Oncologic Surgical Emergencies: A Practical Guide for the General Surgeon

Contents
1: Emergency in Head and Neck Cancer Patients
	1.1	 Airway Obstruction
1: Emergency in Head and Neck Cancer Patients
	1.1	 Airway Obstruction
		1.1.1	 Intubation Management
		1.1.2	 Surgical Management
1: Emergency in Head and Neck Cancer Patients
	1.2	 Bleeding Management
		1.2.1	 Epistaxis Management
1: Emergency in Head and Neck Cancer Patients
	1.2	 Bleeding Management
		1.2.2	 Upper Aerodigestive Bleeding
1: Emergency in Head and Neck Cancer Patients
	1.2	 Bleeding Management
		1.2.3	 Neck Bleeding Management
1: Emergency in Head and Neck Cancer Patients
	1.3	 Tracheoinnominate Fistula
1: Emergency in Head and Neck Cancer Patients
	1.4	 Infectious Emergencies
1: Emergency in Head and Neck Cancer Patients
	References
2: Adrenal Emergencies in the Acute Care Setting
	2.1	 Introduction
	2.2	 Adrenal Hemorrhage
2: Adrenal Emergencies in the Acute Care Setting
	2.3	 Pheochromocytoma
2: Adrenal Emergencies in the Acute Care Setting
	2.4	 Hypercortisolism
2: Adrenal Emergencies in the Acute Care Setting
	2.5	 Adrenal Crisis (Acute Adrenal Insufficiency)
2: Adrenal Emergencies in the Acute Care Setting
	2.6	 Conclusion
	References
3: Thoracic Emergencies
	3.1	 Introduction
3: Thoracic Emergencies
	3.1	 Introduction
		3.1.1	 Airway Obstruction
3: Thoracic Emergencies
	3.1	 Introduction
		3.1.2	 Superior Vena Cava Syndrome
3: Thoracic Emergencies
	3.1	 Introduction
		3.1.3	 Endoluminal Bleeding
		3.1.4	 Pneumonia and Lung Abscess
3: Thoracic Emergencies
	3.1	 Introduction
		3.1.5	 Tracheoesophageal Fistula (TEF)
		3.1.6	 Neoplastic Pleural Effusions with Trapped Lung
3: Thoracic Emergencies
	3.2	 Conclusion
	References
4: Oncological Emergencies: Esophageal Cancer
	4.1	 Introduction
4: Oncological Emergencies: Esophageal Cancer
	4.2	 Esophageal Obstruction
		4.2.1	 Endoscopic Management
4: Oncological Emergencies: Esophageal Cancer
	4.2	 Esophageal Obstruction
		4.2.2	 Alternative Techniques
		4.2.3	 Surgery
		4.2.4	 Endoluminal Brachytherapy
4: Oncological Emergencies: Esophageal Cancer
	4.2	 Esophageal Obstruction
		4.2.5	 Photodynamic Therapy
		4.2.6	 Laser Therapy
		4.2.7	 Other Techniques
	4.3	 Esophageal Perforation
4: Oncological Emergencies: Esophageal Cancer
	4.3	 Esophageal Perforation
		4.3.1	 Conservative Management
		4.3.2	 Surgical Management
4: Oncological Emergencies: Esophageal Cancer
	4.4	 Bleeding
		4.4.1	 Minor Bleeding
4: Oncological Emergencies: Esophageal Cancer
	4.4	 Bleeding
		4.4.2	 Massive Hemorrhage
	4.5	 Airway Invasion
4: Oncological Emergencies: Esophageal Cancer
	4.6	 Conclusion
4: Oncological Emergencies: Esophageal Cancer
	References
5: Stomach
	5.1	 Gastric Cancer
5: Stomach
	5.1	 Gastric Cancer
		5.1.1	 Anatomic Classification of Gastric Cancer
		5.1.2	 Gastric Cancer: Diagnosis and Additional Evaluation in the Non-emergent Setting
	5.2	 Gastric Oncologic Emergencies
5: Stomach
	5.3	 Perforated Gastric Cancer
		5.3.1	 Management of Perforated Gastric Cancer
5: Stomach
	5.3	 Perforated Gastric Cancer
