BOOK
Atlas Of Complicated Abdominal Emergencies: Tips On Laparoscopic And Open Surgery, Therapeutic Endoscopy And Interventional Radiology (With Dvd-rom)
Ti Thiow Kong | Lomanto Davide
(2014)
Additional Information
Book Details
Abstract
This book is novel in that it is a single volume offering useful practical tips in the performance of the broad range of procedures used by gastroenterologists, interventional radiologists and surgeons in the current management of complicated abdominal emergencies and traumatic injuries. Emphasis is placed on practical tips which could be life-saving.The contributors are experienced staff members from the National University Hospital, Singapore. Through a step-by-step narrative and an abundance of medical illustrations, the contributors impart to the reader how best to perform and overcome difficulties encountered in the management of complicated abdominal emergencies. Learning is enhanced by video clips of procedures recorded live, in the DVD-ROM that accompanies the book.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Contents | xvii | ||
| Acknowledgements | vii | ||
| Foreword | ix | ||
| Preface | xv | ||
| Chapter 1 Role of the Accident & Emergency Department \r | 1 | ||
| Recognition of the Sick Patient | 1 | ||
| Approach to Non-traumatic Abdominal Pain | 2 | ||
| Approach to Traumatic Abdominal Pain | 5 | ||
| Ancillary Investigations in the ED | 5 | ||
| Indications for Referral | 6 | ||
| References | 6 | ||
| Chapter 2 Perioperative Management of Patients with Complicated Abdominal Emergencies | 7 | ||
| Shock and Organ Perfusion | 7 | ||
| Outcomes of Resuscitation | 7 | ||
| How to Optimise a Patient Preoperatively | 8 | ||
| Investigations | 9 | ||
| Fluid and Electrolyte Replacement | 9 | ||
| Haematological Therapy | 10 | ||
| Coagulopathy | 10 | ||
| Antibiotics | 11 | ||
| Emergency Laparoscopic Surgery | 11 | ||
| Risk Factors for Surgery | 12 | ||
| Postoperative Care | 13 | ||
| Intensive Care/High Dependency | 13 | ||
| Sepsis Syndromes | 13 | ||
| Acute respiratory distress syndrome(ARDS) | 13 | ||
| Blood transfusion and blood component therapy | 14 | ||
| Postoperative Oliguria | 14 | ||
| Renal Replacement Therapy (RRT) | 14 | ||
| Abdominal compartment syndrome (ACS) | 15 | ||
| Nutrition | 15 | ||
| Pros and cons of TPN | 15 | ||
| Chapter 3 Non-Variceal Upper Gastrointestinal Haemorrhage and Endoscopic Management | 17 | ||
| Introduction | 17 | ||
| Management of Non-Variceal UpperGastrointestinal Bleeding | 17 | ||
| Initial Management | 17 | ||
| Risk stratifying upper gastrointestinalbleeding | 18 | ||
| Rockall score | 18 | ||
| Glasgow–Blatchford score | 18 | ||
| Medical Therapy | 19 | ||
| Endoscopic Therapy | 21 | ||
| Timing of endoscopy | 21 | ||
| Epinephrine injection | 22 | ||
| Thermal therapy | 22 | ||
| Argon plasma coagulation | 23 | ||
| Endoscopic clipping | 24 | ||
| Failure of endoscopic therapy | 26 | ||
| References | 26 | ||
| Chapter 4 Upper Gastrointestinal Variceal Haemorrhage and Endoscopic Management | 29 | ||
| Introduction | 29 | ||
| Grading and Nomenclatureof Varices | 29 | ||
| Management of Variceal Bleeding | 32 | ||
| Medical Management and Resuscitation | 32 | ||
| Endoscopic Management | 33 | ||
| Variceal band ligation | 34 | ||
| Cyanoacrylate glue | 35 | ||
| Endoscopic sclerotherapy | 37 | ||
| Subsequent endoscopy | 38 | ||
| Insertion of the Sengstaken–Blakemoretube | 38 | ||
| Portosystemic shunts: TIPS and surgery | 39 | ||
| References | 40 | ||
| Chapter 5 Interventional Radiology in the Management of Gastrointestinal Haemorrhage | 43 | ||
| Introduction | 43 | ||
| Management Options | 43 | ||
| Catheter Angiography | 44 | ||
| CT Angiography | 45 | ||
