Table Of ContentC LINIC A L
IN T EGR AT ION:
SURGERY
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Hx Ex Ix Rx
C L INIC A L
IN T E GR AT ION:
Student reviewers
Our medical textbooks are assessed and reviewed by the following medical students:
University of Aberdeen School of Medicine and Dentistry: Dylan McClurg
Barts and The London School of Medicine and Dentistry: Jay Singh SURGERY
University of Birmingham College of Medical and Dental Sciences: Hannah Morgan
Cardiff University School of Medicine: Chloe Chia
The University of Edinburgh Medical School: Tanith Bain
University of Exeter Medical School: Zoe Foster
Hull York Medical School: Maalik Imtiaz
King’s College London GKT School of Medical Education: Karan Sagoo
University of Liverpool School of Medicine: Sophie Gunter
University of Manchester Medical School: Holly Egan Edited by
Newcastle University School of Medical Education: Jenita Jona James
Norwich Medical School: Aneesa Khan
University of Nottingham School of Medicine: Tom Charles Samuel Chee
(MBBS (Hons))
University of Sheffield Medical School: Rebecca Nutt
St George’s, University of London: Nawshin Basit
Swansea University Medical School: Jack Bartlett Manda Raz (MBBS (Hons))
University of Central Lancashire School of Medicine: Katie Chi Kei Cheung
University College London Medical School: Camila Nicklewicz
Asiri Arachchi
(MBBS Dip Surg Anatomy FRACS (General Surgery))
We are grateful for their essential feedback.
Additional student reviewers wanted
We are keen to recruit more student reviewers, particularly at UK medical schools where we don’t
currently have anyone in post. If you would like to apply for the position, please contact Simon Watkins
([email protected]) and explain why you would be suitable for the role.
Feedback, errors and omissions
We are always pleased to receive feedback (good and bad) about our books – if you would like to comment on
any of our books, please email [email protected].
We’ve worked really hard with the authors to ensure that everything in the book is correct. However, errors
and ambiguities can still slip through in books as complex as this. If you spot anything you think might be
wrong, please email us and we will look into it straight away. If an error has occurred, we will correct it for
future printings and post a note about it on our website so that other readers of the book are alerted to this.
Thank you for your help.
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Hx Ex Ix Rx
C L INIC A L
IN T E GR AT ION:
Student reviewers
Our medical textbooks are assessed and reviewed by the following medical students:
University of Aberdeen School of Medicine and Dentistry: Dylan McClurg
Barts and The London School of Medicine and Dentistry: Jay Singh SURGERY
University of Birmingham College of Medical and Dental Sciences: Hannah Morgan
Cardiff University School of Medicine: Chloe Chia
The University of Edinburgh Medical School: Tanith Bain
University of Exeter Medical School: Zoe Foster
Hull York Medical School: Maalik Imtiaz
King’s College London GKT School of Medical Education: Karan Sagoo
University of Liverpool School of Medicine: Sophie Gunter
University of Manchester Medical School: Holly Egan Edited by
Newcastle University School of Medical Education: Jenita Jona James
Norwich Medical School: Aneesa Khan
University of Nottingham School of Medicine: Tom Charles Samuel Chee
(MBBS (Hons))
University of Sheffield Medical School: Rebecca Nutt
St George’s, University of London: Nawshin Basit
Swansea University Medical School: Jack Bartlett Manda Raz (MBBS (Hons))
University of Central Lancashire School of Medicine: Katie Chi Kei Cheung
University College London Medical School: Camila Nicklewicz
Asiri Arachchi
(MBBS Dip Surg Anatomy FRACS (General Surgery))
We are grateful for their essential feedback.
Additional student reviewers wanted
We are keen to recruit more student reviewers, particularly at UK medical schools where we don’t
currently have anyone in post. If you would like to apply for the position, please contact Simon Watkins
([email protected]) and explain why you would be suitable for the role.
Feedback, errors and omissions
We are always pleased to receive feedback (good and bad) about our books – if you would like to comment on
any of our books, please email [email protected].
We’ve worked really hard with the authors to ensure that everything in the book is correct. However, errors
and ambiguities can still slip through in books as complex as this. If you spot anything you think might be
wrong, please email us and we will look into it straight away. If an error has occurred, we will correct it for
future printings and post a note about it on our website so that other readers of the book are alerted to this.
Thank you for your help.
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© Scion Publishing Ltd, 2021
First published 2021
All rights reserved. No part of this book may be reproduced or transmitted, in any form or by
any means, without permission.
A CIP catalogue record for this book is available from the British Library.
ISBN 9781911510772
Scion Publishing Limited
The Old Hayloft, Vantage Business Park, Bloxham Road, Banbury OX16 9UX, UK
www.scionpublishing.com
Important Note from the Publisher
The information contained within this book was obtained by Scion Publishing Ltd
from sources believed by us to be reliable. However, while every effort has been made
to ensure its accuracy, no responsibility for loss or injury whatsoever occasioned to
any person acting or refraining from action as a result of information contained herein
can be accepted by the authors or publishers.
Readers are reminded that medicine is a constantly evolving science and while the
authors and publishers have ensured that all dosages, applications and practices
are based on current indications, there may be specific practices which differ
between communities. You should always follow the guidelines laid down by the
manufacturers of specific products and the relevant authorities in the country in
which you are practising.
