement of Systolic Pressure in Peripheral Arteries.
                          • Duplex Scanning
                          • Computerized Tomography (CT)
                          • Advantages
                          • CT Angiography.
                          • CT Urography.
                          • CT Colonography (CTC).
                          • Magnetic Resonance Imaging (MRI)
                          • Advantages
                          • Disadvantages
                          • Positron Emission Tomography (PET)
                          • Advantages
                          • Disadvantages
                          • Mammography
                          • Radioisotope Scanning
                          • Bone Scans
                          • Renal Scans
                          • Lung Scanning
                          • Scanning for Infection
                          • Screening for GI Bleeding
                          • Endoscopy
                          • Use of Endoscopes
                          • Rigid Endoscopes
                          • Sigmoidoscopy.
                          • Oesophagoscopy.
                          • Cystoscopy.
                          • Laparoscopy.
                          • Flexible Endoscopes
                          • Gastroscope (Oesophago-Gastro-Duodenoscope).
                          • Colonoscopy.
                          • Bronchoscopy.
                          • Other Flexible Scopes.
                          • Advantages and Disadvantages of Endoscopy
                          • Advantages
                          • Disadvantages
                          • Complications
                          • Tissue Diagnosis
                          • Biopsy
                          • Cytology
                          • Interventional Radiology
                          • Tissue Diagnosis
                          • Biliary Tract
                          • Urinary Tract
                          • Vascular System
                          • Percutaneous Transluminal Angioplasty (PTA) and Stenting.
                          • Thrombolysis.
                          • Embolization.
                          • Prevention of Pulmonary Emboli.
                          • Endovascular Aneurysm Repair.
                          • 4 Shock and Trauma
                          • Chapter Outline
                          • Shock
                          • Hypovolaemic Shock
                          • Causes.
                          • Classification.
                          • Symptoms and Signs.
                          • Management.
                          • Septic Shock
                          • Causes.
                          • Symptoms and Signs.
                          • Management.
                          • Complications.
                          • Cardiogenic Shock
                          • Causes.
                          • Symptoms and Signs.
                          • Investigations.
                          • Management
                          • Neurogenic Shock
                          • Symptoms and Signs.
                          • Treatment
                          • Anaphylactic Shock
                          • Symptoms and Signs.
                          • Management
                          • Trauma
                          • Initial Assessment of the Trauma Patient
                          • Prehospital Care.
                          • Initial Assessment and Resuscitation.
                          • Primary Survey
                          • Secondary Survey
                          • History.
                          • Examination.
                          • Investigations.
                          • Head Injury ( Ch. 18)
                          • Management.
                          • Thoracic Trauma
                          • Management.
                          • Airway Obstruction
                          • Symptoms and Signs.
                          • Management.
                          • Tension Pneumothorax
                          • Symptoms and Signs.
                          • Management.
                          • Open (Sucking) Pneumothorax
                          • Symptoms and Signs.
                          • Management.
                          • Haemothorax and Massive Haemothorax
                          • Symptoms and Signs.
                          • Management.
                          • Flail Chest
                          • Symptoms and Signs.
                          • Management.
                          • Cardiac Tamponade
                          • Symptoms and Signs.
                          • Management.
                          • Aortic Disruption (TRA)
                          • Symptoms and Signs.
                          • Investigations
                          • Management.
                          • Tracheobronchial Injury
                          • Larynx.
                          • Symptoms and Signs.
                          • Management.
                          • Trachea.
                          • Symptoms and Signs.
                          • Management.
                          • Bronchi.
                          • Symptoms and Signs.
                          • Investigations.
                          • Management.
                          • Oesophageal Injury
                          • Symptoms and Signs.
                          • Management.
                          • Myocardial Contusion
                          • Management.
                          • Pulmonary Contusion
                          • Management.
                          • Pneumothorax ( Ch. 9)
                          • Symptoms and Signs.
                          • Management.
                          • Diaphragmatic Rupture
                          • Symptoms and Signs.
                          • Investigations
                          • Management.
                          • Miscellaneous Thoracic Injuries
                          • Rib Fractures.
                          • Symptoms and Signs.
                          • Management
                          • Sternal Fractures
                          • Management.
                          • Scapular Fractures
                          • Pulmonary Haematoma.
                          • Symptoms and Signs.
                          • Management.
                          • Air Embolism
                          • Symptoms and Signs.
                          • Management.
                          • Abdominal Trauma
                          • Penetrating Trauma
                          • Management.
                          • Blunt Trauma
                          • Symptoms and Signs.
                          • Investigations in Abdominal Trauma
                          • Specific Organ Injuries
                          • Gastrointestinal Tract.
                          • Pancreas.
                          • Symptoms and Signs.
                          • Investigations
                          • Management.
                          • Complications.
                          • Liver.
                          • Symptoms and Signs.
                          • Management
                          • Nonoperative.
                          • Radiological.
                          • Operative.
                          • Complications.
                          • Spleen.
                          • Symptoms and Signs.
                          • Management
                          • Nonoperative.
                          • Radiological.
                          • Operative.
                          • Complications.
                          • Urinary Trauma
                          • Renal.
                          • Symptoms and Signs.
                          • Investigations.
                          • Management.
                          • Complications.
                          • Other Urinary Tract Injuries
                          • Limb Trauma
                          • Vascular Trauma
                          • Skeletal Trauma
                          • Nerve Injuries
                          • Neuropraxia.
                          • Axonotmesis.
                          • Neurotmesis.
                          • Symptoms and Signs.
                          • Investigations.
                          • Management
                          • 5 Preoperative and Postoperative Care
                          • Chapter Outline
                          • Preoperative Preparation
                          • Assessment
                          • Principles of Preoperative Preparation
                          • Postoperative Care
                          • Progress
                          • Conditions Affecting Surgical Risk
                          • General Problems in Surgical Patients
                          • Age
                          • Obesity
                          • Compromised Host
                          • Allergies
                          • Drugs
                          • Medical Problems in Surgical Patients
                          • Cardiovascular
                          • Myocardial Infarction and Angina.
                          • Cardiac Failure.
                          • Arrhythmias.
                          • Valvular Heart Disease.
                          • Hypertension.
                          • Cerebrovascular Disease.
                          • Peripheral Vascular Disease (PVD).
                          • Respiratory Disease
                          • Perioperative Management of Respiratory Disease
                          • Renal Disease
                          • Mild Impairment of Renal Function.
                          • Grossly Impaired Renal Function (Nondialysis Dependent).
                          • Dialysis-Dependent Renal Failure
                          • Haemodialysis.
                          • Continuous Ambulatory Peritoneal Dialysis (CAPD).
                          • Hepatic Disease
                          • Hepatitis.
                          • Obstructive Jaundice.
                          • Haemolytic Disease.
                          • Perioperative Management of Patients with Liver Disease/Obstructive Jaundice
                          • Haematological Disease
                          • Anaemia.
                          • Polycythaemia.
                          • Bleeding Disorders
                          • Inherited.
                          • Anticoagulant Therapy.
                          • Disseminated Intravascular Coagulation (DIC).
                          • Clotting Disorders
                          • Acquired.
                          • Inherited.
                          • Sickle Cell Anaemia.
                          • Endocrine Disease
                          • Diabetes.
                          • Insulin Dependent
                          • Oral Hypoglycaemics
                          • Diabetics Controlled by Diet Alone
                          • Thyroid Disease
                          • Hypothyroidism.
                          • Hyperthyroidism.
                          • Adrenal Disease
                          • Adrenocortical Insufficiency.
                          • Cushing's Syndrome.
                          • American Society of Anesthesiologists' Classification of Physical Status (ASA Grading)
                          • Postoperative Complications
                          • Haemorrhage
                          • Early Postoperative
                          • Secondary Haemorrhage
                          • Wound Problems
                          • Infection
                          • Symptoms and Signs.
                          • Treatment
                          • Wound Breakdown
                          • Burst Abdomen
                          • Incisional Hernia
                          • Treatment.
                          • Anastomotic Breakdown
                          • Causes.
                          • Haematoma
                          • Seroma
                          • Stitch Sinus
                          • Cardiovascular Problems
                          • Lung Problems
                          • Atelectasis
                          • Symptoms and Signs.
                          • Diagnosis.
                          • Treatment.
                          • Aspiration
                          • Pneumonia
                          • Symptoms and Signs.
                          • Diagnosis
                          • Treatment.
                          • Pulmonary Oedema
                          • Symptoms and Signs.
                          • Diagnosis
                          • Treatment.
                          • Pulmonary Embolus (PE)
                          • Symptoms and Signs.
                          • Diagnosis
                          • Treatment
                          • Pneumothorax
                          • Symptoms and Signs.
                          • Treatment
                          • Acute Respiratory Distress Syndrome (ARDS
                          • Shock Lung)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Cerebral Problems
                          • Confusion
                          • Investigations
                          • Treatment
                          • Stroke
                          • Urinary Tract Problems
                          • Acute Retention
                          • Symptoms and Signs.
                          • Treatment.
                          • Urinary Tract Infection (UTI)
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Acute Renal Failure (ARF)
                          • Causes
                          • Prerenal.
                          • Renal.
                          • Postrenal.
                          • Treatment of Anuria/Oliguria
                          • Gastrointestinal Problems
                          • Paralytic Ileus
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment
                          • Mechanical Obstruction
                          • Early (within 2 Weeks of Surgery).
                          • Late (after 2 Weeks).
                          • Gastric Dilatation
                          • Treatment.
                          • Constipation
                          • Treatment
                          • Postoperative Pyrexia
                          • Postoperative Pain Relief
                          • Methods of Postoperative Pain Control
                          • Oral Analgesia
                          • Parenteral Analgesia
                          • Intermittent Intramuscular Opiates.
                          • Intravenous Opiates.
                          • Patient-Controlled Analgesia (PCA) Pump.
                          • Patient Controlled Epidural Anaesthesia (PCEA) Pump.
                          • Spinal.
                          • Epidural.