| Embolic Agents | 47 | ||
| Difficulties | 47 | ||
| Contraindications to Angiography/CT/Embolisation | 47 | ||
| Complications of Angiography | 49 | ||
| Indirect Bleeding | 50 | ||
| References | 52 | ||
| Chapter 6 Bleeding Peptic Ulcer — Surgical Management | 53 | ||
| I. Indications | 53 | ||
| Operative Strategy for Bleeding PepticUlcer | 53 | ||
| II. Preoperative Preparation | 54 | ||
| III. Operative Procedures forBleeding Peptic Ulcer | 54 | ||
| A. Laparotomy and Identifi cation of Siteof Haemorrhage | 54 | ||
| B. Over-Sewing a Bleeding Ulcer | 55 | ||
| C. Techniques for Problematical Duodenal Ulcer Bleeding | 55 | ||
| D. Key Points in Vagotomy-Drainage for Bleeding Duodenal Ulcer | 56 | ||
| Pyloroplasty/gastroenterostomy | 57 | ||
| Truncal vagotomy | 57 | ||
| E. Key Points in Billroth II Gastrectomy/ Vagotomy Antrectomy for Bleeding Duodenal Ulcer | 59 | ||
| Ensure safe duodenal stump closure | 59 | ||
| Dealing with problems related to the posterior duodenal ulcer penetratinginto the pancreas | 60 | ||
| Mobilisation of distal stomach | 61 | ||
| Billroth II gastroenteral anastomosis | 63 | ||
| Surgical Techniques for BleedingGastric Ulcer | 64 | ||
| F. Local Excision of Gastric Ulcer | 64 | ||
| Key Points in Billroth I Gastrectomyfor Bleeding Gastric Ulcer | 64 | ||
| Incisional wound closure | 65 | ||
| Postoperative care | 65 | ||
| References | 65 | ||
| Chapter 7 Surgical Management of Upper Gastrointestinal Perforations | 67 | ||
| Indications | 67 | ||
| Preoperative Preparation | 68 | ||
| Operative Treatment | 68 | ||
| A. Benign Duodenal Ulcer Perforation | 68 | ||
| B. Benign Gastric Ulcer Perforations | 69 | ||
| C. Surgery for Malignant Gastric UlcerPerforation | 70 | ||
| References | 71 | ||
| Chapter 8 Management of Complications Following Bariatric Surgery | 73 | ||
| Introduction | 73 | ||
| General Complications | 73 | ||
| Thromboembolism | 73 | ||
| Atelectasis | 73 | ||
| Nausea and Vomiting | 73 | ||
| Wound Complications | 74 | ||
| Acute Abdominal Complications | 74 | ||
| 1. Bleeding | 74 | ||
| 2. Leaks | 74 | ||
| Treatment options for GJ leak | 75 | ||
| Managing sleeve leak | 75 | ||
| 3. Stenosis and Stricture | 75 | ||
| 4. Gastric Band Slippage and IntestinalObstruction | 76 | ||
| 5. Other Complications | 78 | ||
| Gastric banding | 78 | ||
| Gastric bypass | 78 | ||
| Nutritional problems | 79 | ||
| Chapter 9 Surgery for Appendicitis | 81 | ||
| 1. Indications | 81 | ||
| Operative Strategy of Acute Appendicitis | 81 | ||
| 2. Preoperative Preparation | 81 | ||
| 3. Surgery | 81 | ||
| Open Appendectomy | 81 | ||
| Laparoscopic Appendectomy | 82 | ||
| 4. Postoperative care | 83 | ||
| Special Situations | 83 | ||
| Chapter 10 Emergency Surgery for Perforative Sigmoid Colonic Diverticulitis | 85 | ||
| Introduction | 85 | ||
| Management of Acute Sigmoid Colonic Diverticulitis | 86 | ||
| A. Preoperative Management | 86 | ||
| B. Indications for Surgery | 86 | ||
| C. Options of Surgical Procedure | 86 | ||
| Two-stage approach | 87 | ||
| Single-stage approach | 87 | ||
| Role of laparoscopic surgery in acute \rperforative sigmoid colonic diverticulitis | 87 | ||
| D. Important Considerations in theTechniques for Appropriate Resection | 88 | ||
| E. Position of Patient for Surgery | 88 | ||
| F. Perioperative Precautionsand Preparation | 88 | ||
| Intra-Operative Surgical Techniques | 89 | ||
| A. Incision and Laparotomy | 89 | ||
| B. Mobilisation of the Sigmoidand Descending Colon | 89 | ||
| C. Identification of the Left Ureter | 90 | ||
| Tips and tricks to help locate the ‘difficult’ left ureter | 91 | ||
| Common sites of left ureteric injury during anterior resection | 91 | ||
