Search Results

THE MESENTERY GENERAL CONSIDERATIONS The arterial supply and venous and lymphatic drainage of each digestive organ are located in the mesentery . Thus diseases of individual organs can have significant e ff ects on the adjoining mesentery and its components. Th...

THE PERITONEUM The peritoneal cavity is the largest cavity in the body , the 2 surface area of its lining membrane (2 /uni00A0 m in an adult) being nearly equal to that of the skin ( 65.3 ). The peritoneal membrane is composed of flattened polyhedral cells (...

THE RETROPERITONEAL SPACE AND RETROPERITONEUM The non-mesenteric domain is posterior to the mesenteric domain. The space between both is termed the retroperitoneal space ( Figure 65.19 ) ( 65.4 ). It is a conceptual space as it contains areolar connective tiss...

THE RETROPERITONEUM The retroperitoneum is the region of the non-mesenteric domain deep to the retroperitoneal space. It contains the kidneys, adrenal glands, major vessels, ureters and gonadal vessels and is surrounded by adipose tissue. - Swellings in the r...

TUBERCULOSIS OF THE MESENTERIC L YMPH NODES Tuberculous mesenteric lymphadenitis is considerably less common than acute non-specific lymphadenitis. Tubercle bacilli, usually , but not necessarily , bovine, are ingested and enter the mesenteric lymph nodes by wa...

TUMOURS OF THE PERITONEUM Primary peritoneal malignancy Primary tumours of the peritoneum are rare. They arise in the mesothelium of the peritoneum. Mesothelioma of the peritoneum is less frequent than in the pleural cavity but is equally lethal. Asbestos is...

Treatment Abscesses less than 5 /uni00A0 cm in diameter normally resolve with intravenous antibiotic treatment. As antibiotics take e ff ect, the magnitude of the swinging pyrexia can decrease with each successive spike in temperature. Serial monitoring of C-r...

Tuberculous peritonitis Intra-abdominal tuberculosis (TB) is common in resource- poor countries; however, the incidence is rising in resource-rich countries as a consequence of migration and immunosuppres sion. Mycobacterium avium intracellulare is becoming i...

Tumours of the mesentery Primary tumours of the mesentery include carcinoid, lymphoma, sarcoma and desmoid tumours. The mesentery is a ff ected in local lymphatic spread of carcinoma arising from abdominal viscera ( Figure 65.17 ). If indicated, a benign tum...

VASCULAR ABNORMALITIES OF THE MESENTERY Acute mesenteric ischaemia ). The arterial inflow to the mesenteric domain is limited to three major vessels: the coeliac trunk and the superior and 65.5 ). Additional arterial inferior mesenteric arteries ( - inflow in t...

Volvulus of the intestine and adjoining mesentery V olvulus can only be understood if considered in mesenteric terms. Where a section of intestine is curved, the adjoining mesentery is buckle-shaped or folded. If the intestine progresses from a curve to a c...

APPLIED SURGICAL ANATOMY AND PHYSIOLOGY The oesophagus is a muscular tube connecting the pharynx to the stomach. It starts at the level of the cricoid cartilage (C6 vertebra) and ends at the oesophagogastric junction (OGJ) (opposite T11 thoracic vertebra). In...

Achalasia Pathology and aetiology The term achalasia originated from the Greek word ‘khalasis’, meaning ‘failure to relax’. It is uncommon, with a prevalence of 1.8–12.6 per 100 000 persons per year. The aetiology Leopold Auerbach , 1828–1897, neuropathologis...

Aetiology Iatrogenic perforation secondary to endoscopic procedures such as dilatation of strictures or achalasia is the most common cause. Other endoscopic procedures such as EMR/ESD/ - POEM may result in leakage if there is transmural disruption and mucosa...

Ambulatory reflux and combined pH– impedance monitoring Ambulatory reflux monitoring is considered one of the most important confirmatory tests for GORD. There are two types of monitoring devices: catheter based and wireless capsule ( Figure 66.11 ). Both measu...

BARRETT’S OESOPHAGUS Diagnosis and definitions Barrett’s oesophagus is a known complication of GORD. First described in 1950 as peptic ulceration in a tubular organ lined by columnar epithelium, it was interpreted as an intrathoracic tubular stomach with a con...

Benign pathologies Benign epithelial lesions include papillomas, fibrovascular polyps, glycogen acanthosis, parakeratosis, lipomas, lymph - angiomas and haemangiomas. They are benign, though parakeratosis is associated with malignancy of the oesophagus and hea...

CARCINOMA OF THE OESOPHAGUS Epidemiology Oesophageal cancer is the eighth most common cancer worldwide and the sixth most common cause of cancer death. It most commonly presents in the sixth and seventh decades of life. Squamous cell carcinoma and adenocarci...