                          • Intercostal Nerve Blocks
                          • Direct Infiltration
                          • Blood Transfusion
                          • Blood Products and Alternatives to Transfusion
                          • Clinical Aspects of Blood Transfusion
                          • Complications of Blood Transfusion
                          • Acute
                          • Haemolytic Transfusion Reaction.
                          • Allergic Reaction.
                          • Transfusion Related Acute Lung Injury (TRALI).
                          • Nonhaemolytic Febrile Transfusion Reaction (NHFTR).
                          • Bacterial Sepsis.
                          • Circulatory Overload.
                          • Hypothermia
                          • Delayed
                          • Delayed Haemolytic Transfusion Reaction (DHTR).
                          • Iron Overload
                          • Graft Versus Host Disease.
                          • Immune Modulation.
                          • Infections.
                          • Post-Transfusion Purpura.
                          • Massive Blood Transfusion
                          • Fluid and Electrolyte Balance
                          • Crystalloid and Colloid
                          • Normal Saline.
                          • Five Per Cent Dextrose.
                          • Dextrose Saline.
                          • Hartmann's Solution.
                          • Fluid and Electrolyte Depletion
                          • Management of Na+ and K+ Imbalance
                          • Hyponatraemia (i.e. Low Na+).
                          • Hypernatraemia (i.e. High Na+).
                          • Hypokalaemia (i.e. Low K+).
                          • Hyperkalaemia (i.e. High K+).
                          • Acid-Base Balance
                          • Metabolic Acidosis.
                          • Metabolic Alkalosis.
                          • Respiratory Acidosis.
                          • Respiratory Alkalosis.
                          • Nutritional Support
                          • Causes of Malnutrition
                          • Indications for Nutritional Support
                          • Evaluation of Nutritional Status
                          • Administration of Nutritional Support
                          • Oral Nutrition
                          • Enteral Nutrition
                          • Fine-Bore Nasogastric Tubes.
                          • Surgically Created Gastrostomy or Jejunostomy.
                          • Complications.
                          • Nasogastric Feeding.
                          • Gastrostomy/Jejunostomy.
                          • Parenteral Nutrition
                          • Peripheral Line.
                          • Central Line.
                          • Total Parenteral Nutrition (TPN)
                          • Components of Total Parenteral Nutrition
                          • Monitoring Total Parenteral Nutrition
                          • Complications of Total Parenteral Nutrition
                          • Catheter Related.
                          • Metabolic.
                          • Home Total Parenteral Nutrition
                          • 6 Infection and Surgery
                          • Chapter Outline
                          • Principles of Wound Management
                          • Healing by Primary Intention
                          • Healing by Secondary Intention
                          • Delayed Primary Closure
                          • Factors Affecting Wound Healing
                          • Age.
                          • Nutritional State.
                          • Drugs.
                          • Tissue Oxygenation and Vascularity.
                          • Radiotherapy.
                          • Local Sepsis.
                          • Factors Predisposing to Infection in Surgery
                          • Age.
                          • Underlying Illness.
                          • Obesity and Smoking.
                          • Wound Classification.
                          • Classification of Surgical Wounds
                          • Clean.
                          • Clean Contaminated.
                          • Contaminated.
                          • Dirty.
                          • Prevention of Surgical Site Infection (Incorporating Nice Guidelines 2008)
                          • Preoperative Precautions
                          • Perioperative Precautions
                          • Postoperative Precautions
                          • Antibiotics in Surgery
                          • Principles of Antibiotic Therapy
                          • Selection of Antibiotic
                          • Route of Administration
                          • Duration of Therapy
                          • Dosage
                          • Complications of Antibiotic Therapy
                          • Prophylactic Antibiotics
                          • Indications for Prophylactic Antibiotics
                          • Specific Antibiotics
                          • Surgical Infections
                          • Sepsis
                          • Management of Sirs
                          • Cellulitis
                          • Symptoms and SIRS.
                          • Investigations
                          • Treatment.
                          • Necrotizing Fasciitis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Gas Gangrene
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Prophylactic.
                          • Therapeutic.
                          • Tetanus
                          • Symptoms and Signs
                          • History of Injury.
                          • Differential Diagnosis
                          • Treatment
                          • Prophylactic
                          • Therapeutic
                          • Prognosis.
                          • Methicillin-Resistant Staphylococcus Aureus (MRSA)
                          • Risk Factors for Colonization.
                          • Clinical Presentation.
                          • Infection Control.
                          • Management
                          • Carriers.
                          • Patients with MRSA Infection.
                          • Infection and the Surgeon
                          • HIV
                          • Risk Categories
                          • Prevention of HIV
                          • Hepatitis B
                          • Hepatitis C
                          • Precautions for the Care of Known and Suspected HIV, HBV and HCV Carriers
                          • Universal Precautions
                          • Special Precautions
                          • Management of Sharps Injuries
                          • Procedure at Occupational Health or Emergency Department
                          • Postexposure Prophylaxis
                          • Hepatitis B
                          • Hepatitis C
                          • HIV
                          • 7 Management of Malignant Disease
                          • Chapter Outline
                          • Screening
                          • Premalignant Conditions
                          • General Symptoms and Signs of Malignant Disease
                          • Primary Tumour
                          • Palpable Swelling.
                          • Obstruction.
                          • Bleeding
                          • Symptoms Due to Compression or Invasion of Local Structures.
                          • Metastases
                          • Generalized Manifestations.
                          • Asymptomatic Incidental Findings.
                          • Staging and Grading of Cancer
                          • Clinical and Pathological Staging
                          • Grading of Tumours
                          • Diagnostic Procedures
                          • Biopsy.
                          • Imaging (e.g. Ultrasound, CT or MRI).
                          • Positron Emission Tomography (PET).
                          • Tumour Markers
                          • a-Fetoprotein (AFP).
                          • Carcinoembryonic Antigen (CEA).
                          • Human Chorionic Gonadotrophin (hCG).
                          • Prostate-Specific Antigen (PSA).
                          • CA19-9.
                          • CA125.
                          • CA15-3.
                          • The Multidisciplinary Team (MDT) Meeting
                          • Treatment of Cancer
                          • Surgery
                          • Curative
                          • Palliative
                          • Radiotherapy
                          • Delivery of Radiotherapy
                          • External Beam Radiation.
                          • Proton Beam Therapy.
                          • Implantation Radiotherapy (e.g. Intracavitary or Intralesional).
                          • Systemic Irradiation.
                          • Use of Radiotherapy
                          • Primary Treatment.
                          • Adjuvant and Neoadjuvant Treatment.
                          • Palliative Radiotherapy
                          • Systemic.
                          • Total Body Irradiation.
                          • Radioactive Isotopes.
                          • Chemotherapy
                          • Side Effects
                          • Chemoradiotherapy
                          • Hormonal Manipulation
                          • Breast
                          • Inhibition of Ovarian Function.
                          • Blocking the Binding of Oestrogen to Cancer Cells.
                          • Blocking Peripheral Oestrogen Production.
                          • Prostate
                          • Surgical Orchidectomy.
                          • Luteinizing Hormone Releasing Hormone (LHRH) Analogues, e.g. Goserelin.
                          • Oestrogen, e.g. Diethylstilboestrol.
                          • Antiandrogens.
                          • Inhibition of Adrenal Enzyme Synthesis.
                          • Biological Therapies
                          • Palliative Care
                          • Principles of Palliative Care
                          • Treatment of Symptoms
                          • Pain
                          • Nausea and Vomiting
                          • Constipation
                          • Dysphagia
                          • Mouth Care
                          • Cough
                          • Insomnia and Agitation
                          • 8 Head, Neck and Otorhinolaryngology
                          • Chapter Outline
                          • Scalp and Facial Swellings
                          • Neck Swellings
                          • Superficial
                          • Lymph Nodes
                          • Investigation of Cervical Lymphadenopathy
                          • Deep Swellings of the Anterior Triangle
                          • Swellings That Move on Swallowing
                          • Thyroid.
                          • Thyroglossal Duct Cyst.
                          • Symptoms and Signs.
                          • Treatment.
                          • Swellings That Do Not Move on Swallowing
                          • Salivary Glands: Inflammatory.
                          • Acute Sialadenitis.
                          • Symptoms and Signs.
                          • Treatment.
                          • Chronic Sialadenitis.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Salivary Glands: Autoimmune.
                          • Mikulicz's Syndrome.
                          • Sjögren's Syndrome.
                          • Treatment.
                          • Salivary Glands: Tumours.
                          • Benign Salivary Gland Tumours: Pleomorphic Adenoma.
                          • Symptoms and Signs.
                          • Differential Diagnosis.
                          • Treatment.
                          • Complications.
                          • Benign Salivary Gland Tumours: Adenolymphoma (Warthin's Tumour).
                          • Symptoms and Signs.
                          • Treatment.
                          • Malignant Salivary Gland Tumours.
                          • Symptoms and Signs.
                          • Treatment.
                          • Branchial Cyst
                          • Symptoms and Signs.
                          • Differential Diagnosis of a Branchial Cyst.
                          • Treatment.
                          • Carotid Body Tumour
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Carotid Aneurysm
                          • Deep Swellings of the Posterior Triangle
                          • Cervical Rib
                          • Symptoms and Signs.
                          • Diagnosis
                          • Treatment.
                          • Subclavian Artery Aneurysm
                          • Pharyngeal Pouch
                          • Cystic Hygroma
                          • Symptoms and Signs.
                          • Treatment.
                          • Oral Disorders
                          • Stomatitis
                          • General Principles of Management
                          • Examination.
                          • Investigations
                          • Treatment.
                          • Ulcers
                          • Traumatic.
                          • Aphthous.
                          • Herpes Simplex.
                          • Syphilitic.
                          • Tuberculous.
                          • Malignant.
                          • Leukoplakia
                          • Erythroplakia
                          • Cystic Lesions of the Lips and Mouth
                          • Mucous Retention Cyst
                          • Symptoms and Signs.
                          • Treatment.