| D. Splenic Flexure Take Down | 92 | ||
| Tips and tricks to tackle difficultsplenic flexure | 93 | ||
| E. Vascular Control | 93 | ||
| Ligation of the inferior mesenteric artery (IMA) | 93 | ||
| How to identify the IMA? | 93 | ||
| Ligation of the inferior mesenteric vein (IMV) | 94 | ||
| F. Determination of the Proximal Transection Margin | 94 | ||
| How to ensure adequate proximal bowel length for tension-free anastomosis | 94 | ||
| G. Determination of the Distal Transection Margin | 95 | ||
| How to ensure that all the sigmoid colon is resected? | 95 | ||
| H. Preparation for ColorectalAnastomosis | 95 | ||
| On-table colonic lavage | 95 | ||
| I. Construction of the ColorectalAnastomosis | 96 | ||
| How to ensure an optimal and safe colorectal anastomosis? | 96 | ||
| When is it not safe to anastomose? | 96 | ||
| J. Completion of Surgery | 96 | ||
| K. Postoperation Care | 96 | ||
| References | 97 | ||
| Chapter 11 Surgical Management of Obstructive Colorectal Malignancy | 99 | ||
| Introduction | 99 | ||
| I. Preoperative Management | 99 | ||
| II. Management Options | 100 | ||
| III. Endoscopic Colonic Stenting | 101 | ||
| Indications | 101 | ||
| IV. Defunctioning Stoma | 104 | ||
| Indications | 104 | ||
| Postoperative Considerations | 105 | ||
| V. Resectional Surgery With or Without Primary Anastomosis | 105 | ||
| VI. Clinical Consideration after Surgery | 106 | ||
| References | 106 | ||
| Chapter 12 Surgical Management of Acute Cholecystitis | 109 | ||
| Definition | 109 | ||
| Risk Factors for DifficultLaparoscopic Cholecystectomyin Acute Cholecystitis | 109 | ||
| Preoperative preparation | 110 | ||
| Surgical Treatment | 110 | ||
| Laparoscopic approach | 110 | ||
| References | 115 | ||
| Chapter 13 ERCP in the Management of Cholangitis and Bile Duct Injuries | 117 | ||
| Pre- ERCP Preparation | 117 | ||
| ERCP for Choledocholithiasis | 117 | ||
| ERCP in Malignancy Involving theBiliary Tract | 119 | ||
| ERCP in Bile Duct Injuries | 120 | ||
| Difficult Biliary Cannulation | 121 | ||
| Post- ERCP Care | 121 | ||
| References | 121 | ||
| Chapter 14 Surgical Management of Bile Duct & Pancreatic Emergencies | 123 | ||
| A) Acute Cholangitis | 123 | ||
| B) Acute Pancreatitis withor without Necrosis | 126 | ||
| C) Bile Duct Injuries During Surgery | 129 | ||
| D) Pancreatic Trauma | 131 | ||
| E) ERCP Perforation | 133 | ||
| Chapter 15 Laparoscopic Drainage of Liver Abscess | 135 | ||
| I. Introduction | 135 | ||
| II. Management Strategy for LiverAbscesses | 135 | ||
| III. Operative Procedure Via Laparoscopic Approach | 136 | ||
| IV. Postoperative Management | 138 | ||
| Special situations | 139 | ||
| Final Note | 140 | ||
| Chapter 16 Interventional Radiology in the Management of Intra-Abdominal Abscess | 141 | ||
| Introduction | 141 | ||
| Advantages of Radiological Drainage | 141 | ||
| Disadvantages of Radiological Drainage | 142 | ||
| Radiological Evaluation of the Abscess | 142 | ||
| 1) Diagnosis of Abscess | 142 | ||
| 2) Identify a Potential Cause for an Abscess | 143 | ||
| 3) Determine Drainability of an Abscess | 144 | ||
| 4) Identifying the Complications from an Abscess | 144 | ||
| 5) Aid Drainage Planning | 145 | ||
| Patient Preparation for Radiological Drainage | 145 | ||
| Role of RadiologicalIntervention | 146 | ||
| Contraindications | 146 | ||
| Technique | 147 | ||
| Imaging Guidance | 147 | ||
| Insertion of the Drain | 147 | ||
| Drainage Catheter | 148 | ||
| Tips on Drain Insertion and Maintenance | 149 | ||
| Site Specific Comments on Radiological Drainage of Intra-Abdominal Abscess | 149 | ||
| Liver Abscess | 149 | ||
| Subphrenic and Lesser Sac Abscess | 151 | ||
| Percutaneous Cholecystostomy | 151 | ||
