Atlas of Complicated Abdominal Emergencies Tips on Laparoscopic and Open Surgery, Therapeutic Endoscopy and Interventional Radiology Radiotherapy

Contents
Acknowledgements
Foreword
Preface
Chapter 1 Role of the Accident & Emergency Department
	Recognition of the Sick Patient
	Approach to Non-traumatic Abdominal Pain
	Approach to Traumatic Abdominal Pain
	Ancillary Investigations in the ED
	Indications for Referral
	References
Chapter 2 Perioperative Management of Patients with Complicated Abdominal Emergencies
	Shock and Organ Perfusion
	Outcomes of Resuscitation
	How to Optimise a Patient Preoperatively
	Investigations
	Fluid and Electrolyte Replacement
	Haematological Therapy
	Coagulopathy
	Antibiotics
	Emergency Laparoscopic Surgery
	Risk Factors for Surgery
	Postoperative Care
		Intensive Care/High Dependency
		Sepsis Syndromes
		Acute respiratory distress syndrome(ARDS)
		Blood transfusion and blood component therapy
		Postoperative Oliguria
		Renal Replacement Therapy (RRT)
		Abdominal compartment syndrome (ACS)
		Nutrition
		Pros and cons of TPN
Chapter 3 Non-Variceal Upper Gastrointestinal Haemorrhage and Endoscopic Management
	Introduction
	Management of Non-Variceal UpperGastrointestinal Bleeding
		Initial Management
			Risk stratifying upper gastrointestinalbleeding
			Rockall score
			Glasgow–Blatchford score
		Medical Therapy
		Endoscopic Therapy
			Timing of endoscopy
			Epinephrine injection
			Thermal therapy
			Argon plasma coagulation
			Endoscopic clipping
			Failure of endoscopic therapy
	References
Chapter 4 Upper Gastrointestinal Variceal Haemorrhage and Endoscopic Management
	Introduction
	Grading and Nomenclatureof Varices
	Management of Variceal Bleeding
		Medical Management and Resuscitation
			Endoscopic Management
				Variceal band ligation
				Cyanoacrylate glue
				Endoscopic sclerotherapy
				Subsequent endoscopy
				Insertion of the Sengstaken–Blakemoretube
				Portosystemic shunts: TIPS and surgery
	References
Chapter 5 Interventional Radiology in the Management of Gastrointestinal Haemorrhage
	Introduction
	Management Options
		Catheter Angiography
		CT Angiography
		Embolic Agents
		Difficulties
		Contraindications to Angiography/CT/Embolisation
		Complications of Angiography
		Indirect Bleeding
	References
Chapter 6 Bleeding Peptic Ulcer — Surgical Management
	I. Indications
		Operative Strategy for Bleeding PepticUlcer
	II. Preoperative Preparation
	III. Operative Procedures forBleeding Peptic Ulcer
		A. Laparotomy and Identifi cation of Siteof Haemorrhage
		B. Over-Sewing a Bleeding Ulcer
		C. Techniques for Problematical Duodenal Ulcer Bleeding
		D. Key Points in Vagotomy-Drainage for Bleeding Duodenal Ulcer
			Pyloroplasty/gastroenterostomy
			Truncal vagotomy
		E. Key Points in Billroth II Gastrectomy/ Vagotomy Antrectomy for Bleeding Duodenal Ulcer
			Ensure safe duodenal stump closure
			Dealing with problems related to the posterior duodenal ulcer penetratinginto the pancreas
			Mobilisation of distal stomach
			Billroth II gastroenteral anastomosis
	Surgical Techniques for BleedingGastric Ulcer
		F. Local Excision of Gastric Ulcer
			Key Points in Billroth I Gastrectomyfor Bleeding Gastric Ulcer
			Incisional wound closure
			Postoperative care
	References
Chapter 7 Surgical Management of Upper Gastrointestinal Perforations
	Indications
	Preoperative Preparation
	Operative Treatment
		A. Benign Duodenal Ulcer Perforation
		B. Benign Gastric Ulcer Perforations
		C. Surgery for Malignant Gastric UlcerPerforation
	References
Chapter 8 Management of Complications Following Bariatric Surgery
	Introduction
	General Complications
		Thromboembolism
		Atelectasis
		Nausea and Vomiting
		Wound Complications