                          • Ranula
                          • Symptoms and Signs.
                          • Treatment.
                          • Sublingual Dermoid
                          • Symptoms and Signs.
                          • Treatment.
                          • Tonsillitis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Tonsillectomy
                          • Voice and Swallowing Disorders
                          • Hoarseness
                          • Vocal Cord Paralysis
                          • Swallowing Disorders
                          • Carcinoma of the Upper Aerodigestive Tract
                          • The Oral Cavity
                          • Predisposing Factors.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Squamous Cell Carcinoma of the Pharynx and Larynx
                          • Nasopharyngeal Carcinoma (NPC)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Oropharyngeal Carcinoma
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Carcinoma of the Hypopharynx and Cervical Oesophagus
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Laryngeal Carcinoma
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Neck Dissection
                          • Indications.
                          • Classification.
                          • Complications.
                          • Disorders of the Ear
                          • Otitis Externa
                          • Symptoms and Signs.
                          • Treatment.
                          • Acute Otitis Media (AOM)
                          • Symptoms and Signs.
                          • Treatment.
                          • Complications.
                          • Chronic Suppurative Otitis Media (CSOM)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Facial Paralysis.
                          • Disorders of the Nose and Paranasal Sinuses
                          • Nasal Obstruction
                          • Nasal Polyps.
                          • Rhinosinusitis.
                          • Fungal Rhinosinusitis (FRS).
                          • Tumours.
                          • ENT Emergencies
                          • Epistaxis
                          • Nasal Trauma
                          • Swallowed Foreign Body
                          • Peritonsillar Abscess (Quinsy)
                          • Deep Neck Space Infections
                          • Acute Epiglottitis
                          • Acute Sensorineural Hearing Loss (SNHL)
                          • 9 Thorax
                          • Chapter Outline
                          • Heart and Great Vessels
                          • Principles of Cardiac Surgery
                          • Indications for Surgery
                          • Contraindications for Surgery
                          • Preoperative Preparation
                          • Surgery
                          • Cardiopulmonary Bypass (Fig. 9.1).
                          • Postoperative Complications
                          • Low Cardiac Output.
                          • Respiratory Failure.
                          • Renal Failure.
                          • Jaundice.
                          • Cerebral Damage.
                          • Atrial Fibrillation (AF).
                          • Postoperative Treatment
                          • Maintenance of Cardiac Output.
                          • Prevention of Respiratory Problems.
                          • Maintenance of Urine Output.
                          • Prevention of Cerebral Problems.
                          • Prevention of Atrial Fibrillation.
                          • Congenital Heart Disease
                          • Acyanotic
                          • Ventricular Septal Defect (VSD).
                          • Atrial Septal Defect (ASD).
                          • Patent Ductus Arteriosus (PDA).
                          • Coarctation of the Aorta.
                          • Congenital Valve Disease in Children.
                          • Cyanotic
                          • Tetralogy of Fallot.
                          • Transposition of the Great Vessels
                          • Acquired Valvular Heart Disease
                          • Types of Valve
                          • Mechanical Valves.
                          • Tissue Valves.
                          • Human Cryopreserved Allograft Valves.
                          • Complications of Artificial Valves
                          • Ischaemic Heart Disease
                          • Aetiology.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Conservative.
                          • Percutaneous Transluminal Coronary Angioplasty (PTCA).
                          • Coronary Artery Bypass Graft (CABG).
                          • Surgery for Complications of Myocardial Infarction (MI)
                          • Ventricular Aneurysm.
                          • Mitral Regurgitation.
                          • Ruptured Intraventricular Septum.
                          • Pericarditis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications of Pericarditis
                          • Cardiac Tamponade.
                          • Symptoms and Signs.
                          • Treatment.
                          • Constrictive Pericarditis.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Thoracic Aorta
                          • Aneurysms
                          • Symptoms and Signs
                          • Asymptomatic.
                          • Investigations
                          • Treatment.
                          • Aortic Dissection
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Medical.
                          • Surgical.
                          • Prognosis.
                          • Thoracic Trauma
                          • Pleura and Lungs
                          • Pneumothorax
                          • Spontaneous (Primary) Pneumothorax.
                          • Spontaneous (Secondary) Pneumothorax.
                          • Traumatic.
                          • Pleural Effusion
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Tumours of the Pleura
                          • Pulmonary Infections
                          • Bronchiectasis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications.
                          • Lung Abscess
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Tuberculosis
                          • Lung Tumours
                          • Bronchial Carcinoma
                          • Symptoms and Signs
                          • Primary.
                          • Complications
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Metastatic Lung Tumours
                          • Solitary Pulmonary Nodules (Coin Lesions)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Mediastinum
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • 10 Breast
                          • Chapter Outline
                          • The Assessment of Breast Disease - Triple Assessment
                          • Clinical Assessment
                          • History
                          • Examination
                          • Look (Observation)
                          • Feel (Palpation)
                          • Move.
                          • General Examination Findings.
                          • Investigations
                          • Pathology
                          • The Multi-Disciplinary Team (MDT)
                          • Carcinoma of the Breast
                          • Risk Factors for Breast Cancer
                          • Presentation
                          • Investigations
                          • Types of Primary Breast Cancer
                          • Clinical Staging
                          • Treatment of Breast Cancer
                          • Local Treatments (Surgery and Radiotherapy)
                          • Surgery
                          • Breast Conservation Surgery (BCS).
                          • Mastectomy.
                          • Staging and Management of the Axilla.
                          • Complications of Surgery
                          • Radiotherapy
                          • Complications of Radiotherapy.
                          • Systemic Therapies (Chemotherapy, Endocrine Therapy and Biological Therapies, Plus Bisphosphonates)
                          • Chemotherapy
                          • Biological Therapies
                          • Complications of Chemotherapy and Biological Therapies.
                          • Bisphosphonates
                          • Endocrine Therapy
                          • Complications of Endocrine Therapies.
                          • Follow-up
                          • Locally Recurrent Disease.
                          • Palliation
                          • Palliation of locally advanced breast cancer
                          • Palliation of metastatic breast cancer
                          • Breast Reconstruction
                          • Breast Screening
                          • Ductal Carcinoma in Situ (DCIS)
                          • Treatment.
                          • Staging
                          • Lobular Carcinoma in Situ (LCIS)
                          • Paget's Disease of the Nipple
                          • Symptoms and Signs.
                          • Differential Diagnosis.
                          • Investigations.
                          • Treatment.
                          • Prognosis.
                          • Inflammatory Carcinoma of the Breast
                          • Symptoms and Signs.
                          • Diagnosis
                          • Treatment.
                          • Prognosis.
                          • Special Contexts for Breast Cancer
                          • Pregnancy
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Male Breast Carcinoma
                          • Investigation
                          • Treatment.
                          • Prognosis.
                          • Pseudolipoma
                          • Risk Reduction in Moderate and High Risk Women
                          • Congenital Disorders of the Breast
                          • Duplication
                          • Treatment
                          • Absence and Hypoplasia
                          • Treatment
                          • Aberrations of Normal Development and Involution
                          • Aberrations of Development (<25 Years of Age)
                          • Juvenile Hypertrophy.
                          • Treatment
                          • Fibroadenoma
                          • Symptoms and Signs.
                          • Investigation.
                          • Treatment
                          • Phyllodes Tumours
                          • Investigation.
                          • Treatment.
                          • Aberrations of Mature Reproductive Life (25-40 Years of Age)
                          • Benign Breast Change.
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Aberrations of Involution (35-55 Years of Age)
                          • Macrocysts.
                          • Symptoms and Signs.
                          • Investigation.
                          • Treatment
                          • Sclerosing Lesions.
                          • Duct Ectasia.
                          • Symptoms and Signs.
                          • Differential Diagnosis
                          • Investigations
                          • Treatment
                          • Intraductal Papilloma.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Other Benign Conditions of the Breast
                          • Bacterial Mastitis and Breast Abscess
                          • Symptoms and Signs
                          • Investigation
                          • Treatment
                          • Periductal Mastitis
                          • Symptoms and Signs.
                          • Differential Diagnosis.
                          • Investigations
                          • Treatment
                          • Fat Necrosis
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Hamartoma
                          • Gynaecomastia
                          • Treatment.
                          • Other Related Conditions
                          • Tietze's Disease.
                          • Mondor's Disease.
                          • 11 Endocrine Surgery
                          • Chapter Outline
                          • Thyroid
                          • Congenital
                          • Lingual Thyroid
                          • Thyroglossal Cyst.
                          • Thyroglossal Fistula
                          • Examination of the Thyroid Gland
                          • Symptoms of Thyroid Disease
                          • Swelling in the Neck
                          • Hoarse Voice.
                          • Dysphagia.
                          • Dyspnoea.
                          • Pain.
                          • Eye Symptoms.
                          • Hyperthyroidism.
                          • Hypothyroidism.
                          • Incidental Finding on Imaging for Another Problem.
                          • Investigation of Thyroid Dysfunction/Swellings
                          • Laboratory Tests.
                          • Fine Needle Aspiration.
                          • Plain Radiograph of Chest (to Include Thoracic Inlet).
                          • Ultrasound Scan.
                          • Radioisotope Scan.
                          • CT/MRI ( Fig. 11.1).
                          • The Patient with a Thyroid Swelling (Goitre)
                          • Diffuse Enlargement
                          • Simple Goitre.
                          • Symptoms and Signs.
                          • Treatment.
                          • Graves' Disease
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Antithyroid Drugs (Carbimazole, Propylthiouracil).
                          • Radioiodine.
                          • Surgery.
                          • Nodular Enlargement
                          • Multinodular Goitre.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Retrosternal Goitre
                          • Solitary Thyroid Nodule
                          • Cyst.
                          • Colloid Nodule.
                          • Follicular Nodule (As Described On Cytology).
                          • Thyroid Cancer
                          • Symptoms and Signs.
                          • Differentiated Thyroid Cancer
                          • Papillary (70%).
                          • Follicular (20%).
