Bruce E. Jarrell

NMS Surgery Casebook, Second Edition
......Page 1
Half-Title Page
......Page 3
Title Page
......Page 5
Copyright......Page 6
Dedication......Page 7
Preface......Page 8
Contributors......Page 9
Contents......Page 11
Case 1.1: Routine Surgery in a Healthy Patient......Page 13
Case 1.2: Common Risk Factors Associated with Routine Surgery......Page 19
Case 1.3: Common Problems in a Patient Waiting to Enter the Operating Room......Page 21
Case 1.4: Surgery in a Patient with Pulmonary Symptoms......Page 22
Case 1.5: Urgent Surgery in a Patient with Severe, Acute Pulmonary Function Problems......Page 23
Case 1.6: Cardiac and Neurologic Risk Associated with Surgery for Peripheral Vascular Disease......Page 25
Case 1.7: Surgery in a Patient with Liver Failure......Page 29
Case 1.8: Surgery in a Patient with Chronic Kidney Problems......Page 33
Case 1.9: Surgery in a Patient with Cardiac Valvular Disease......Page 34
Case 1.10: Endocarditis Prophylaxis in a Surgical Patient with Valvular Heart Disease......Page 35
Case 1.11: Surgery in a Patient with Cardiomyopathy......Page 36
Key Thoughts......Page 37
Case 2.1: Postoperative Fluid and Electrolyte Management......Page 38
Case 2.2: Postoperative Acute Renal Failure......Page 41
Case 2.3: Postoperative Fever......Page 43
Case 2.4: High Fever in the Immediate Postoperative Period......Page 45
Case 2.5: Postoperative Cardiopulmonary Problems......Page 46
Case 2.6: Management of a Small Bowel Fistula......Page 47
Case 3.1: Wound Management and Complications......Page 49
Case 3.2: Wound Infection......Page 53
Case 3.3: Wound Classification Based on Risk of Subsequent Infection......Page 56
Key Thoughts......Page 61
Case 4.1: Asymptomatic Abnormality Seen on Chest Radiography......Page 62
Case 4.2: Symptomatic Abnormality Seen on Chest Radiography......Page 64
Case 4.3: Symptomatic Abnormality Located in the Hilum on Chest Radiography......Page 68
Case 4.4: Lung Mass with Possible Metastases......Page 72
Case 4.5: Symptomatic Superior Sulcus Tumor......Page 74
Case 4.6: Hemoptysis and Atelectasis in a Young Patient......Page 76
Case 4.7: New-Onset Pleural Effusion without Heart Failure......Page 77
Case 4.8: Sudden Chest Pain and Shortness of Breath in a Young Patient......Page 79
Case 4.9: Pleural-Based Chest Pain, Fever, and Pleural Effusion......Page 83
Case 4.10: Progressively Increasing Substernal Chest Pain......Page 85
Case 4.11: Mitral Valve Disease that Requires Surgery......Page 89
Case 4.12: Aortic Valve Disease that Requires Surgery......Page 90
Case 4.14: Recurrent Regurgitation of Undigested Food......Page 92
Case 4.15: Dysphagia......Page 94
Case 4.16: Dysphagia......Page 95
Case 4.17: Dysphagia......Page 102
Case 4.18: Muscular Weakness and a Mediastinal Mass......Page 105
Key Thoughts......Page 108
Case 5.1: Brief Neurologic Event......Page 109
Case 5.2: Other Transient Neurologic Events......Page 115
Case 5.4: Acute Vascular Event in the Leg......Page 116
Case 5.5: Claudication......Page 123
Case 5.6: Claudication and Absence of a Femoral Pulse......Page 126
Case 5.7: Toe Ulceration in Peripheral Vascular Disease......Page 127
Case 5.8: Aortoiliac Occlusive Disease......Page 132
Case 5.9: Cardiac Risk in Major Vascular Reconstruction......Page 135
Case 5.10: Pulsatile Mass in the Abdomen......Page 136
Case 5.11: Ruptured Abdominal Aortic Aneurysm......Page 139
Case 5.12: Complications of Abdominal Aortic Replacement......Page 140
Case 5.13: Chronic Postprandial Abdominal Pain and Weight Loss......Page 141
Case 5.14: Tearing Chest and Back Pain......Page 144
Case 5.15: Postoperative Leg Swelling......Page 145
Case 5.16: Prevention of Deep Venous Thrombosis......Page 148
Case 5.17: Postoperative Shortness of Breath......Page 151
Case 5.18: Confounding Findings in Pulmonary Embolism......Page 152
Case 5.19: Recurrent Pulmonary Embolism on Anticoagulation Therapy......Page 153