	Acute Abdominal Complications
	1. Bleeding
	2. Leaks
		Treatment options for GJ leak
		Managing sleeve leak
	3. Stenosis and Stricture
	4. Gastric Band Slippage and IntestinalObstruction
	5. Other Complications
		Gastric banding
		Gastric bypass
		Nutritional problems
Chapter 9 Surgery for Appendicitis
	1. Indications
		Operative Strategy of Acute Appendicitis
	2. Preoperative Preparation
	3. Surgery
		Open Appendectomy
		Laparoscopic Appendectomy
	4. Postoperative care
		Special Situations
Chapter 10 Emergency Surgery for Perforative Sigmoid Colonic Diverticulitis
	Introduction
	Management of Acute Sigmoid Colonic Diverticulitis
		A. Preoperative Management
		B. Indications for Surgery
		C. Options of Surgical Procedure
			Two-stage approach
			Single-stage approach
			Role of laparoscopic surgery in acute 
perforative sigmoid colonic diverticulitis
		D. Important Considerations in theTechniques for Appropriate Resection
		E. Position of Patient for Surgery
		F. Perioperative Precautionsand Preparation
	Intra-Operative Surgical Techniques
		A. Incision and Laparotomy
		B. Mobilisation of the Sigmoidand Descending Colon
		C. Identification of the Left Ureter
			Tips and tricks to help locate the ‘difficult’ left ureter
			Common sites of left ureteric injury during anterior resection
		D. Splenic Flexure Take Down
			Tips and tricks to tackle difficultsplenic flexure
		E. Vascular Control
			Ligation of the inferior mesenteric artery (IMA)
			How to identify the IMA?
			Ligation of the inferior mesenteric vein (IMV)
		F. Determination of the Proximal Transection Margin
			How to ensure adequate proximal bowel length for tension-free anastomosis
		G. Determination of the Distal Transection Margin
			How to ensure that all the sigmoid colon is resected?
		H. Preparation for ColorectalAnastomosis
			On-table colonic lavage
		I. Construction of the ColorectalAnastomosis
			How to ensure an optimal and safe colorectal anastomosis?
			When is it not safe to anastomose?
		J. Completion of Surgery
		K. Postoperation Care
		References
Chapter 11 Surgical Management of Obstructive Colorectal Malignancy
	Introduction
	I. Preoperative Management
	II. Management Options
	III. Endoscopic Colonic Stenting
		Indications
	IV. Defunctioning Stoma
		Indications
		Postoperative Considerations
	V. Resectional Surgery With or Without Primary Anastomosis
	VI. Clinical Consideration after Surgery
	References
Chapter 12 Surgical Management of Acute Cholecystitis
	Definition
	Risk Factors for DifficultLaparoscopic Cholecystectomyin Acute Cholecystitis
		Preoperative preparation
		Surgical Treatment
			Laparoscopic approach
	References
Chapter 13 ERCP in the Management of Cholangitis and Bile Duct Injuries
	Pre- ERCP Preparation
	ERCP for Choledocholithiasis
	ERCP in Malignancy Involving theBiliary Tract
	ERCP in Bile Duct Injuries
	Difficult Biliary Cannulation
	Post- ERCP Care
	References
Chapter 14 Surgical Management of Bile Duct & Pancreatic Emergencies
	A) Acute Cholangitis
	B) Acute Pancreatitis withor without Necrosis
	C) Bile Duct Injuries During Surgery
	D) Pancreatic Trauma
	E) ERCP Perforation
Chapter 15 Laparoscopic Drainage of Liver Abscess
	I. Introduction
	II. Management Strategy for LiverAbscesses
	III. Operative Procedure Via Laparoscopic Approach
	IV. Postoperative Management
	Special situations
	Final Note
Chapter 16 Interventional Radiology in the Management of Intra-Abdominal Abscess
	Introduction
	Advantages of Radiological Drainage
	Disadvantages of Radiological Drainage
	Radiological Evaluation of the Abscess
		1) Diagnosis of Abscess
		2) Identify a Potential Cause for an Abscess
		3) Determine Drainability of an Abscess