                          • Treatment.
                          • Prognosis.
                          • Anaplastic Carcinoma (5%)
                          • Medullary Carcinoma (5%)
                          • Lymphoma (1%)
                          • Inflammatory Conditions of the Thyroid
                          • Subacute Thyroiditis (De Quervain's)
                          • Riedel's Thyroiditis
                          • Hashimoto's Disease
                          • Thyroidectomy
                          • Indications
                          • Preoperative Preparation
                          • Operations
                          • Complications
                          • Haemorrhage.
                          • Vocal Cord Palsy Due To Recurrent Laryngeal Nerve Injury.
                          • Superior Laryngeal Nerve (External Branch) Injury.
                          • Thyroid Storm (Thyrotoxic Crisis).
                          • Hypocalcaemia.
                          • Hypothyroidism.
                          • Other Complications.
                          • Parathyroid
                          • Hyperparathyroidism
                          • Primary Hyperparathyroidism
                          • Symptoms and Signs.
                          • Stones.
                          • Bones.
                          • Abdominal Groans.
                          • Moans.
                          • Other.
                          • Investigations
                          • Differential Diagnosis.
                          • Treatment.
                          • Secondary Hyperparathyroidism
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Tertiary Hyperparathyroidism
                          • Adrenal Gland
                          • Adrenal Cortex
                          • Cushing's Syndrome
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • ACTH Independent Hypercortisolism.
                          • ACTH Dependent Hypercortisolism.
                          • Primary Hyperaldosteronism
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Adrenal Medulla
                          • Phaeochromocytoma
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Adrenal Insufficiency
                          • Causes
                          • Primary
                          • Secondary
                          • Symptoms and Signs
                          • Acute Adrenal Insufficiency.
                          • Chronic Adrenal Insufficiency.
                          • Investigations
                          • Treatment.
                          • Adrenal Incidentaloma
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Carcinoma of the Adrenal Gland
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Metastasis to the Adrenal Gland
                          • Multiple Endocrine Neoplasia (MEN)
                          • MEN I
                          • MEN IIa
                          • MEN IIb
                          • 12 Abdominal Wall and Hernia
                          • Chapter Outline
                          • Herniae
                          • General Description of a Hernia
                          • Hernia (Fig. 12.1A)
                          • Defect
                          • Sac
                          • Contents of the Sac
                          • Reducible Hernia
                          • Irreducible Hernia
                          • Classification of Hernia
                          • Congenital
                          • Acquired
                          • Types of Hernia (Fig. 12.2)
                          • Groin Hernia
                          • Inguinal Herniae
                          • Femoral Hernia
                          • Other Types of Hernia
                          • Umbilical Hernia
                          • Paraumbilical Hernia
                          • Epigastric Hernia
                          • Incisional Hernia
                          • Richter's Hernia (Fig. 12.3)
                          • Spigelian Hernia
                          • Sliding Hernia (Hernia-en-Glissade) (Fig. 12.4)
                          • Obturator Hernia
                          • Lumbar Hernia
                          • Frequency of the Different Types of Hernia
                          • Are Investigations Necessary to Support the Diagnosis of a Hernia?
                          • Swellings in the Groin and Scrotum
                          • Saphena Varix
                          • Hydrocele of the Cord
                          • Lipoma of the Cord
                          • An Imperfectly Descended Testis
                          • Inguinal Lymph Nodes
                          • Malgaigne's Bulges
                          • Femoral Artery Aneurysm
                          • Other Conditions of the Abdominal Wall
                          • Umbilicus
                          • Discharge
                          • Patent Vitellointestinal Duct.
                          • Patent Urachus.
                          • Abscess in a Urachal Cyst.
                          • Infection.
                          • Umbilical Calculus.
                          • Endometriosis.
                          • Mass
                          • Umbilical Hernia.
                          • Secondary Carcinoma.
                          • Rectus Sheath Haematoma
                          • Symptoms and Signs.
                          • Treatment.
                          • Tumours of the Abdominal Wall
                          • 13 Acute Abdomen
                          • Chapter Outline
                          • Basic Principles
                          • History
                          • Age.
                          • Pain.
                          • Vomiting
                          • Defaecation
                          • Fever.
                          • Past History
                          • Examination
                          • General.
                          • Pulse, Temperature, Respiration
                          • Cervical Lymphadenopathy.
                          • Chest.
                          • Abdomen
                          • Inspection.
                          • Palpation.
                          • Percussion.
                          • Auscultation.
                          • Rectal Examination.
                          • Vaginal Examination.
                          • Investigations
                          • Causes
                          • Diagnosis.
                          • Management.
                          • Treatment
                          • Indications for Surgery in the Acute Abdomen.
                          • Medical Causes of Acute Abdominal Pain
                          • Referred Pain.
                          • Haematological.
                          • Infective and Inflammatory.
                          • Endocrine and Metabolic.
                          • Peritonitis
                          • Symptoms and Signs.
                          • Investigations
                          • Complications
                          • Systemic.
                          • Local.
                          • Prognosis.
                          • Treatment.
                          • Resuscitation.
                          • Treatment of Causative Lesion.
                          • Postoperative Care.
                          • Intra-Abdominal Abscesses
                          • Intraperitoneal Abscesses
                          • Extraperitoneal Abscesses
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • 14 Alimentary Tract
                          • Chapter Outline
                          • Oesophagus
                          • Investigation of Dysphagia
                          • History
                          • Examination.
                          • Investigations
                          • Treatment.
                          • Foreign Body
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Oesophageal Perforation
                          • Symptoms and Signs.
                          • Investigations
                          • Complication.
                          • Treatment
                          • Conservative.
                          • Surgical.
                          • Oesophageal Stricture
                          • Gastro-Oesophageal Reflux Disease
                          • Hiatus Hernia
                          • Sliding Hiatus Hernia.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Conservative.
                          • Surgical.
                          • Rolling or Paraoesophageal Hiatus Hernia.
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Treatment.
                          • Achalasia
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Treatment
                          • Botulinum Toxin.
                          • Oesophageal Pneumatic Dilatation.
                          • Heller's Operation (i.e. Cardiomyotomy).
                          • Barrett's Oesophagus
                          • Carcinoma of the Oesophagus
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Caustic Oesophagitis
                          • Symptoms and Signs.
                          • Investigations.
                          • Complications
                          • Early.
                          • Late.
                          • Treatment
                          • Emergency.
                          • Medical.
                          • Endoscopic Dilatation of Strictures.
                          • Surgery.
                          • Prognosis.
                          • Plummer-Vinson Syndrome (Syn. Paterson-Brown-Kelly Syndrome)
                          • Treatment.
                          • Stomach and Duodenum
                          • Peptic Ulceration
                          • Symptoms and Signs
                          • Duodenal Ulcer (DU).
                          • Gastric Ulcer (GU).
                          • Investigations
                          • Treatment
                          • Medical
                          • Surgical.
                          • Complications of Peptic Ulceration
                          • Haemorrhage.
                          • Perforation.
                          • Pyloric Obstruction.
                          • Zollinger-Ellison Syndrome
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Carcinoma of the Stomach
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Curative.
                          • Palliative.
                          • Prognosis.
                          • Gastric Surgery and its Complications
                          • Operations
                          • Vagotomy (Fig. 14.4).
                          • Pyloroplasty (Fig. 14.4).
                          • Gastroenterostomy (Fig. 14.4).
                          • Highly Selective Vagotomy.
                          • Gastrectomy (Fig. 14.5).
                          • Complications
                          • Recurrent Ulceration.
                          • Epigastric Fullness.
                          • Bilious Vomiting.
                          • Dumping
                          • Early.
                          • Late.
                          • Diarrhoea.
                          • Nutritional Disturbances
                          • Weight Loss.
                          • Steatorrhoea.
                          • Anaemia.
                          • Bolus Obstruction.
                          • Carcinoma.
                          • Upper Gastrointestinal Tract Bleeding
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Indications for Surgical Intervention
                          • Interventional Options are Nonoperative or Operative
                          • Nonoperative
                          • Operative
                          • Prognosis.
                          • Other Conditions of the Stomach and Duodenum
                          • Stomach
                          • Gastrointestinal Stromal Tumour (GIST).
                          • Lymphoma (Mucosal Associated Lymphoid Tumour, MALT).
                          • Duodenum
                          • Conditions of the Small Bowel
                          • Meckel's Diverticulum
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Crohn's Disease
                          • Typhoid
                          • Tuberculosis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Tumours of the Small Intestine
                          • Benign
                          • Malignant
                          • Carcinoid Tumour
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Small Bowel Obstruction
                          • Causes.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Conservative
                          • Indications for Surgery.
                          • Prognosis.
                          • Appendicitis
                          • Symptoms and Signs.
                          • Investigations
                          • Differential Diagnosis.
                          • Abdominal Disease.
                          • Urinary Tract.
                          • Gynaecological Causes.
                          • Extra-Abdominal Causes.
                          • Treatment.
                          • Complications.
                          • Appendix Mass
                          • Appendix Abscess
                          • Appendicitis in Pregnancy
                          • Conditions of the Colon, Rectum and Anus
                          • Colonic Polyps
                          • Hamartomas
                          • Juvenile Polyps.
                          • Peutz-Jeghers Syndrome.
                          • Neoplastic Polyps
                          • Adenomatous Polyps and Villous Adenomas.
                          • Familial Polyposis Coli.
                          • Gardner's Syndrome.
                          • Inflammatory Pseudopolyps.
                          • Symptoms and Signs of Polyps.
                          • Investigations
                          • Treatment.
                          • Colorectal Cancer
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment ( Fig. 14.13)
                          • Elective
                          • Emergency.
                          • Prognosis.
                          • Surveillance after Curative Resection.
                          • Bowel Screening.
                          • Inflammatory Bowel Disease
                          • Crohn's Disease
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Treatment
                          • Medical.
                          • Surgical.
                          • Prognosis.
                          • Ulcerative Colitis
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Treatment
                          • Medical.
