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TUBERCULOSIS OF SMALL INTESTINE Introduction Infection by M. tuberculosis is common in the tropics. In these days of international travel and increased migration, tuber culosis in general and intestinal tuberculosis in particular are no longer clinical curios...

TUBERCULOSIS Although tuberculosis can a ff ect all systems in the body , in the tropical world the surgeon is most often faced with tuberculosis a ff ecting the cervical lymph nodes and the small intestine. Therefore, in this chapter tuberculous cervical lympha...

TUBERCULOUS CERVICAL LY M P H A D E N I T I S Introduction This is common in the Indian subcontinent. A young person who has recently arrived from an endemic area, presenting with cervical lymphadenopathy , should be diagnosed as having tuberculous lymphadenit...

TUBERCULOUS CERVICAL LY M P H A D E N I T I S Introduction This is common in the Indian subcontinent. A young person who has recently arrived from an endemic area, presenting with cervical lymphadenopathy , should be diagnosed as having tuberculous lymphadenit...

TYPHOID Introduction Typhoid fever is caused by Salmonella Typhi , also called the typhoid bacillus, a Gram-negative organism. Like most infec tions occurring in the tropics, the organism gains entry into the human gastrointestinal tract as a result of poor h...

Treatment Medical treatment is very e ff ective and should be the first choice in the elective situation, with surgery being reserved for complications. Metronidazole and tinidazole are the e ff ective drugs. After treatment with metronidazole and tinidazole, dil...

Anatomy of the lungs The left lung is divided by the oblique fissure, which lies nearer to the vertical than horizontal, so the upper and lower lobes could also be called anterior and posterior. On the right, the equivalent of the left upper lobe is further di...

BENIGN LUNG TUMOURS Benign tumours of the lung are uncommon and account for fewer than 15% of solitary lesions seen on chest radiographs. A peripheral tumour usually causes no symptoms until it is large; a central tumour may present with haemoptysis and sign...

CHEST TRAUMA The approach to trauma must be methodical and exact because the signs, particularly in the presence of other injury , - . - (a) (b) Figure 60.27 (a) A large solitary bulla seen on videothoracoscopy. (b) The bulla de /f_l ated and rolled in prepar...

DISORDERS OF THE CHEST WALL Tumours of the chest wall These can be tumours of any component of the chest wall, i.e. bone, cartilage and soft tissue. They are treated similarly to those that occur at other sites and require specialist surgical - input only if ...

DISORDERS OF THE PLEURA Pneumothorax Pneumothorax is the presence of air outside the lung, within the pleural space. It must be distinguished from bullae or air cysts within the lung. Bullae can be the cause of an air leak from the lung and can therefore coe...

Disorders of the diaphragm Disorders of the diaphragm can be broadly classified as disor ders of innervation, leading to paralysis of the diaphragm, with elevation and reduction of thoracic volume leading to breathlessness, and disorders of anatomy , which...

FURTHER READING Baas P , Fennell D, Kerr KM et al . Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26 (Suppl 5): v31–9. Batchelor TJP , Rasburn NJ, Abdelnour-Berchtold E et al . Guideli...

Haemoptysis Diseases causing repeated haemoptysis include carcinoma, bronchiectasis, carcinoid tumours and some infections. Severe - mitral stenosis is now a rare cause. Patients with repeated - haemoptysis should be investigated, at the very least by chest ra...

INTRODUCTION Anatomical development of the lungs The lungs are derived from an outpouching of the primitive foregut during the fourth week of intrauterine life. This bud becomes a two-lobed structure, the ends of which ultimately become the lungs. The lobar ...

Inhaled foreign bodies This is a fairly common occurrence in small children and is often marked by a choking incident that then apparently passes. Surprisingly large objects can be inhaled and become lodged in the wider calibre and more vertically placed RMB. ...

Inserting and managing a chest drain An intercostal tube connected to an underwater seal is central to the management of chest disease; however, the management of the pleura and of chest drains can be troublesome, even in experienced hands. The safest site f...

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