Case 5.20: Gastrointestinal Bleeding as a Complication of Anticoagulation Therapy......Page 154
Case 5.21: Severe Deep Venous Thrombosis......Page 155
Key Thoughts......Page 156
Case 6.1: Acute Epigastric Pain No. 1......Page 158
Case 6.2: Acute Epigastric Pain No. 2......Page 160
Case 6.3: Acute Epigastric Pain No. 3......Page 162
Case 6.4: Acute Epigastric Pain No. 4......Page 163
Case 6.5: Acute Epigastric Pain No. 5......Page 167
Case 6.6: Acute Epigastric Pain No. 6......Page 170
Case 6.7: Acute Epigastric Pain No. 7......Page 171
Case 6.8: Upper Gastrointestinal Bleeding No. 1......Page 173
Case 6.9: Upper Gastrointestinal Bleeding No. 2......Page 182
Case 6.10: Acute Epigastric Pain No. 8......Page 184
Key Thoughts......Page 185
Case 7.2: Right Upper Quadrant Pain No. 1......Page 186
Case 7.3: Right Upper Quadrant Pain No. 2......Page 189
Case 7.5: Right Upper Quadrant Pain No. 4......Page 191
Case 7.7: Right Upper Quadrant Pain No. 6......Page 192
Case 7.8: Right Upper Quadrant Pain No. 7......Page 194
Case 7.9: Right Upper Quadrant Pain No. 8......Page 196
Case 7.10: Complications of Laparoscopic Cholecystectomy......Page 197
Case 7.11: Painless Jaundice......Page 199
Case 7.12 :  Painless Jaundice due to Obstruction at the Common Bile Duct Bifurcation......Page 204
Case 7.13: Other Biliary Tract Cancers......Page 206
Case 7.14: Acute Epigastric Pain No. 10......Page 207
Case 7.15: Acute Epigastric Pain No. 11......Page 208
Case 7.16: Acute Epigastric Pain No. 12......Page 211
Case 7.17: Hepatic Mass......Page 213
Case 7.18: Fever and Pain in the Right Upper Quadrant......Page 220
Key Thoughts......Page 222
Case 8.1: Crampy Abdominal Pain No. 1......Page 223
Case 8.3: Crampy Abdominal Pain No. 3......Page 228
Case 8.5: Crampy Abdominal Pain No. 4......Page 230
Case 8.7: Abdominal Pain No. 6......Page 231
Case 8.8: Abdominal Pain No. 7......Page 235
Case 8.10: Management of Crohn Colitis......Page 237
Case 8.11: Complications of Long-Standing Ulcerative Colitis......Page 238
Case 8.12: Complications of Acute Colitis......Page 240
Case 8.13: Right Lower Quadrant Pain No. 1......Page 242
Case 8.14: Right Lower Quadrant Pain No. 2......Page 243
Case 8.17: Right Lower Quadrant Pain No. 4......Page 247
Case 8.18: Right Lower Quadrant Pain No. 5......Page 249
Case 8.19: Screening for Colorectal Cancer......Page 250
Case 8.20: Heme-Positive Stool No. 1......Page 251
Case 8.21: Heme-Positive Stool No. 2......Page 253
Case 8.22: Heme-Positive Stool No. 3......Page 256
Case 8.23: Heme-Positive Stool No. 4......Page 261
Case 8.24: Operative Findings in Colon Cancer No. 1......Page 262
Case 8.25: Complications of Postoperative Colectomy......Page 263
Case 8.26: Heme-Positive Stool No. 5......Page 264
Case 8.27: Heme-Positive Stool No. 6......Page 266
Case 8.28: Metastasis in Colorectal Cancer......Page 271
Case 8.29: Heme-Positive Stool No. 7......Page 272
Case 8.30: Left Lower Quadrant Pain No. 1......Page 273
Case 8.31: Left Lower Quadrant Pain No. 2......Page 275
Case 8.32: Left Lower Quadrant Pain No. 3......Page 276
Case 8.34: Massive Lower Gastrointestinal Bleeding......Page 278
Case 8.35: Persistent Bleeding with a Massive Lower Gastrointestinal Bleed......Page 281
Case 8.36: Syndromes of Acute Colonic Dilation and Obstruction......Page 284
Case 8.38: Perianal Problems......Page 287
Case 8.39: Colostomies......Page 289
Case 9.1: Thyroid Nodule Found on Examination......Page 291
Case 9.2: Symptomatic Hypercalcemia......Page 299
Case 9.3: Medical Management of Acute Hypercalcemia......Page 302
Case 9.4: Secondary Hyperparathyroidism......Page 303
Case 9.5: Hyperparathyroidism and Severe Hypertension in the Same Patient......Page 304
Case 9.7: History of Hyperparathyroidism and Intractable Duodenal Ulcers......Page 306
Case 9.8: Medullary Carcinoma of the Thyroid......Page 309
Case 9.9: Incidentally Discovered Adrenal Mass......Page 310