                          • Surgical.
                          • Prognosis.
                          • Diverticular Disease
                          • Symptoms and Signs.
                          • Acute Diverticulitis.
                          • Chronic Diverticular Disease.
                          • Investigations
                          • Differential Diagnosis.
                          • Complications.
                          • Treatment
                          • Uncomplicated, Symptomatic Diverticular Disease.
                          • Acute Diverticulitis.
                          • Perforation with Paracolic Abscess.
                          • Perforation with Purulent Peritonitis.
                          • Perforation with Generalized Faecal Peritonitis.
                          • Fistula Formation.
                          • Haemorrhage.
                          • Intestinal Obstruction.
                          • Volvulus
                          • Sigmoid Volvulus
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Caecal Volvulus
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Prognosis.
                          • Irradiation Proctitis
                          • Angiodysplasia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Large Bowel Obstruction
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Anal Conditions
                          • Haemorrhoids
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Conservative
                          • Surgical
                          • Complications of Haemorrhoidectomy.
                          • Differential Diagnosis.
                          • Rectal Prolapse
                          • Symptoms and Signs.
                          • Differential Diagnosis.
                          • Treatment.
                          • Complications.
                          • Rectal Prolapse in Children
                          • Perianal Haematoma
                          • Symptoms and Signs.
                          • Treatment.
                          • Anal Fissures
                          • Symptoms and Signs.
                          • Differential Diagnosis.
                          • Treatment
                          • Conservative.
                          • Surgical.
                          • Anorectal Abscesses ( Fig. 14.19)
                          • Symptoms and Signs.
                          • Treatment.
                          • Complications.
                          • Fistula-in-Ano
                          • Symptoms and Signs.
                          • Investigations
                          • Differential Diagnosis.
                          • Treatment.
                          • Pruritus Ani
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Sexually Transmitted Diseases
                          • Condylomata Acuminata (Anal Warts)
                          • Gonorrhoea
                          • Herpes
                          • Syphilis
                          • Acquired Immunodeficiency Syndrome (AIDS)
                          • Premalignant Anal Conditions
                          • Anal Malignancies
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Rectal Bleeding
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Liver
                          • Infections in the Liver
                          • Abscess
                          • Symptoms and Signs.
                          • Investigations
                          • Differential Diagnosis.
                          • Treatment.
                          • Amoebic Abscess
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Hydatid Disease
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Liver Tumours
                          • Primary Malignant Tumours
                          • Hepatocellular Carcinoma (HCC).
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Cholangiocarcinoma.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Hepatic Metastases
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Portal Hypertension
                          • Causes
                          • Prehepatic.
                          • Hepatic.
                          • Posthepatic.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment of Bleeding Oesophageal Varices
                          • Acute Bleed.
                          • Definitive Treatment after Bleeding
                          • Prophylaxis.
                          • Prognosis.
                          • Extrahepatic Biliary System
                          • Cholelithiasis (Gallstones)
                          • Complications
                          • Gallbladder.
                          • In the Ducts.
                          • In the Gut.
                          • Acute Cholecystitis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Chronic Cholecystitis
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Biliary Colic
                          • Symptoms and Signs.
                          • Treatment.
                          • Mucocele
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Empyema
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Perforation of the Gallbladder
                          • Carcinoma
                          • Cholangitis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Gallstone Ileus
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Acalculous Cholecystitis
                          • Treatment of Gallstones
                          • Nonsurgical Treatment
                          • Oral Dissolution Therapy.
                          • Extracorporeal Shock Wave Lithotripsy.
                          • Endoscopy.
                          • Treatment of Asymptomatic Gallstones.
                          • Obstructive Jaundice
                          • Causes
                          • In the Lumen.
                          • In the Wall.
                          • Outside the Wall.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Gallstone in CBD.
                          • Congenital Biliary Atresia.
                          • Traumatic Stricture.
                          • Sclerosing Cholangitis.
                          • Cholangiocarcinoma.
                          • Choledochal Cyst.
                          • Carcinoma of the Head of the Pancreas or Ampulla of Vater.
                          • Nodes at the Porta Hepatis.
                          • Complications of Surgery on the Jaundiced Patient.
                          • Pancreas
                          • Pancreatitis
                          • Acute Pancreatitis
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Differential Diagnosis.
                          • Treatment
                          • Mild Case.
                          • Severe Case.
                          • Indications for Surgery
                          • Prognosis.
                          • Chronic Pancreatitis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Medical.
                          • Surgical.
                          • Prognosis.
                          • Pancreatic Cysts
                          • Pancreatic Pseudocyst
                          • Symptoms and Signs.
                          • Investigation
                          • Complications.
                          • Treatment.
                          • Tumours of the Pancreas
                          • Carcinoma of the Pancreas
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Prognosis.
                          • Endocrine Tumours of the Pancreas
                          • Insulinoma
                          • Symptoms and Signs
                          • Related to Cerebral Glucose Deprivation.
                          • Related to GI Tract.
                          • Investigations
                          • Treatment.
                          • Spleen
                          • Splenomegaly
                          • Indications for Splenectomy.
                          • Effects of Splenectomy
                          • Haematological
                          • Immunological.
                          • Postsplenectomy Management.
                          • Rupture of the Spleen ( Ch. 4)
                          • Spontaneous Rupture.
                          • 15 Peripheral Vascular Disease
                          • Chapter Outline
                          • Arterial
                          • History
                          • Other Systems
                          • Examination
                          • Arterial Occlusive Disease
                          • Acute Arterial Occlusion
                          • Causes
                          • Embolus.
                          • Thrombosis.
                          • Trauma.
                          • Symptoms and Signs
                          • Acute Embolus in a Normal Limb.
                          • Acute-on-Chronic Ischaemia in a Limb with Peripheral Vascular Disease.
                          • Investigations
                          • Treatment.
                          • Embolus in a Normal Limb.
                          • Thrombosis in a Limb with Peripheral Vascular Disease.
                          • Prognosis.
                          • Chronic Arterial Occlusion
                          • Lower Limb (Aorto-Ilio-Femoral Disease)
                          • Causes.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Medical.
                          • Endovascular.
                          • Surgical.
                          • Prognosis.
                          • Upper Limb
                          • Causes.
                          • Symptoms and Signs.
                          • Treatment.
                          • Cerebrovascular Disease
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Medical.
                          • Endovascular.
                          • Surgical.
                          • Renovascular Disease
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Medical.
                          • Endovascular.
                          • Surgery.
                          • Visceral Ischaemic Disease
                          • Acute Mesenteric Ischaemia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Chronic Mesenteric Ischaemia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Acute Mesenteric Venous Thrombosis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Aneurysms
                          • Aortic Aneurysms
                          • Aetiology.
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Treatment.
                          • Ruptured Aortic Aneurysm (Fig. 15.5).
                          • Investigations.
                          • Treatment.
                          • Inflammatory Aneurysm
                          • Iliac Artery Aneurysm
                          • Femoral Aneurysms
                          • Symptoms and Signs.
                          • Treatment.
                          • Popliteal Aneurysm
                          • Symptoms and Signs.
                          • Treatment.
                          • Visceral Artery Aneurysms
                          • Symptoms and Signs.
                          • Prognosis.
                          • False Aneurysms
                          • Other Vascular Problems
                          • Thromboangiitis Obliterans (Buerger's Disease)
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Raynaud's Phenomenon
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Diabetic Foot
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Neuropathic Foot
                          • Ischaemic Foot
                          • Thoracic Outlet Syndrome
                          • Symptoms and Signs
                          • Neurological.
                          • Arterial.
                          • Venous.
                          • Investigations
                          • Treatment.
                          • Arteriovenous Fistula
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Treatment.
                          • Vascular Access for Haemodialysis
                          • Complications
                          • Amputations
                          • Indications for Amputation
                          • Principles of Amputation
                          • Preparation for Amputation
                          • Types of Amputation
                          • Minor.
                          • Major
                          • Below-Knee Amputation.
                          • Gritti-Stokes Amputation.
                          • Above-Knee Amputation.
                          • Less Frequently Performed Amputations.
                          • Postoperative Care
                          • Pain Relief.
                          • Care of the Good Limb.
                          • Physiotherapy.
                          • Prosthesis.
                          • Complications
                          • Early.
                          • Late.
                          • Venous Disorders
                          • Varicose Veins
                          • Symptoms and Signs.
                          • Investigations.
                          • Complications.
                          • Treatment.
                          • Deep Vein Thrombosis (DVT)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prevention.
                          • Therapeutic.
                          • Chronic Venous Insufficiency
                          • Symptoms and Signs
                          • Investigations
                          • Treatment.
                          • Medical.
                          • Surgery.
                          • Superficial Thrombophlebitis
                          • Lymphoedema
                          • Primary
                          • Secondary
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Vascular Trauma
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Emergency Measures.
                          • Complications.
                          • 16 Urology
                          • Chapter Outline
                          • Taking a Urological History
                          • Symptoms
                          • Haematuria.
                          • Lower Urinary Tract Symptoms (LUTS).
                          • Storage Symptoms.
                          • Voiding Symptoms.
                          • Pain.
                          • Incontinence.
                          • Past Medical History
                          • Drug History
                          • Social History
                          • Family History
                          • Urological Investigations
                          • Essential
                          • If Appropriate to Presentation
                          • Imaging
                          • Congenital Disorders of the Urinary Tract
                          • Kidney and Ureter
                          • Congenital Absence of One Kidney.
                          • Pelvic Kidney.
                          • Horseshoe Kidney.
                          • Congenital Hydronephrosis (PUJO).
                          • Infantile Polycystic Disease.
                          • Adult Polycystic Disease.
                          • Medullary Sponge Kidney.
                          • Ureteric Duplication.
                          • Ureterocele.
                          • Megaureter.
                          • Vesicoureteric Reflux.
                          • Diagnosis.
                          • Treatment.
                          • Bladder
                          • Ectopia Vesica (Exstrophy of the Bladder).
                          • Complications.
                          • Treatment.
