S Devaji Rao MS MNAMS FICS
Teaching Faculty National Board of Examinations Senior Consultant in General Surgery Surgical Gastroenterology and Surgical Oncology St Isabel's Hospital,
Mylapore, Chennai, Tamil Nadu, India
Chennai Meenakshi Multispecialty Hospital Ltd
Chennai, Tamil Nadu, India
fm7Preface
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© 2012, Jaypee Brothers Medical Publishers
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This book has been published in good faith that the contents provided by the author contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the author specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the author. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
General Surgical Emergencies
First Edition: 2012
9789350259610
Printed at
fm5Dedicated to
My teachers
My parents
Uma Bai and Siva Rao
My beloved wife
Kalpana
My daughters
Bhavna and Kirthana
Many textbooks are available dealing with the details of emergency surgical conditions. Not many are available dealing exclusively with the emergency conditions, especially those related to surgery. Not that every patient coming to the casualty at odd hours with an acute symptom has a life-threatening emergency, but it becomes necessary to comfort the patient at the first instant, followed by a quick diagnosis of the clinical condition. It is also imperative that the impending emergency should be identified by the clinician, so that a catastrophe is avoided. The classical example of such confusing situation is the acute pancreatitis. This can present with a variety of symptoms which will not give a lead towards diagnosis, but the whole clinical picture establishes after some time, and takes the patient through a very tough morbid situation, and may also end in death.
This concise book has been designed in such a way that the common emergency conditions are detailed to the extent so that surgical students or the casualty doctors or young surgeons may not miss the diagnosis. It cannot replace the many well-established textbooks, but it gives sufficient information for a clinician to manage the emergency.
Color photographs are useful add-ons to these chapters, which will make the reader remember the information for a long time.
Every new doctor who is resident in the casualty and the intensive care unit will face with a variety of clinical problems, and I hope the handbook will come handy.
I also hope that I have hit the required details at the right level for the young surgeons.
S Devaji Rao
fm9Acknowledgments
I sincerely thank Professor SM Balaji, Professor J Cornelius, Dr Gayathri, Dr M Kanagavel, Dr Kirthana Rao, Professor N Mohan, Dr R Narasimhan, Professor MG Rajamanickam, Professor R Rajaraman, Professor N Sekar, Dr K Sridhar, Professor V Srinivasan, Dr V Thulasiraman, Dr Usha Dorairajan, Professor PS Venkatesh Rao and Dr S Vijayaraghavan, who contributed their clinical photographs, from their personal collections. My special thanks to my friends Dr Mani Veeraraghavan for the endoscopy photographs and Dr V Ganesan for the ultrasound photographs. Most of the CT and MRI pictures were procured from Bharat Scans, Chennai, Tamil Nadu, India, and I sincerely thank Dr R Emmanuel for providing them.
My special thanks to my daughters Dr Bhavna for going through the script and making corrections, and Dr Kirthana for drawing the diagrams.
My very special thanks goes to my wife Kalpana for the tolerance during the preparation of this manual.