By Lattimer R
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Extra resources for Key Topics in General Surgery
If greater than 2 cm or incompletely excised, right hemicolectomy is necessary. Appendiceal villous adenomas occur, and these may result in a grossly distended, non-inflammed mucocele of the appendix. Primary adenocarcinomas occur but are rare. Complications Overall mortality for appendicitis is less than 1% but rises to over 5% in the presence of perforation, especially in the elderly. The most frequent complication is wound sepsis. With appropriate perioperative antibiotic prophylaxis the prevalence, even in cases of perforation, can be reduced to 5%.
Soft tissue or bony malignancy. • Malformations, deformities. • Intractable ulceration. • Painful paralysed limbs. The ideal amputation stump • Primary wound healing. • No redundant tissue. Amputations 25 • Cylindrical stump. • No pressure on suture line. • Painless. • Full extension and flexion in adjacent joints. Complications • Wound infection. • Breakdown of suture line. • Stump too long or too short. • Bony spurs. • Stump neuroma. • Phantom pain. • Causalgia. • Muscle herniation. • Deep vein thrombosis.
Barium enema. Accurate in the diagnosis of appendicitis, revealed by non-filling of the appendiceal lumen, but failure to reach the appendix can result in false positives, and generally an unnecessary and time-consuming investigation. 4. Ultrasound. Visualization of the appendix by ultrasonography may be diagnostic for acute appendicitis. The sensitivity of the technique is reduced in early appendicitis and in retrocaecal appendix. Ultrasound can accurately diagnose other conditions mimicking appendicitis, and not requiring surgery, like mesenteric adenitis, renal abnormalities and ovarian disorders, as well as diagnosing disorders where surgical intervention is indicated, such as ectopic pregnancy.