| Pancreatic Collection/Abscess | 152 | ||
| Pelvic Abscess | 152 | ||
| Enteric Abscess | 153 | ||
| Others | 153 | ||
| Conclusion | 154 | ||
| References | 155 | ||
| Chapter 17 Management of Gynaecological Emergencies | 157 | ||
| I. Ectopic Pregnancy | 157 | ||
| Operative procedures | 157 | ||
| II. Ruptured Tubo-Ovarian Abscess | 160 | ||
| Preoperative | 160 | ||
| Operative procedures | 160 | ||
| Postoperative | 162 | ||
| III. Haemorrhage or LeakingOvarian Cyst and Adnexal Torsion | 162 | ||
| A. Adnexal torsion | 162 | ||
| Preoperative — Benign Ovarian Cyst | 163 | ||
| Laparoscopic intervention | 163 | ||
| 2. Laparoscopic ovarian oophorectomy | 165 | ||
| 3. Open Cystectomy | 166 | ||
| Chapter 18 Ureteric Injuries | 167 | ||
| Introduction | 167 | ||
| Review of Anatomy and Exposure of the Ureter | 167 | ||
| Repair of Bladder Injuries | 168 | ||
| Basic Direct Anastomotic Repair of the Ureter | 168 | ||
| Ureteroneocystostomy (Ureteric Reimplantation) and Psoas Hitch | 169 | ||
| Boari Flap | 170 | ||
| Other Manoeuvres | 170 | ||
| Post-Operative Care | 171 | ||
| Conclusion | 171 | ||
| Chapter 19 Ruptured and Leaking Abdominal Aortic Aneurysms | 173 | ||
| I. General Principles of Management of Ruptured/Leaking AAAs Include: | 173 | ||
| II. Perioperative Care | 174 | ||
| III. Open Repair: Surgical Techniqueand Principles | 174 | ||
| IV. Mycotic Aneurysms | 178 | ||
| V. Endovascular Stenting ofRuptured/Leaking AAAs | 178 | ||
| VI. Post-Surgery Follow-up | 178 | ||
| Chapter 20 Management of Severe Blunt Abdominal Injury | 181 | ||
| I. Introduction and Indications | 181 | ||
| II. Preoperative Management | 181 | ||
| III. OT Preparation | 181 | ||
| IV. Operative Procedure | 182 | ||
| Damage Control Mode | 183 | ||
| Splenic Injuries | 183 | ||
| Bowel Injuries | 184 | ||
| Kidney Injuries | 184 | ||
| Pancreatic Injuries | 185 | ||
| Liver Injuries | 187 | ||
| VI. Postoperative Care | 190 | ||
| V. Wound Closure | 189 | ||
| Chapter 21 Abdominal Wall Reconstruction and Closure | 193 | ||
| Introduction | 193 | ||
| Preoperative Planning | 193 | ||
| Choice of Surgical Technique | 194 | ||
| Operative Procedure | 195 | ||
| 1. Component Separation Technique | 195 | ||
| 2. Transposition of Rectus Sheath/Rectus Muscle | 196 | ||
| 3. Bilateral Skin Flap Advancement | 196 | ||
| 4. Use of Skin Grafts | 197 | ||
| 5. Use of Alloplastic Materials | 197 | ||
| 6. Flap Closure | 198 | ||
| 7. Adjunctions in Abdominal WoundClosure — Vacuum Assisted Closure | 199 | ||
| Postoperative Management | 199 | ||
| References | 200 | ||
| Chapter 22 Abdominal Emergencies in Children | 201 | ||
| Laparotomy | 201 | ||
| Laparoscopy | 202 | ||
| Interventional Radiology | 202 | ||
| Air Enema | 202 | ||
| Neonatal Intestinal Obstruction | 203 | ||
| Infantile Hypertrophic Pyloric Stenosis | 203 | ||
| Duodenal Atresia | 204 | ||
| Duodenoduodenostomy | 205 | ||
| Malrotation with Volvulus | 205 | ||
| Intestinal Atresia | 206 | ||
| Hirschsprung’s Disease (HD) | 208 | ||
| Anorectal Malformations | 209 | ||
| Inguinal Hernia in Children | 209 | ||
| References | 209 | ||
| Chapter 23 Instrumentation and Techniques in Emergency Laparoscopic Surgery | 211 | ||
| Introduction | 211 | ||
| Benefits of Laparoscopy in Emergency | 211 | ||
| Indications of Emergency Laparoscopy | 211 | ||
| Instrumentation | 212 | ||
| Instruments Required for Accessand Exposure | 212 | ||
| Instruments Required for ProcedureProper | 216 | ||
| Instruments for Removal of Specimen | 219 | ||
| Instruments for Port Closure | 219 | ||
| Patient Position and O.T. Setup | 219 | ||
| Dissection, Retraction and Haemostasis | 221 | ||
| Suggested Reading | 222 | ||
| Index | 223 |