		5.3.2	 Graham Patch Repair
5: Stomach
	5.3	 Perforated Gastric Cancer
		5.3.3	 Wedge Resection
		5.3.4	 Partial Gastric Resection
5: Stomach
	5.3	 Perforated Gastric Cancer
		5.3.5	 Radical Gastrectomy with Lymph Node Dissection
		5.3.6	 Laparoscopic vs. Open Repair
5: Stomach
	5.4	 Gastrointestinal Bleeding
5: Stomach
	5.5	 Gastric Outlet Obstruction
5: Stomach
	5.6	 Palliative Surgery for Gastric Oncologic Emergencies
5: Stomach
	References
6: Duodenum
	6.1	 Introduction
	6.2	 Neoplasms of the Duodenum
		6.2.1	 Primary Duodenal Malignancies
6: Duodenum
	6.2	 Neoplasms of the Duodenum
		6.2.1	 Primary Duodenal Malignancies
			6.2.1.1	 Adenocarcinoma
			6.2.1.2	 Neuroendocrine Tumors (NETs)
			6.2.1.3	 Lymphomas
6: Duodenum
	6.2	 Neoplasms of the Duodenum
		6.2.1	 Primary Duodenal Malignancies
			6.2.1.4	 Gastrointestinal Stromal Tumors (GISTs)
		6.2.2	 Benign Duodenal Neoplasms
6: Duodenum
	6.2	 Neoplasms of the Duodenum
		6.2.3	 Extension of a Pancreatic Malignancy
6: Duodenum
	6.2	 Neoplasms of the Duodenum
		6.2.4	 Metastatic Disease to the Duodenum
	6.3	 Surgical Emergencies
		6.3.1	 Intestinal Obstruction
			6.3.1.1	 Presentation
			6.3.1.2	 Physical Exam and Laboratory Findings
			6.3.1.3	 Imaging
6: Duodenum
	6.3	 Surgical Emergencies
		6.3.1	 Intestinal Obstruction
			6.3.1.4	 Management
6: Duodenum
	6.3	 Surgical Emergencies
		6.3.2	 Duodenal Perforation
			6.3.2.1	 Presentation
			6.3.2.2	 Physical Exam and Laboratory Findings
6: Duodenum
	6.3	 Surgical Emergencies
		6.3.2	 Duodenal Perforation
			6.3.2.3	 Imaging
			6.3.2.4	 Management
6: Duodenum
	6.3	 Surgical Emergencies
		6.3.3	 Duodenal Bleeding
			6.3.3.1	 Presentation
			6.3.3.2	 Physical Exam and Laboratory Findings
6: Duodenum
	6.3	 Surgical Emergencies
		6.3.3	 Duodenal Bleeding
			6.3.3.3	 Imaging
			6.3.3.4	 Management
6: Duodenum
	6.4	 Special Considerations
		6.4.1	 Metastatic Disease
	6.5	 Anatomic Considerations
		6.5.1	 Involvement of the Ampulla
6: Duodenum
	6.5	 Anatomic Considerations
		6.5.2	 Enteric Access
6: Duodenum
	6.5	 Anatomic Considerations
		6.5.3	 Goals of Care
	6.6	 Conclusion
	References
7: Emergency Presentation of Small Bowel Tumours
	7.1	 Aetiology
7: Emergency Presentation of Small Bowel Tumours
	7.2	 Emergency Presentation
7: Emergency Presentation of Small Bowel Tumours
	7.3	 Initial Management and Diagnosis
		7.3.1	 Radiology
7: Emergency Presentation of Small Bowel Tumours
	7.3	 Initial Management and Diagnosis
		7.3.2	 Endoscopy
7: Emergency Presentation of Small Bowel Tumours
	7.4	 Operative Approach
7: Emergency Presentation of Small Bowel Tumours
	7.5	 Post-operative Outcomes and Complications
7: Emergency Presentation of Small Bowel Tumours
	7.6	 Post-operative Prognosis and Management
7: Emergency Presentation of Small Bowel Tumours
	7.7	 Conclusion
7: Emergency Presentation of Small Bowel Tumours
	References
8: Right Colon
8: Right Colon
	8.1	 Obstructive Right Colon Cancer (ORCC)
8: Right Colon
	8.2	 Perforated Right Colon Cancer
8: Right Colon
	8.3	 Hemorrhagic Right Colon Cancer