                          • Urachal Abnormalities.
                          • Urethra
                          • Calculous Disease
                          • Aetiology
                          • Types of Calculi
                          • Calcium Oxalate (75%).
                          • Phosphate (15%).
                          • Urate (5%).
                          • Cystine (2%).
                          • Xanthine and Pyruvate Stones.
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment
                          • Acute Episode
                          • Stone Removal.
                          • Prevention of Recurrence.
                          • Bladder Calculi
                          • Treatment.
                          • Prevention of Recurrence.
                          • Obstructive Uropathy
                          • Symptoms and Signs.
                          • Investigations.
                          • Imaging
                          • Treatment.
                          • Complications.
                          • Urinary Tract Infections (UTI)
                          • Symptoms and Signs
                          • Acute Pyelonephritis.
                          • Cystitis.
                          • Investigations
                          • Treatment.
                          • Sterile Pyuria
                          • Urinary Tract Tuberculosis
                          • Urethral Strictures
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Urinary Retention
                          • Acute Urinary Retention
                          • Symptoms and Signs.
                          • Treatment.
                          • Chronic Retention
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Tumours of the Renal Tract
                          • Kidney
                          • Renal Cell Carcinoma (Adenocarcinoma)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Renal Pelvis and Ureter
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Bladder
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Prognosis.
                          • Prostate
                          • Benign Prostatic Hyperplasia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prostatic Carcinoma
                          • Symptoms and Signs.
                          • Investigations
                          • Gleason Grade and Scoring.
                          • Treatment.
                          • Prognosis.
                          • Prostatitis
                          • Symptoms and Signs
                          • Acute Bacterial Prostatitis.
                          • Chronic Prostatitis.
                          • Investigations.
                          • Treatment.
                          • Testes and Epididymis
                          • Imperfectly Descended Testes
                          • Symptoms and Signs.
                          • Treatment.
                          • Complications of Imperfect Descent.
                          • Hydrocele
                          • Vaginal Hydrocele.
                          • Congenital Hydrocele.
                          • Infantile Hydrocele.
                          • Hydrocele of the Cord.
                          • Symptoms and Signs.
                          • Treatment.
                          • Epididymal Cyst
                          • Symptoms and Signs.
                          • Treatment.
                          • Varicocele
                          • Symptoms and Signs.
                          • Treatment.
                          • Infections of the Testis and Epididymis
                          • Symptoms and Signs.
                          • Treatment
                          • Acute.
                          • Chronic.
                          • Testicular Torsion
                          • Symptoms and Signs.
                          • Treatment.
                          • Testicular Trauma
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Testicular Tumours
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Penis
                          • Conditions of the Foreskin
                          • Balanoposthitis.
                          • Phimosis.
                          • Treatment.
                          • Paraphimosis.
                          • Treatment.
                          • Balanitis Xerotica Obliterans (BXO).
                          • Circumcision.
                          • Carcinoma of the Penis
                          • Symptoms and Signs.
                          • Treatment.
                          • Peyronie's Disease
                          • Priapism
                          • Treatment
                          • 17 Orthopaedics
                          • Chapter Outline
                          • Fractures
                          • Causation
                          • Trauma.
                          • Stress Fractures.
                          • Pathological Fractures.
                          • Pattern (Fig. 17.1)
                          • Transverse Fracture.
                          • Spiral or Oblique Fracture.
                          • Segmental Fracture.
                          • Crush Fracture.
                          • Burst Fracture.
                          • Avulsion Fracture.
                          • Fracture-Dislocation.
                          • Greenstick Fracture.
                          • Comminuted Fracture.
                          • Relation to Surrounding Structures
                          • Closed Fracture.
                          • Open Fracture.
                          • Intra-Articular Fracture.
                          • Extra-Articular Fracture.
                          • Complex Fracture.
                          • Assessment of Fractures
                          • Symptoms and Signs.
                          • Investigations.
                          • Principles of Fracture Treatment
                          • First Aid
                          • Treatment of Shock
                          • Definitive Fracture Management
                          • Reduction.
                          • How Should It Be Done?
                          • Closed Reduction.
                          • Open Reduction.
                          • How is Reduction Held?
                          • Types of Stability
                          • Absolute Stability.
                          • Relative Stability.
                          • Methods of Stabilizing a Fracture
                          • External
                          • Plaster of Paris or Synthetic Material Casts.
                          • Traction.
                          • Internal Fixation
                          • Wires.
                          • Screws.
                          • Plating.
                          • Intramedullary Nail.
                          • External Fixation Devices.
                          • Indications for Internal Fixation
                          • Open Fractures.
                          • Rehabilitation.
                          • Complications of Fractures
                          • Immediate (at Time of Fracture)
                          • Early (during the Period of Initial Treatment)
                          • Local
                          • General
                          • Venous Thromboembolism (VTE) (for DVT and PE Ch. 5).
                          • Compartment Syndrome.
                          • Acute Urinary Retention.
                          • Pneumonia
                          • Fat Embolism.
                          • Crush Syndrome.
                          • Late (after the Period of Initial Treatment)
                          • Delayed Union.
                          • Nonunion.
                          • Malunion.
                          • Complex Regional Pain Syndrome (Causalgia, Reflex Sympathetic Osteodystrophy, Sudeck's Atrophy).
                          • Avascular Necrosis of Bone.
                          • Myositis Ossificans.
                          • Osteoarthritis (OA).
                          • Post-Traumatic Stress Disorder.
                          • Spinal Trauma
                          • Management of Spinal Injuries
                          • Whiplash Associated Disorder
                          • Treatment.
                          • Fractures and Dislocations of the Spine
                          • Classification by Mechanism of Injury
                          • Cervical Spine Fractures and Dislocations
                          • Symptoms and Signs.
                          • Investigations
                          • Radiographs
                          • Treatment
                          • Fractures of the Atlas.
                          • C1-C2 Subluxation.
                          • Odontoid Peg Fracture.
                          • Burst Fractures.
                          • Anterior Wedge Fractures.
                          • Facet Joint Dislocations.
                          • Isolated Spinous Process Avulsion.
                          • Thoracic Spine
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Lumbar Spine
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Fractures of the Transverse Processes
                          • Fractures of Sacrum and Coccyx
                          • Coccydynia
                          • Spinal Cord Injury
                          • Types of Spinal Cord Injury
                          • Anterior Cord Syndrome.
                          • Central Cord Syndrome - Common in Elderly.
                          • Brown-Séquard Syndrome - Rare.
                          • Mixed Syndromes.
                          • Management and Complications of Cord Injury
                          • Respiratory.
                          • Cardiovascular.
                          • Urinary Tract.
                          • Gastrointestinal.
                          • Hypothermia.
                          • Thromboembolism.
                          • Pressure Sores.
                          • Long-Term Management of Spinal Trauma
                          • Nursing Care
                          • Physiotherapy
                          • Occupational Therapy
                          • Social Services
                          • Others
                          • Prognosis
                          • Pelvic Fractures
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Shock - Balanced Fluid Resuscitation.
                          • The Fracture Itself.
                          • Urethral Trauma.
                          • Complications.
                          • Injuries to the Lower Limb
                          • Hip and Thigh
                          • Traumatic Dislocation of the Hip
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications.
                          • Fractures of the Proximal Femur
                          • Symptoms and Signs.
                          • Investigations
                          • Complications.
                          • Treatment
                          • General.
                          • Fracture.
                          • Fractures of the Femoral Shaft
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Conservative.
                          • Surgical
                          • Complications.
                          • Fractures and Dislocations around the Knee
                          • Supracondylar Fractures ( Fig. 17.6)
                          • Isolated Femoral Condylar Fractures
                          • Tibial Plateau Fractures
                          • Dislocation of the Knee
                          • Injuries to the Extensor Mechanism
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Fractures and Dislocations of the Patella
                          • Fractures
                          • Treatment.
                          • Dislocation of the Patella
                          • Acute or Traumatic.
                          • Recurrent.
                          • Fractures of the Tibial Shaft
                          • Treatment.
                          • Stable Fractures.
                          • Unstable Fractures.
                          • Open Wounds.
                          • Complications.
                          • Isolated Fractures of the Fibula
                          • Fractures around the Ankle
                          • Classification (Fig. 17.7)
                          • Axial Compression Fractures (Plafond Fracture).
                          • Investigations
                          • Treatment.
                          • Maisonneuve Fracture ( Fig. 17.8).
                          • Fractures and Dislocations in the Foot
                          • Talus Fracture
                          • Calcaneal Fracture
                          • Metatarsal Fractures
                          • Shaft Fractures
                          • Stress Fracture ('March' Fracture)
                          • Lisfranc Fracture
                          • Fractures of the Toes
                          • Injuries to the Upper Limb
                          • Fractures and Dislocations Around the Shoulder
                          • Clavicular Fracture
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Complications.
                          • Dislocation of the Sternoclavicular Joint
                          • Acromioclavicular Joint
                          • Subluxation.
                          • Dislocation.
                          • Scapular Fracture
                          • Dislocation of the Shoulder
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Kocher's Method.
                          • Hippocratic Method.
                          • Complications.
                          • Recurrent Dislocation
                          • Treatment.
                          • Fractures of the Humerus
                          • Proximal Humerus (Fig. 17.10)
                          • Treatment.
                          • Complications.
                          • Shaft of the Humerus
                          • Treatment.
                          • Complications.
                          • Fractures and Dislocations around the Elbow
                          • Supracondylar Fracture
                          • Treatment.
                          • Complications.
                          • Lateral Condyle/Epicondyle
                          • Medial Condyle/Epicondyle
                          • Dislocation of the Elbow
                          • Treatment.
                          • Fractures of the Radius and Ulna
                          • Fracture of the Radial Head
                          • Fracture of the Olecranon
                          • Fractures of the Radial and Ulnar Shafts
                          • Treatment
                          • Children.
                          • Adults.
                          • Fractures of the Distal Radius
                          • Colles' Fracture (Fig. 17.11).
