Schein's Common Sense Emergency Abdominal Surgery

Abstract

Background.- General philosophy.- A brief history of emergency abdominal surgery.- Before the operation: The acute abdomen. Rational diagnostic procedures. Abdominal imaging. Optimizing the patient. Pre-operative antibiotics. Family, ethics, informed consent and medico-legal consideration. Before the flight: pre-operative checklist.- The Operation: The incision. Abdominal exploration: finding what is wrong. Peritonitis: Contamination and infection, Principles of treatment. The intestinal anastomosis. Esophageal emergencies. Diaphragmatic emergencies. Upper gastrointestinal hemorrhage. Perforated peptic ulcer. Acute pancreatitis. Acute cholecystitis. Acute cholangitis. Small bowel obstruction. Acute abdominal wall hernias. Acute mesenteric ischemia. Inflammatory bowel disease and other types of colitis. Colonic obstruction. Acute diverticulitis. Massive lower GI bleeding. Acute appendicitis. Anorectal emergencies. Surgical complications of endoscopy. Gynecological emergencies. Abdominal emergencies in infancy and childhood. The AIDS patient. Penetrating abdominal trauma. Blunt abdominal trauma. The abdominal compartment syndrome. Abdominal aortic emergencies. Abdominal closure. Before landing.- After the operation: Postoperative care. Nutrition. Postoperative antibiotics. Postoperative ileus vs. intestinal obstruction. Intra-abdominal abscesses. Anastomotic leaks and fistulas. Re-laparostomies and laparostomies for infection. Abdominal wall dehiscence. LIRS, SIRS, Sepsis, MODS and tertiary peritonitis. Wound management. Post operative bleeding. The role of laparoscopy. The aftermath and the M & M meeting.