	References
9: Appendiceal Tumors
	9.1	 Introduction
9: Appendiceal Tumors
	9.2	 Clinical Presentation and Differential Diagnosis
9: Appendiceal Tumors
	9.3	 Classification and Staging
9: Appendiceal Tumors
	9.4	 Grading
9: Appendiceal Tumors
	9.5	 Staging (WHO Classification of Digestive Tumor—Fifth Edition)
9: Appendiceal Tumors
	9.6	 NETs
9: Appendiceal Tumors
	9.7	 Anatomy and Imaging Features of Each Subtype
	9.8	 Imaging Features of Epithelial Neoplasm
		9.8.1	 Colonic Type/Non-mucinous
		9.8.2	 Mucinous Type
9: Appendiceal Tumors
	9.8	 Imaging Features of Epithelial Neoplasm
		9.8.3	 Neuroendocrine Tumors
		9.8.4	 Goblet Cell Adenocarcinoma
9: Appendiceal Tumors
	9.8	 Imaging Features of Epithelial Neoplasm
		9.8.5	 Lymphoma
9: Appendiceal Tumors
	9.9	 Treatment
		9.9.1	 Adenocarcinomas
		9.9.2	 Goblet Cell Adenocarcinomas
9: Appendiceal Tumors
	9.9	 Treatment
		9.9.3	 Neuroendocrine Tumors
9: Appendiceal Tumors
	9.9	 Treatment
		9.9.4	 Mucinous Tumors
	References
10: Left Colon
	10.1	 Introduction
10: Left Colon
	10.2	 Left Colon Obstruction
10: Left Colon
	10.3	 Management of Obstruction of the Left Colon
10: Left Colon
	10.4	 Loop Colostomies
	10.5	 Hartmann Procedure
10: Left Colon
	10.6	 Single-Stage Primary Resection and Anastomosis
10: Left Colon
	10.7	 Total Abdominal Colectomy
	10.8	 Self-Expanding Stents
10: Left Colon
	10.9	 Perforation
	10.10	 Free Perforation
10: Left Colon
	10.11	 Abscess
	10.12	 Bleeding
10: Left Colon
	10.13	 Minimally Invasive Surgery
	10.14	 Outcomes
10: Left Colon
	10.15	 Conclusion
	References
11: Rectum
	11.1	 Introduction
11: Rectum
	11.2	 Obstruction
		11.2.1	 Clinical Presentation
		11.2.2	 Workup
11: Rectum
	11.2	 Obstruction
		11.2.3	 Treatment
11: Rectum
	11.2	 Obstruction
		11.2.4	 Creation of a Diverting Ostomy
		11.2.5	 Endoscopic Stent Placement
11: Rectum
	11.2	 Obstruction
		11.2.6	 Palliative Care
11: Rectum
	11.3	 Perforation
		11.3.1	 Clinical Presentation and Workup
		11.3.2	 Intraperitoneal Perforation
11: Rectum
	11.3	 Perforation
		11.3.3	 Extraperitoneal Perforation
		11.3.4	 Treatment
		11.3.5	 Intraperitoneal Perforation
11: Rectum
	11.3	 Perforation
		11.3.6	 Extraperitoneal Perforation
	11.4	 Bleeding
		11.4.1	 Clinical Presentation
11: Rectum
	11.4	 Bleeding
		11.4.2	 Workup
11: Rectum
	11.4	 Bleeding
		11.4.3	 Treatment
11: Rectum
	11.4	 Bleeding
		11.4.4	 Local Interventions
11: Rectum
	11.4	 Bleeding
		11.4.5	 Endoscopic Therapies
11: Rectum
	11.4	 Bleeding
		11.4.6	 Interventional Radiology Therapies
		11.4.7	 Radiation Therapy
11: Rectum
	11.4	 Bleeding
		11.4.8	 Surgical Resection
		11.4.9	 Experimental Therapies
	11.5	 Outcomes of Emergency Surgery
11: Rectum
	11.6	 Oncologic Considerations
		11.6.1	 Perforation
		11.6.2	 Bleeding
		11.6.3	 Wound Healing Complications and Timing of Restarting Systemic Therapies
11: Rectum
	11.7	 Conclusion
	References
12: Liver Oncologic Surgical Emergencies
	12.1	 Introduction
12: Liver Oncologic Surgical Emergencies
	12.2	 Anatomy and Physiology
12: Liver Oncologic Surgical Emergencies
