By Seth J. Karp MD, James P.G. Morris MD
Part of the Blueprints sequence, Blueprints Surgery offers a concise overview of what scholars want to know of their surgical procedure rotations or the forums. every one bankruptcy is short and contains pedagogical beneficial properties reminiscent of bolded keyword phrases, tables, figures, and key issues bins. This version has been completely up-to-date and considerably improved, with extra aspect and intensity of assurance, extra tables and figures, and case experiences. A question-and-answer part on the finish of the ebook contains a hundred board-format questions with whole rationales for every resolution choice.
A spouse site encompasses a query financial institution containing an extra 50 questions and completely searchable text.
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Additional resources for Blueprints Surgery
Polypoid fungating nodular tumors are usually well differentiated and carry a relatively good prognosis after surgery. Ulcerating or penetrating tumors are the most common and are often mistaken for benign peptic ulcers because of their sessile nature. Superficial spreading lesions diffusely infiltrate through mucosa and submucosa and have a poor prognosis because most are metastatic at the time of diagnosis. The pathologic staging of gastric cancer is based on depth of tumor invasion and lymph node status.
Surgery is reserved for perforation, massive bleeding, gastric outlet obstruction, and nonhealing ulcers. • Stress gastritis and ulceration are secondary to mucosal ischemia caused by hypotension and hypoperfusion. • Cushing’s ulcers occur in patients with intracranial pathology, most probably secondary to neuronally mediated acid hypersecretion. ” Diagnosis is confirmed by the secretin-stimulation test. Medical treatment includes H2 blockade, proton pump inhibition, and somatostatin analogs. Complete surgical resection can be curative.
TREATMENT Medical treatment is similar for gastric and duodenal ulceration. The goals of medical therapy are to decrease production of or neutralize stomach acid and to enhance mucosal protection against acid attack. Medications include antacids (CaCO3), H2-blockers (cimetidine, ranitidine), mucosal coating agents (sucralfate), and proton-pump inhibitors (omeprazole). If H. pylori is present, treatment with oral antibiotics is associated with a 90% eradication rate. Treatment regimens may consist of tetracycline/metronidazole/bismuth subsalicylate, amoxicillin/metronidazole/ranitidine, or other combinations.