Case 10.1: Evaluation of a Skin Lesion......Page 311
Case 10.2: Diagnosis of Malignant Melanoma in a Skin Lesion......Page 313
Case 10.4: Malignant Melanoma with Distant Metastasis......Page 318
Case 10.5: Special Problems in Malignant Melanoma No. 1......Page 319
Case 10.6: Special Problems in Malignant Melanoma No. 2......Page 320
Case 10.8: Sarcoma of the Lower Extremity......Page 321
Case 10.9: Metastatic Sarcoma to the Lung......Page 325
Case 10.10: Pain in the Groin......Page 328
Case 10.11: Inguinal Hernia......Page 330
OPEN REPAIRS......Page 332
LAPAROSCOPIC PROCEDURES......Page 333
Case 10.12: Additional Hernia-Related Problems......Page 336
Case 10.13: Ventral Hernia......Page 340
Key Thoughts......Page 341
Case 11.1: Screening for Breast Cancer......Page 342
Case 11.2: Evaluation of a Mammographic Abnormality......Page 344
Case 11.3: Evaluation of Mammographic Microcalcifications......Page 346
Case 11.4: Biopsy Results in Lesions Visible on Mammography......Page 347
Case 11.5: Management of a Woman with a Palpable Breast Mass
......Page 349
Case 11.8: Management of a Woman with Nipple Discharge......Page 352
Case 11.9: Staging and Prognosis in Infiltrating Ductal Carcinoma......Page 353
Case 11.10: Some Clinical Factors that Affect Prognosis......Page 355
Case 11.12: Surgical Management of Breast Cancer......Page 357
Case 11.13: Treatment Options for Stages I and II Breast Cancer......Page 362
Case 11.14 : Breast Reconstruction......Page 364
Case 11.15: Medical Management of Breast Cancer......Page 365
Case 11.17: Breast Mass with Cellulitis and Edema
......Page 367
Case 11.18:  Events that Occur Later in Patients with Breast Cancer......Page 368
Case 11.19:  Breast Problems in Pregnancy and the Peripartum Period......Page 369
Case 11.20:  Breast Cancer in Patients of Advanced Age and Decreased Function......Page 370
Case 11.22: Gynecomastia......Page 371
Case 12.1: Primary and Secondary Assessment of Injuries......Page 372
Case 12.2: Initial Airway Management......Page 373
Case 12.3: Initial Pulmonary Management
......Page 374
Case 12.4: Initial Management of Pneumothorax in a Patient with Hypotension......Page 377
Case 12.5:  Initial Management of Hypotension and Neck Vein Distention with Normal Breath Sounds
......Page 379
Case 12.6:  Initial Management of Hypotension with Normal Breath Sounds and No Neck Vein Distention......Page 381
Case 12.7: Initial Cervical Spine Management......Page 384
Case 12.8: Initial Assessment of Thoracic Injury......Page 387
Case 12.9: Management of an Indistinct or Widened Mediastinum
......Page 389
Case 12.10:  Initial Abdominal Assessment Based on Mechanism of Injury......Page 393
Case 12.11: Initial Assessment of Abdominal Injury
......Page 394
Case 12.12: Management of Abdominal Injuries Visible on CT Scan......Page 398
Case 12.13: Management of Operative Findings with Abdominal Trauma......Page 404
Case 12.14: Initial Neurologic Injury Assessment and Management......Page 406
Case 12.15: Other Neurologic Problems......Page 407
Case 12.16: Management of Continuing Hemorrhage......Page 409
Case 12.17: Management of Postoperative Problems in Trauma Patients......Page 410
Case 12.18: Traumatic Arteriovenous Fistula......Page 413
Case 12.19: Management of Continuing Pulmonary Problems......Page 415
Case 12.20: Management of Respiratory Distress......Page 416
Case 12.21: Stab Wound to the Neck......Page 418
Case 12.22: Other Injuries to the Neck......Page 420
Case 12.23: Burn......Page 421
Case 12.24: Total Parenteral Nutrition......Page 425
Case 13.1: Acute Respiratory Distress......Page 431
Case 13.2: Respiratory Distress with Oral Intake......Page 433
Case 13.3: Bilious Emesis......Page 436
Case 13.4: Imperforate Anus......Page 443
Case 13.5: Vomiting in a 2-Week-Old......Page 444
Case 13.6: Abdominal Wall Defects......Page 446
Case 13.7: Abdominal Pain in a 1-Year-Old......Page 449
Index......Page 451