	12.3	 Surgical Principles of Emergent Liver Surgery
12: Liver Oncologic Surgical Emergencies
	12.3	 Surgical Principles of Emergent Liver Surgery
		12.3.1	 Hemorrhage Control
12: Liver Oncologic Surgical Emergencies
	12.3	 Surgical Principles of Emergent Liver Surgery
		12.3.2	 Infection Control
		12.3.3	 Oncologic Surgical Emergencies in Patients with Chronic Liver Disease
12: Liver Oncologic Surgical Emergencies
	12.4	 Tumor-Related Emergencies
		12.4.1	 Primary Tumor
			12.4.1.1	 Hemorrhage
12: Liver Oncologic Surgical Emergencies
	12.4	 Tumor-Related Emergencies
		12.4.1	 Primary Tumor
			12.4.1.2	 Thrombosis
			12.4.1.3	 Necrosis/Abscess
			12.4.1.4	 Cholestasis
12: Liver Oncologic Surgical Emergencies
	12.4	 Tumor-Related Emergencies
		12.4.2	 Metastatic Tumor
	12.5	 Treatment-Related Emergencies
		12.5.1	 Surgical Intervention-Related Emergencies
12: Liver Oncologic Surgical Emergencies
	12.5	 Treatment-Related Emergencies
		12.5.1	 Surgical Intervention-Related Emergencies
			12.5.1.1	 Hemorrhage
			12.5.1.2	 Cholangitis
			12.5.1.3	 Acute Liver Failure
			12.5.1.4	 Thrombosis
12: Liver Oncologic Surgical Emergencies
	12.5	 Treatment-Related Emergencies
		12.5.2	 Locoregional Intervention-Related Emergencies
		12.5.3	 Chemotherapy-Related Emergencies
			12.5.3.1	 Systemic Anticancer Therapy-Related Liver Emergencies
12: Liver Oncologic Surgical Emergencies
	12.5	 Treatment-Related Emergencies
		12.5.3	 Chemotherapy-Related Emergencies
			12.5.3.2	 Systemic Anticancer Therapy-Related Biliary Emergencies
12: Liver Oncologic Surgical Emergencies
	12.6	 Conclusions
	References
13: Pancreas
	13.1	 Oncologic Surgical Emergencies: Pancreatic Neoplasms
13: Pancreas
	13.2	 Pancreatitis
	13.3	 Jaundice
13: Pancreas
	13.4	 Occlusion
	13.5	 Perforation
	References
14: Biliary Tract
	14.1	 Introduction
14: Biliary Tract
	14.2	 Anatomy
14: Biliary Tract
	14.3	 Risk Factors
14: Biliary Tract
	14.4	 Clinical Presentation
14: Biliary Tract
	14.5	 Diagnostic Laboratory Studies
		14.5.1 Basic Labs
		14.5.2 Tumor Markers for Cholangiocarcinoma
			14.5.2.1	 Carbohydrate Antigen 19-9 (CA 19-9)
			14.5.2.2	 Carcinoembryonic Antigen (CEA)
14: Biliary Tract
	14.5	 Diagnostic Laboratory Studies
		14.5.2 Tumor Markers for Cholangiocarcinoma
			14.5.2.3	 Alpha Fetoprotein
	14.6	 Diagnostic Imaging
	14.7	 Ultrasound
14: Biliary Tract
	14.8	 Computed Tomography
14: Biliary Tract
	14.9	 Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography
	14.10	 Endoscopic Ultrasound
	14.11	 Cholangiography
14: Biliary Tract
	14.12	 Positron-Emission Tomography
	14.13	 Additional Considerations in Primary Sclerosing Cholangitis
14: Biliary Tract
	14.14	 Complete Staging Evaluation
		14.14.1 Gallbladder Cancer
14: Biliary Tract
	14.14	 Complete Staging Evaluation
		14.14.2 Cholangiocarcinoma
14: Biliary Tract
	14.15	 Histology
14: Biliary Tract
	14.16	 Prognostic Factors
	14.17	 Neoadjuvant Therapy
	14.18	 Approach to Surgical Resection
		14.18.1 Role of Staging Laparoscopy
14: Biliary Tract
	14.18	 Approach to Surgical Resection