                          • Distal Radial Fracture.
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Complications.
                          • Smith's Fracture.
                          • Barton's Fracture.
                          • Fractures and Dislocations of the Carpal Bones
                          • Fracture of the Scaphoid
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications.
                          • Dislocation of the Carpus
                          • Fractures and Dislocations of the Metacarpals and Phalanges
                          • Fractures at the Base of the Thumb
                          • Fractures of the Metacarpal Bones
                          • Treatment.
                          • Fractures and Dislocations of the Phalanges
                          • Treatment.
                          • Fractures of the Terminal Phalanges
                          • Mallet Finger
                          • Conditions of Joints
                          • Arthritis
                          • Osteoarthritis (Osteoarthrosis, OA)
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Conservative.
                          • Surgical.
                          • Rheumatoid Arthritis (RA)
                          • Other Conditions of Joints
                          • Loose Bodies
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Osteochondritis Dissecans
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Neuropathic Joints (Charcot's Joints)
                          • Haemophilia and Related Disorders
                          • Symptoms and Signs.
                          • Treatment.
                          • Arthroplasty
                          • Design of Joint Replacements
                          • Practice of Joint Replacement
                          • Indications.
                          • Preoperative Preparation (Good Practice).
                          • Intraoperative Preparation (Enhanced Recovery).
                          • Complications
                          • Early.
                          • Intermediate.
                          • Late.
                          • Conditions of Menisci, Ligaments, Tendons, Capsules and Bursae
                          • Knee
                          • Meniscal Tears
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Ligamentous Damage
                          • Collateral Ligaments
                          • Medial.
                          • Lateral.
                          • Cruciate Ligament Tears
                          • Anterior.
                          • Posterior.
                          • Treatment of Ligamentous Injuries.
                          • Bursae around the Knee
                          • Housemaid's Knee (Prepatellar Bursitis).
                          • Clergyman's Knee (Infrapatellar Bursitis).
                          • Semimembranosus Bursa.
                          • Baker's Cyst.
                          • Ankle
                          • Sprained Ankle
                          • Rupture of the Achilles Tendon
                          • Plantar Fasciitis
                          • Shoulder
                          • Impingement Syndrome
                          • Investigations
                          • Treatment.
                          • Frozen Shoulder
                          • Treatment.
                          • Rotator Cuff Tears
                          • Rupture of the Long Head of Biceps
                          • Elbow
                          • Tennis Elbow (Lateral Epicondylitis)
                          • Golfer's Elbow (Medial Epicondylitis)
                          • Student's Elbow (Olecranon Bursitis)
                          • Wrist
                          • Tenosynovitis
                          • Hand
                          • Ganglion
                          • Trigger Finger
                          • Dupuytren's Contracture
                          • Symptoms and Signs.
                          • Treatment.
                          • Miscellaneous Conditions of the Limbs
                          • Upper Limb
                          • Ulnar Neuritis
                          • Carpal Tunnel Syndrome
                          • Symptoms and Signs.
                          • Investigations.
                          • Differential Diagnosis.
                          • Treatment.
                          • Lower Limb
                          • Metatarsalgia
                          • Hallux Valgus
                          • Treatment.
                          • Hallux Rigidus
                          • Hammer Toes
                          • Mallet Toe
                          • Infection of Bones and Joints
                          • Acute Infection of Bones and Joints
                          • Acute Osteomyelitis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Acute Pyogenic Arthritis
                          • Symptoms and Signs.
                          • Investigations
                          • Differential Diagnosis.
                          • Treatment.
                          • Chronic Infections of Bones and Joints
                          • Chronic Osteomyelitis
                          • Secondary to Acute Osteomyelitis.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications.
                          • Chronic Osteomyelitis Due to Specific Chronic Infections.
                          • Tuberculosis of Bones and Joints.
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Bone Tumours
                          • Investigations.
                          • Biopsy.
                          • Treatment.
                          • Benign Tumours
                          • Osteoma ('Ivory' Osteoma)
                          • Osteoid Osteoma
                          • Chondroma
                          • Fibroma and Fibrous Dysplasia
                          • Bone Cysts
                          • Malignant Tumours
                          • Primary
                          • Osteosarcoma (Osteogenic Sarcoma).
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Prognosis.
                          • Osteoclastoma (Giant Cell Tumour).
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Ewing's Tumour (Primitive Peripheral Neuroectodermal Tumour).
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Chondrosarcoma.
                          • Fibrosarcoma.
                          • Myeloma (Plasma Cell Dyscrasia).
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Secondary
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Backache
                          • Osteoarthritis of the Spine
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Prolapsed Intervertebral Disc
                          • Symptoms and Signs
                          • Back Pain.
                          • Nerve Root Compression.
                          • Cauda Equina Syndrome.
                          • Investigations
                          • Treatment of Disc Prolapse.
                          • Conservative.
                          • Surgical.
                          • Spondylolisthesis
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Scheuermann's Disease (Adolescent Kyphosis)
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Ankylosing Spondylitis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications.
                          • Cervical Spondylosis
                          • Symptoms and Signs.
                          • Investigations
                          • Differential Diagnosis.
                          • Treatment.
                          • Cervical Disc Prolapse
                          • Symptoms and Signs
                          • Lateral Cervical Protrusion.
                          • Midline Protrusion.
                          • Investigations
                          • Treatment.
                          • Metabolic Bone Disease
                          • Osteomalacia and Rickets
                          • Osteoporosis
                          • Hyperparathyroidism ( Ch. 11)
                          • Paget's Disease of Bone
                          • Paediatric Orthopaedics
                          • Scoliosis
                          • Adolescent Idiopathic Scoliosis
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Conditions of the Hip
                          • Developmental Dysplasia of the Hip (DDH)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Irritable Hip
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Differential Diagnosis.
                          • Perthes' Disease
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Slipped Upper Femoral Epiphysis
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Complications.
                          • Club Foot (Talipes Equinovarus)
                          • Symptoms and Signs.
                          • Treatment.
                          • Prognosis.
                          • Osteochondritides
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Osteochondritis of the Tibial Tubercle (Osgood-Schlatter Disease)
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • 18 Neurosurgery
                          • Chapter Outline
                          • Head Injury
                          • Assessment
                          • Criteria for Urgent CT Scan and Consultation with a Neurosurgical Unit
                          • Criteria for Hospital Admission after Recent Head Injury
                          • Criteria for Involving the Neurosurgical Department
                          • Types of Brain Injury
                          • Primary
                          • Secondary
                          • Assessment of Head Injury
                          • Emergency
                          • Evaluate CNS Injury
                          • Pulse, Respiration and Blood Pressure.
                          • Check for CSF Rhinorrhoea or Otorrhoea
                          • Scalp Lacerations or Depressed Fractures
                          • Assess Amnesia
                          • CT and MRI Brain Scanning
                          • Assessing a CT Scan of the Head
                          • Soft Tissue Window
                          • Bone Window
                          • Assessing an MRI Scan
                          • Incidental Findings on MRI Cranial Imaging
                          • Skull Fractures
                          • Linear, Stellate or Comminuted Nondepressed.
                          • Depressed Fracture ( Fig. 18.1C).
                          • Compound Fracture.
                          • Compound Comminuted Fractures with Damage to the Underlying Brain.
                          • Fractures of the Base of the Skull.
                          • Summary
                          • Management of CSF Leakage.
                          • Intracranial Bleeding
                          • Extradural
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Subdural
                          • Acute.
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Chronic.
                          • Investigations.
                          • Treatment.
                          • Intracerebral
                          • Cerebral Hypoxia
                          • Management of Head Injuries
                          • Minor
                          • Observations during Admission.
                          • Major
                          • Other Complications of Head Injury
                          • Epilepsy.
                          • Postconcussion Syndrome.
                          • Brainstem Death.
                          • Management of Raised Intracranial Pressure (ICP)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Intracranial Tumours
                          • Symptoms and Signs.
                          • Investigation.
                          • Parenchymal/Intrinsic Tumours
                          • Extra-Axial/Extrinsic Tumours
                          • Major Categories of Extra-Axial/Extrinsic Tumours
                          • Management.
                          • Acoustic Neuroma (Vestibular Schwannoma)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Pituitary Tumours
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Craniopharyngioma
                          • Spinal Tumours
                          • Symptoms and Signs.
                          • Differential Diagnosis.
                          • Investigations
                          • Treatment
                          • Primary Tumours.
                          • Metastatic Lesions.
                          • Intracranial Vascular Lesions
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Hydrocephalus
                          • Symptoms and Signs
                          • Congenital.
                          • Acquired.
                          • In the Elderly.
                          • Investigations
                          • Treatment.
                          • CNS Bacterial Infections
                          • Clinical Syndrome Presentation.
                          • Investigations.
                          • Management.
                          • Postoperative Complications in Neurosurgery
                          • Complications Following Cranial Surgery
                          • Neurosurgical Procedures for Pain Relief
                          • Brainstem Death
                          • Clinical Testing
                          • Neurosurgical Procedures
                          • 19 Plastic Surgery and Skin
                          • Chapter Outline
                          • The Reconstructive Ladder (Fig. 19.1)
                          • Providing Skin Cover
                          • Direct Closure
                          • Healing by Secondary Intention
                          • Skin Graft
                          • Split-Skin Graft (Fig. 19.2)
                          • Full Thickness Graft ( Fig. 19.2)
                          • Flaps
                          • Free Flaps
                          • Tissue Expansion
                          • Burns
                          • Classification of Depth ( Fig. 19.2)
                          • Superficial
                          • Superficial Partial Thickness
                          • Deep Dermal
                          • Full Thickness
                          • Management of Burns
                          • First Aid
                          • Assessment and Immediate Management of the Patient with Significant Burns
                          • Early Management of Burns
                          • The Systemic Effects of Major Burns
                          • Multidisciplinary Care and Follow-up
                          • Hand Injuries
                          • Principles of Management of Hand Trauma
                          • First Aid
                          • At Hospital
                          • History
                          • Examination (Compare with Contralateral Hand)
                          • Investigations
                          • Prophylaxis Against Infection.