		4) Identifying the Complications from an Abscess
		5) Aid Drainage Planning
	Patient Preparation for Radiological Drainage
	Role of RadiologicalIntervention
		Contraindications
	Technique
		Imaging Guidance
		Insertion of the Drain
		Drainage Catheter
	Tips on Drain Insertion and Maintenance
	Site Specific Comments on Radiological Drainage of Intra-Abdominal Abscess
		Liver Abscess
		Subphrenic and Lesser Sac Abscess
		Percutaneous Cholecystostomy
		Pancreatic Collection/Abscess
		Pelvic Abscess
		Enteric Abscess
		Others
	Conclusion
	References
Chapter 17 Management of Gynaecological Emergencies
	I. Ectopic Pregnancy
		Operative procedures
	II. Ruptured Tubo-Ovarian Abscess
		Preoperative
		Operative procedures
		Postoperative
	III. Haemorrhage or LeakingOvarian Cyst and Adnexal Torsion
		A. Adnexal torsion
			Preoperative — Benign Ovarian Cyst
			Laparoscopic intervention
		2. Laparoscopic ovarian oophorectomy
		3. Open Cystectomy
Chapter 18 Ureteric Injuries
	Introduction
	Review of Anatomy and Exposure of the Ureter
	Repair of Bladder Injuries
	Basic Direct Anastomotic Repair of the Ureter
	Ureteroneocystostomy (Ureteric Reimplantation) and Psoas Hitch
	Boari Flap
	Other Manoeuvres
	Post-Operative Care
	Conclusion
Chapter 19 Ruptured and Leaking Abdominal Aortic Aneurysms
	I. General Principles of Management of Ruptured/Leaking AAAs Include:
	II. Perioperative Care
	III. Open Repair: Surgical Techniqueand Principles
	IV. Mycotic Aneurysms
	V. Endovascular Stenting ofRuptured/Leaking AAAs
	VI. Post-Surgery Follow-up
Chapter 20 Management of Severe Blunt Abdominal Injury
	I. Introduction and Indications
	II. Preoperative Management
	III. OT Preparation
	IV. Operative Procedure
		Damage Control Mode
		Splenic Injuries
		Bowel Injuries
		Kidney Injuries
		Pancreatic Injuries
		Liver Injuries
	VI. Postoperative Care
	V. Wound Closure
Chapter 21 Abdominal Wall Reconstruction and Closure
	Introduction
	Preoperative Planning
	Choice of Surgical Technique
	Operative Procedure
		1. Component Separation Technique
		2. Transposition of Rectus Sheath/Rectus Muscle
		3. Bilateral Skin Flap Advancement
		4. Use of Skin Grafts
		5. Use of Alloplastic Materials
		6. Flap Closure
		7. Adjunctions in Abdominal WoundClosure — Vacuum Assisted Closure
	Postoperative Management
	References
Chapter 22 Abdominal Emergencies in Children
	Laparotomy
	Laparoscopy
	Interventional Radiology
		Air Enema
	Neonatal Intestinal Obstruction
	Infantile Hypertrophic Pyloric Stenosis
	Duodenal Atresia
		Duodenoduodenostomy
	Malrotation with Volvulus
		Intestinal Atresia
	Hirschsprung’s Disease (HD)
		Anorectal Malformations
	Inguinal Hernia in Children
	References
Chapter 23 Instrumentation and Techniques in Emergency Laparoscopic Surgery
	Introduction
	Benefits of Laparoscopy in Emergency
	Indications of Emergency Laparoscopy
	Instrumentation
		Instruments Required for Accessand Exposure
		Instruments Required for ProcedureProper
		Instruments for Removal of Specimen
		Instruments for Port Closure
	Patient Position and O.T. Setup
	Dissection, Retraction and Haemostasis
	Suggested Reading
Index
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Copyright
Title Page
Dedication
Contents
Chapter 1: ‘I’m thinking’ – Oh, but are you?
Chapter 2: Renegade perception
Chapter 3: The Pushbacker sting
Chapter 4: ‘Covid’: The calculated catastrophe
Chapter 5: There is no ‘virus’
Chapter 6: Sequence of deceit
Chapter 7: War on your mind
Chapter 8: ‘Reframing’ insanity
Chapter 9: We must have it? So what is it?
Chapter 10: Human 2.0
Chapter 11: Who controls the Cult?
Chapter 12: Escaping Wetiko
Postscript
Appendix: Cowan-Kaufman-Morell Statement on Virus Isolation
Bibliography
Index