		14.18.2 Unresectable Disease
		14.18.3 Resectable Gallbladder Cancer
			14.18.3.1	 Early-Stage Disease (Stage 0, I, or II)
14: Biliary Tract
	14.18	 Approach to Surgical Resection
		14.18.3 Resectable Gallbladder Cancer
			14.18.3.2	 Locally Advanced or Node-Positive Disease
	14.19	 Gallbladder Cancer Diagnosed During Cholecystectomy
	14.20	 Gallbladder Cancer Diagnosed After Cholecystectomy
		14.20.1 T1a Disease
14: Biliary Tract
	14.20	 Gallbladder Cancer Diagnosed After Cholecystectomy
		14.20.2 T1b Disease
		14.20.3 T2 Disease
		14.20.4 T3/T4 Disease
	14.21	 Resectability of Localized Cholangiocarcinoma
14: Biliary Tract
	14.21	 Resectability of Localized Cholangiocarcinoma
		14.21.1 Intrahepatic Cholangiocarcinoma
		14.21.2 Perihilar Cholangiocarcinoma
14: Biliary Tract
	14.21	 Resectability of Localized Cholangiocarcinoma
		14.21.3 Distal Cholangiocarcinoma
	14.22	 Role of Liver Transplantation in Cholangiocarcinoma Treatment
14: Biliary Tract
	14.23	 Gallbladder Cancer Resection Techniques
		14.23.1 Simple Cholecystectomy for Tis, T1a Disease
		14.23.2 Extended Cholecystectomy for T2, T3 Disease
		14.23.3 Role of Lymphadenectomy
14: Biliary Tract
	14.23	 Gallbladder Cancer Resection Techniques
		14.23.4 Laparoscopic Port Site Excision
	14.24	 Cholangiocarcinoma Resection Techniques
		14.24.1 Roux-en-Y Biliary-Enteric Anastomosis
14: Biliary Tract
	14.24	 Cholangiocarcinoma Resection Techniques
		14.24.2 Distal Cholangiocarcinoma
	14.25	 Localized, Unresectable Gallbladder Cancer
	14.26	 Localized, Unresectable Cholangiocarcinoma
14: Biliary Tract
	14.27	 Adjuvant Therapy for Resected Gallbladder Cancer and Cholangiocarcinoma
	14.28	 Advanced, Unresectable Disease
		14.28.1 Obstructive Jaundice
14: Biliary Tract
	14.28	 Advanced, Unresectable Disease
		14.28.2 Palliative Chemotherapy
	14.29	 Conclusion
14: Biliary Tract
	References
15: Oncologic Surgical Emergencies: Spleen
	15.1	 Splenic Surgical Anatomy and Functions
15: Oncologic Surgical Emergencies: Spleen
	15.2	 Hematologic Malignancies and Splenic Tumors
15: Oncologic Surgical Emergencies: Spleen
	15.2	 Hematologic Malignancies and Splenic Tumors
		15.2.1	 Leukemias
		15.2.2	 Lymphomas
		15.2.3	 Primary Splenic Malignancy (Angiosarcoma)
15: Oncologic Surgical Emergencies: Spleen
	15.2	 Hematologic Malignancies and Splenic Tumors
		15.2.4	 Secondary Metastatic Disease
	15.3	 Clinical Presentation and Management
15: Oncologic Surgical Emergencies: Spleen
	15.4	 Operative Management
		15.4.1	 Approach and Techniques
15: Oncologic Surgical Emergencies: Spleen
	15.4	 Operative Management
		15.4.2	 Open Splenectomy
		15.4.3	 Laparoscopic Splenectomy
		15.4.4	 Angioembolization
15: Oncologic Surgical Emergencies: Spleen
	15.5	 Postoperative Considerations
15: Oncologic Surgical Emergencies: Spleen
	15.6	 Conclusions
	References
16: Gynecologic Oncological Surgical Emergencies
	16.1	 Introduction
16: Gynecologic Oncological Surgical Emergencies
	16.2	 Bowel Perforation
16: Gynecologic Oncological Surgical Emergencies
	16.3	 Bowel Obstruction
