By James Gossage, Bijan Modarai, Arun Sahai, Richard Worth
The purpose of the a hundred instances sequence is to supply a unique studying and revision instrument that works via guiding the reader via medical circumstances, imitating those who scholars and junior medical professionals are inclined to meet in twist of fate and emergency and outpatient departments, and quite often perform.
100 instances in Surgery provides a hundred surgical situations often obvious and taken care of by means of clinical scholars and junior medical professionals. The patient's background, exam and preliminary research effects are awarded along questions about the prognosis and administration of every case. the reply contains a distinctive dialogue on every one subject delivering a vital revision reduction for college students and junior doctors.
Making medical judgements is without doubt one of the such a lot tough and hard components of educating to develop into a physician. those instances will educate scholars and junior medical professionals to know very important surgical stipulations and support them increase their diagnostic and administration skills.
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Corticosteroids can be used to induce remission, and salicylic acid derivatives employed to maintain remission – these can be administered as enemas or suppositories where the disease only involves the rectum. If diarrhoea is particularly problematic, agents such as codeine phosphate and loperamide may be considered. The potential for malignant change is relatively high with long-standing ulcerative colitis and the risk in patients with pancolitis is approximately 3 per cent after 10 years. The risk of developing mucosal dysplasia increases with time, and surveillance should commence after 7 years.
1 shows an erect chest x-ray. 1 Erect chest x-ray. Questions • What is the likely diagnosis? • How should this patient be managed? • How should this patient be managed after discharge? 51 100 Cases in Surgery ANSWER 24 The x-ray shows free intraperitoneal gas beneath the hemidiaphragms, consistent with a perforated intra-abdominal viscus. The most common cause is a perforation of a peptic ulcer. Ulcers situated on the anterior duodenal wall perforate into the abdominal cavity, resulting in free intraperitoneal gas.
His appetite has been normal, but he reports a 2-stone weight loss. The past history was otherwise unremarkable. His father died from cancer at the age of 45 years, but he is unsure of the origin. Examination No pallor or lymphadenopathy is present. The abdomen is soft and non-tender with no palpable masses. Digital rectal examination is normal. 1). 1 Lesion on sigmoidoscopy. Questions • What is the likely diagnosis? • How should the patient be investigated? • What are the options for treatment?