                          • Surgery
                          • Approach to the Hand Wound.
                          • Tendon Injury.
                          • Nerve Injury.
                          • Vessel Injury.
                          • Bone Injury.
                          • Secondary Reconstructive Surgery.
                          • Reimplantation of Severed Part.
                          • Rehabilitation.
                          • Hand Infections
                          • Paronychia (Whitlow)
                          • Pulp Space Infection (Felon)
                          • Suppurative Tenosynovitis
                          • Symptoms and Signs.
                          • Treatment.
                          • Deep Palmar Space Infection
                          • Symptoms and Signs.
                          • Treatment.
                          • Bites
                          • Symptoms and Signs.
                          • Treatment.
                          • Cosmetic (Aesthetic) Surgery
                          • Reconstructive Breast Surgery
                          • Reconstruction Following Mastectomy
                          • Augmentation Mammaplasty
                          • Indications.
                          • Treatment.
                          • Complications.
                          • Reduction Mammaplasty
                          • Indications.
                          • Treatment.
                          • Complications.
                          • Gynaecomastia
                          • Other Types of Surgery
                          • Rhinoplasty
                          • Prominent Ears
                          • Blepharoplasty
                          • Face Lift
                          • Abdominoplasty
                          • Liposuction
                          • Filler Injections
                          • Cleft Lip and Palate
                          • Symptoms and Signs.
                          • Treatment.
                          • Prognosis.
                          • Skin and Soft Tissue
                          • Epidermis - Benign
                          • Skin Tags (Pedunculated Papillomas)
                          • Warts (Verrucae Vulgaris)
                          • Seborrhoeic Keratoses
                          • Keratoacanthoma
                          • Epidermis - Premalignant
                          • Actinic (Solar) Keratoses
                          • Bowen's Disease
                          • Leukoplakia
                          • Epidermis - Malignant
                          • Basal Cell Carcinoma (Rodent Ulcer)
                          • Squamous Cell Carcinoma
                          • Melanocytic Lesions - Benign and Premalignant
                          • Freckle (Ephelis)
                          • Solar Lentigo
                          • Naevi (Fig. 19.9)
                          • Spitz Naevus.
                          • Halo Naevus.
                          • Blue Naevus.
                          • Common.
                          • Cellular.
                          • Congenital Naevi.
                          • Lentigo Maligna.
                          • Malignant Melanoma
                          • Classification
                          • Superficial Spreading Melanoma.
                          • Nodular Melanoma.
                          • Lentigo Maligna Melanoma.
                          • Acral Lentiginous Melanoma.
                          • Staging.
                          • Treatment
                          • Prognosis.
                          • Dermis - Benign
                          • Pyogenic Granuloma
                          • Fibrous Histiocytoma
                          • Keloid
                          • Dermis - Malignant
                          • Kaposi's Sarcoma
                          • Metastatic Carcinoma
                          • Others
                          • Skin Appendages - Benign
                          • Boil (Furuncle)
                          • Carbuncle
                          • Hidradenitis Suppurativa
                          • Sebaceous Cysts
                          • Dermoid Cysts
                          • Congenital.
                          • Acquired.
                          • Pilonidal Sinus
                          • Skin Appendages - Malignant
                          • Subcutaneous Tissue - Benign
                          • Lipoma
                          • Neurofibroma
                          • Subcutaneous Tissues - Malignant
                          • Disorders of the Nails
                          • Ingrowing Toenail (IGTN)
                          • Treatment
                          • Noninfected.
                          • Infected.
                          • Complications.
                          • Onychogryphosis
                          • Nail Bed Lesions
                          • Haematoma.
                          • Melanoma.
                          • Subungual Exostosis.
                          • Glomus Tumour.
                          • Lesions of Vascular Origin
                          • Campbell de Morgan Spots
                          • Benign Vascular Tumours
                          • Haemangiomas (Strawberry Naevi).
                          • Glomus Tumour.
                          • Malignant Vascular Tumours
                          • Vascular Malformations
                          • Capillary Malformations (Port-Wine Stains).
                          • Venous Malformations, Arteriovenous Malformations (AVM).
                          • Lymphatic Malformations.
                          • 20 Paediatric Surgery
                          • Chapter Outline
                          • Alimentary Tract Emergencies in the Newborn
                          • Oesophageal Atresia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Duodenal Atresia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Small Bowel Atresia
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Malrotation and Volvulus
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Meconium Ileus
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications.
                          • Anorectal Abnormalities
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Necrotizing Enterocolitis (NEC)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Diaphragmatic Hernia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Hirschsprung's Disease
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Abdominal Wall Defects
                          • Gastroschisis
                          • Treatment.
                          • Exomphalos
                          • Treatment.
                          • Rare Abdominal Wall Defects
                          • Alimentary Tract Problems in Older Infants and Children
                          • Congenital Hypertrophic Pyloric Stenosis
                          • Symptoms and Signs.
                          • Diagnosis.
                          • Treatment.
                          • Complications.
                          • Intussusception
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Obstructed Inguinal Hernia
                          • Symptoms and Signs.
                          • Treatment.
                          • Acute Appendicitis
                          • Mesenteric Adenitis
                          • Constipation
                          • Urinary Tract Infections (UTIs)
                          • Lower Lobar Pneumonia
                          • Testicular Torsion ( Ch. 16)
                          • Crohn's Disease
                          • Gynaecological Problems
                          • Chronic and Recurrent Abdominal Pain
                          • Infants with Jaundice
                          • Biliary Atresia
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Prognosis.
                          • Choledochal Cyst
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Abdominal Masses in Childhood
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Abdominal Malignancies in Childhood
                          • Abdominal Neuroblastoma
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Nephroblastoma (Wilms' Tumour)
                          • Signs and Symptoms.
                          • Investigations
                          • Treatment.
                          • Rectal Bleeding in Children
                          • Fissure-in-Ano
                          • Polyps
                          • Rectal Prolapse
                          • Symptoms and Signs.
                          • Treatment.
                          • Meckel's Diverticulum
                          • Intussusception.
                          • Neck Lumps in Children
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • 21 Organ and Tissue Transplantation
                          • Chapter Outline
                          • Classification
                          • Autograft.
                          • Isografts.
                          • Allografts.
                          • Xenografts.
                          • Organ and Tissue Donors
                          • Deceased Donors
                          • Donation after Brain Death (DBD)
                          • General Criteria ( Table 21.1).
                          • Obtaining Permission for Deceased Organ Donation.
                          • Donation after Circulatory Death (DCD)
                          • Brainstem Death
                          • Living Donors
                          • Directed
                          • Genetically and Emotionally Related.
                          • Paired Donation.
                          • Nondirected
                          • Domino.
                          • Altruistic.
                          • Independent Assessors
                          • Work-Up for a Living Donor
                          • Living Donor Nephrectomy
                          • Complications of Living Donor Nephrectomy.
                          • Tissue Typing and Crossmatch
                          • ABO Compatibility.
                          • Histocompatibility Matching.
                          • Cytotoxic Crossmatch.
                          • ABO-Incompatible and Positive Crossmatch Living Donor Kidney Transplantation
                          • Organ Preservation
                          • Warm Ischaemic Time.
                          • Cold Ischaemic Time.
                          • Siting of the Transplant
                          • Orthotopic.
                          • Heterotopic.
                          • Rejection
                          • Hyperacute
                          • Accelerated Acute Rejection
                          • Acute Rejection
                          • Cell-Mediated.
                          • Antibody-Mediated.
                          • Chronic Allograft Injury
                          • Immunosuppression
                          • Corticosteroids
                          • Antiproliferative Drugs
                          • Calcineurin Inhibitors
                          • mTOR Inhibitors
                          • Polyclonal Antibodies
                          • Monoclonal Antibodies
                          • Specific Organs
                          • Kidney Transplant
                          • Recipient.
                          • Donor.
                          • Operation.
                          • Diagnosis of Rejection
                          • Complications
                          • Early
                          • Late
                          • Results
                          • Liver Transplant
                          • Recipient.
                          • Donor.
                          • Operation.
                          • Diagnosis of Rejection.
                          • Complications
                          • Early
                          • Late
                          • Results
                          • Heart and Heart/Lung Transplant
                          • Recipient.
                          • Donor.
                          • Operation
                          • Heart.
                          • Lung.
                          • Diagnosis of Rejection
                          • Heart.
                          • Lung.
                          • Complications
                          • Heart.
                          • Lung.
                          • Results
                          • Heart, Heart/Lung
                          • Lung
                          • Pancreatic Transplantation
                          • Recipient.
                          • Donor.
                          • Operation.
                          • Diagnosis of Rejection.
                          • Complications.
                          • Results.
                          • Small Bowel Transplantation
                          • General Complications
                          • Infection
                          • Management of Infection.
                          • Malignancy
                          • Long-term Follow-up of Transplant Patients.
                          • 22 Gynaecology and Obstetrics
                          • Chapter Outline
                          • Ectopic Pregnancy
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Ovary
                          • Ovarian Cyst
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Ovarian Cancer
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Pelvic Inflammatory Disease (PID)
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Ambulant Patients with Mild Symptoms.
                          • Patient Systemically Unwell.
                          • Dysmenorrhoea
                          • Endometriosis
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment.
                          • Complications.
                          • Uterine Fibroids
                          • Symptoms and Signs.
                          • Investigations
                          • Treatment
                          • Surgery.
                          • Mittelschmerz
                          • Symptoms and Signs.
                          • Investigations.
                          • Treatment.
                          • Abdominal Trauma in Pregnancy
                          • Index
                          • A
                          • B
                          • C
                          • D
                          • E
                          • F
                          • G
                          • H
                          • I
                          • J
                          • K
                          • L
                          • M
                          • N
                          • O
                          • P
                          • Q
                          • R
                          • S
                          • T
                          • U
                          • V
                          • W
                          • X
                          • Z

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