16: Gynecologic Oncological Surgical Emergencies
	16.4	 Vaginal Bleeding
16: Gynecologic Oncological Surgical Emergencies
	16.5	 Hemoperitoneum
16: Gynecologic Oncological Surgical Emergencies
	16.6	 Ovarian Torsion
	16.7	 Hematometra
16: Gynecologic Oncological Surgical Emergencies
	16.8	 Urinary Obstruction
16: Gynecologic Oncological Surgical Emergencies
	16.9	 Complicated Ascites
	16.10	 Conclusion
	References
17: Kidney
	17.1	 Introduction
	17.2	 Parenchymal and Collecting System Emergencies
17: Kidney
	17.3	 Ureteral Obstruction
17: Kidney
	17.4	 Bowel-Related Emergencies
17: Kidney
	17.5	 Conclusion
17: Kidney
	References
18: Urologic Emergencies in Oncology Patients
	18.1	 Introduction
	18.2	 Ureteral Obstruction
		18.2.1	 Epidemiology
18: Urologic Emergencies in Oncology Patients
	18.2	 Ureteral Obstruction
		18.2.2	 Etiology
		18.2.3	 Pathophysiology
18: Urologic Emergencies in Oncology Patients
	18.2	 Ureteral Obstruction
		18.2.4	 Clinical Presentation
			18.2.4.1	 Lower Urinary Tract Obstruction
18: Urologic Emergencies in Oncology Patients
	18.2	 Ureteral Obstruction
		18.2.4	 Clinical Presentation
			18.2.4.2	 Acute Upper Urinary Tract Obstruction
			18.2.4.3	 Chronic Upper Urinary Tract Obstruction
		18.2.5	 Evaluation
			18.2.5.1	 Renal Ultrasonography
			18.2.5.2	 Nuclear Medicine Renography
18: Urologic Emergencies in Oncology Patients
	18.2	 Ureteral Obstruction
		18.2.5	 Evaluation
			18.2.5.3	 Computed Tomography and Magnetic Resonance Imaging
			18.2.5.4	 Urodynamics
		18.2.6	 Management
18: Urologic Emergencies in Oncology Patients
	18.2	 Ureteral Obstruction
		18.2.6	 Management
			18.2.6.1	 Ureteral Stents
			18.2.6.2	 Percutaneous Nephrostomy Tubes
18: Urologic Emergencies in Oncology Patients
	18.2	 Ureteral Obstruction
		18.2.6	 Management
			18.2.6.3	 Surgical Management
	18.3	 Bladder Outlet Obstruction
		18.3.1	 Epidemiology
18: Urologic Emergencies in Oncology Patients
	18.3	 Bladder Outlet Obstruction
		18.3.2	 Etiology
		18.3.3	 Pathophysiology
		18.3.4	 Clinical Presentation
18: Urologic Emergencies in Oncology Patients
	18.3	 Bladder Outlet Obstruction
		18.3.5	 Evaluation
			18.3.5.1	 Female Anatomy
			18.3.5.2	 Male Anatomy
18: Urologic Emergencies in Oncology Patients
	18.3	 Bladder Outlet Obstruction
		18.3.6	 Management
			18.3.6.1	 Management After Radiation Therapy
18: Urologic Emergencies in Oncology Patients
	18.3	 Bladder Outlet Obstruction
		18.3.6	 Management
			18.3.6.2	 Management of Post-radical Prostatectomy Vesicourethral Anastomotic Strictures
	References
19: Peritoneal Carcinomatosis
	19.1	 Peritoneal Carcinomatosis: Overview
19: Peritoneal Carcinomatosis
	19.2	 The Role of the Acute Care Surgeon (ACS) in Patients with Peritoneal Carcinomatosis
19: Peritoneal Carcinomatosis
	19.3	 Diagnosis
	19.4	 Malignant Bowel Obstruction (MBO) Due to Peritoneal Carcinomatosis
19: Peritoneal Carcinomatosis
	19.4	 Malignant Bowel Obstruction (MBO) Due to Peritoneal Carcinomatosis
		19.4.1	 Surgical Palliation
		19.4.2	 Nonsurgical Palliation
19: Peritoneal Carcinomatosis
	19.5	 Other Surgical Emergencies in Patients with PC
19: Peritoneal Carcinomatosis
	19.6	 Conclusions
	References
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.1	 Introduction
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.2	 Pathogenesis
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.3	 Staging
	20.4	 Diagnosis
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.5	 Gastric Lymphomas
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.5	 Gastric Lymphomas
		20.5.1	 Clinical Presentation
		20.5.2	 Investigations
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.5	 Gastric Lymphomas
		20.5.3	 Management
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.5	 Gastric Lymphomas
		20.5.4	 Immediate Treatment
		20.5.5	 Surgical Treatment
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.6	 Small Bowel Lymphomas
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.6	 Small Bowel Lymphomas
		20.6.1	 Clinical Presentation
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.6	 Small Bowel Lymphomas
		20.6.2	 Investigations
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.6	 Small Bowel Lymphomas
		20.6.3	 Surgical Treatment
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.7	 Colorectal Lymphomas
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	20.7	 Colorectal Lymphomas
		20.7.1	 Clinical Presentation
		20.7.2	 Investigations
		20.7.3	 Surgical Techniques
20: Miscellaneous Rare Malignancies: Intra-abdominal Lymphomas
	References
21: Miscellaneous Rare Malignancies: GIST
	21.1	 Introduction
21: Miscellaneous Rare Malignancies: GIST
	21.2	 Emergency Surgery in GISTs
21: Miscellaneous Rare Malignancies: GIST
	21.3	 Treatment
	21.4	 Conclusion
	References
22: Miscellaneous Rare Malignancies: Desmoplastic
	22.1	 Introduction
22: Miscellaneous Rare Malignancies: Desmoplastic
	22.2	 Diagnosis in Emergency Setting
22: Miscellaneous Rare Malignancies: Desmoplastic
	22.3	 Clinical Presentations in Emergency Setting
		22.3.1	 Perforation
22: Miscellaneous Rare Malignancies: Desmoplastic
	22.3	 Clinical Presentations in Emergency Setting
		22.3.2	 Abscess Formation
22: Miscellaneous Rare Malignancies: Desmoplastic
	22.3	 Clinical Presentations in Emergency Setting
		22.3.3	 Obstruction
		22.3.4	 Hemoperitoneum
22: Miscellaneous Rare Malignancies: Desmoplastic
	22.3	 Clinical Presentations in Emergency Setting
		22.3.5	 Ascites
		22.3.6	 Combined Presentations
	22.4	 Surgery
22: Miscellaneous Rare Malignancies: Desmoplastic
	22.5	 Nonoperative Management
22: Miscellaneous Rare Malignancies: Desmoplastic
	References
23: Surgical Emergencies in Cancer Surgeries: Sarcoma
	23.1	 Introduction
23: Surgical Emergencies in Cancer Surgeries: Sarcoma
	23.2	 Extremity Sarcoma
		23.2.1	 Extremity Sarcoma: Tumor-Related Emergencies
			23.2.1.1	 Hemorrhage
23: Surgical Emergencies in Cancer Surgeries: Sarcoma
	23.2	 Extremity Sarcoma
		23.2.1	 Extremity Sarcoma: Tumor-Related Emergencies
			23.2.1.2	 Obstruction
		23.2.2	 Extremity Sarcoma: Treatment-Related Emergencies
			23.2.2.1	 Hemorrhagic
23: Surgical Emergencies in Cancer Surgeries: Sarcoma
	23.2	 Extremity Sarcoma
		23.2.2	 Extremity Sarcoma: Treatment-Related Emergencies
			23.2.2.2	 Infectious
	23.3	 Retroperitoneal Sarcoma
23: Surgical Emergencies in Cancer Surgeries: Sarcoma
	23.3	 Retroperitoneal Sarcoma
		23.3.1	 RP Sarcoma: Tumor-Related Emergencies
		23.3.2	 RP Sarcoma: Treatment-Related Emergencies
23: Surgical Emergencies in Cancer Surgeries: Sarcoma
	23.4	 Summary
	References
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.1	 Introduction
	24.2	 Epidemiology
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.3	 Classification of Appendiceal Mucinous Neoplasms
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.4	 Pathophysiology of PMP
	24.5	 Classification of PMP
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.6	 Clinical Presentation
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.7	 Evaluation and Management
		24.7.1	 Localized AMNs
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.7	 Evaluation and Management
		24.7.2	 AMNs with Peritoneal Dissemination
			24.7.2.1	 Initial Evaluation
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.7	 Evaluation and Management
		24.7.2	 AMNs with Peritoneal Dissemination
			24.7.2.2	 Management
24: Miscellaneous Rare Malignancies: Pseudomyxoma Peritonei
	24.8	 Complications and Outcomes
	24.9	 Summary
	References
25: Ethical Issues in Emergency Surgery
	25.1	 Introduction
25: Ethical Issues in Emergency Surgery
	25.2	 Triage
25: Ethical Issues in Emergency Surgery
	25.3	 Informed Consent
25: Ethical Issues in Emergency Surgery
	25.3	 Informed Consent
		25.3.1	Jehovah’s Witnesses and Blood Transfusions
25: Ethical Issues in Emergency Surgery
	25.4	 Palliative Care
25: Ethical Issues in Emergency Surgery
	25.5	 Surgical Training
25: Ethical Issues in Emergency Surgery
	25.6	 Medicolegal Issues and Guidelines
25: Ethical Issues in Emergency Surgery
	25.7	 Research
		25.7.1	 Research in Comparison to Clinical Practice
		25.7.2	 The Tuskegee Experiment and Belmont Report
25: Ethical Issues in Emergency Surgery
	25.7	 Research
		25.7.3	 The Nuremberg Code
25: Ethical Issues in Emergency Surgery
	25.7	 Research
		25.7.4	 The Declaration of Helsinki
			25.7.4.1	 General Principles
			25.7.4.2	 Risks, Burdens and Benefits
			25.7.4.3	 Vulnerable Groups and Individuals
25: Ethical Issues in Emergency Surgery
	25.7	 Research
		25.7.4	 The Declaration of Helsinki
			25.7.4.4	 Scientific Requirements and Research Protocols
			25.7.4.5	 Research Ethics Committees
			25.7.4.6	 Privacy and Confidentiality
			25.7.4.7	 Informed Consent
25: Ethical Issues in Emergency Surgery
	25.7	 Research
		25.7.4	 The Declaration of Helsinki
			25.7.4.8	 Use of Placebo
			25.7.4.9	 Post-trial Provisions
			25.7.4.10	 Research Registration and Publication and Dissemination of Results
25: Ethical Issues in Emergency Surgery
	25.7	 Research
		25.7.4	 The Declaration of Helsinki
			25.7.4.11	 Unproven Interventions in Clinical Practice
	References