Although every effort has been made to ensure that all owners of copyright material
have been acknowledged in this publication, we would be pleased to acknowledge in
subsequent reprints or editions any omissions brought to our attention.
Registered names, trademarks, etc. used in this book, even when not marked as such,
are not to be considered unprotected by law.
Typeset by Evolution Design & Digital Ltd, Kent, UK
Printed in the UK
Last digit is the print number: 10 9 8 7 6 5 4 3 2 1
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CONTENTS
© Scion Publishing Ltd, 2021
First published 2021
All rights reserved. No part of this book may be reproduced or transmitted, in any form or by
About the editors viii
any means, without permission.
List of contributors ix
A CIP catalogue record for this book is available from the British Library. Preface x
ISBN 9781911510772 Abbreviations xi
Chapter 1 Cardiothoracic surgery 1
Scion Publishing Limited Case 1 Aortic stenosis 1
Case 2 Infective endocarditis 6
The Old Hayloft, Vantage Business Park, Bloxham Road, Banbury OX16 9UX, UK
Case 3 Ischaemic heart disease 12
www.scionpublishing.com Case 4 Lung cancer 18
Case 5 Mediastinal mass 25
Important Note from the Publisher
Case 6 Mitral regurgitation 30
The information contained within this book was obtained by Scion Publishing Ltd Case 7 Pleural empyema 35
from sources believed by us to be reliable. However, while every effort has been made
Case 8 Spontaneous pneumothorax 41
to ensure its accuracy, no responsibility for loss or injury whatsoever occasioned to
Case 9 Thoracic trauma 47
any person acting or refraining from action as a result of information contained herein
Case 10 Type A aortic dissection 54
can be accepted by the authors or publishers.
Readers are reminded that medicine is a constantly evolving science and while the Chapter 2 ENT surgery 59
authors and publishers have ensured that all dosages, applications and practices
Case 11 Acoustic neuroma 59
are based on current indications, there may be specific practices which differ
Case 12 Acute bacterial parotitis 65
between communities. You should always follow the guidelines laid down by the
Case 13 Acute otitis media 71
manufacturers of specific products and the relevant authorities in the country in
which you are practising. Case 14 Acute rhinosinusitis 77
Case 15 Epistaxis 82
Although every effort has been made to ensure that all owners of copyright material
Case 16 Foreign body 88
have been acknowledged in this publication, we would be pleased to acknowledge in
subsequent reprints or editions any omissions brought to our attention. Case 17 Oropharyngeal cancer 94
Case 18 Peritonsillar abscess 100
Registered names, trademarks, etc. used in this book, even when not marked as such,
Case 19 Retropharyngeal abscess 106
are not to be considered unprotected by law.
Case 20 Thyroid cancer 113
Chapter 3 General surgery 119
Case 21 Abdominal trauma 119
Case 22 Acute cholecystitis 125
Case 23 Acute pancreatitis 130
Case 24 Diverticulitis 134
Case 25 Groin hernia 139
Case 26 Large bowel obstruction 142
Case 27 Perianal abscess 147
Case 28 PR bleeding 150
Case 29 Sigmoid volvulus 153
Case 30 Small bowel obstruction 156
Typeset by Evolution Design & Digital Ltd, Kent, UK
Printed in the UK
Last digit is the print number: 10 9 8 7 6 5 4 3 2 1
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vi CONTENTS
Chapter 4 Neurosurgery 161
Case 31 Cauda equina syndrome 161
Case 32 Cervical myelopathy/radiculopathy 166
Case 33 CNS tumour 172
Case 34 Extradural haemorrhage 178
Case 35 Hydrocephalus 184
Case 36 Lumbar myelopathy/radiculopathy 189
Case 37 Pituitary apoplexy 195
Case 38 Subarachnoid haemorrhage 201
Case 39 Subdural haematoma 206
Case 40 Traumatic spinal cord injury 211
Chapter 5 Orthopaedic surgery 217
Case 41 Ankle injury 217
Case 42 Anterior cruciate ligament injury 223
Case 43 Colles’ fracture 229
Case 44 Monoarticular arthropathy 235
Case 45 Neck of femur fracture 241
Case 46 Neck trauma 248
Case 47 Open fracture 253
Case 48 Osteoarthritis and total hip replacement 259
Case 49 Osteosarcoma 265
Case 50 Rotator cuff injury 269
Chapter 6 Paediatric surgery 273
Case 51 Appendicitis 273
Case 52 Hirschsprung disease 279
Case 53 Hypospadias 285
Case 54 Inguinal hernias 290
Case 55 Intestinal malrotation with volvulus 294
Case 56 Intussusception 300
Case 57 Necrotising enterocolitis 304
Case 58 Neonatal bowel atresias 311
Case 59 Ovarian torsion 317
Case 60 Pyloric stenosis 321
Chapter 7 Plastic surgery 325
Case 61 Breast lump and lymphoedema 325
Case 62 Burns in a child and non-accidental injury 330
Case 63 Carpal tunnel syndrome 335
Case 64 Cleft lip and palate 338
Case 65 Electrical burns in an adult 342
Case 66 Hand contractures and trigger finger 347
Case 67 Hand injuries and digit amputation 351
Case 68 Pressure ulcers 357
Case 69 The purple spot 361
Case 70 The skin lesion 366
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CONTENTS vii
Chapter 8 Urology 371
Case 71 Fournier’s gangrene 371
Case 72 Haematuria 374
Case 73 Prostate cancer 377
Case 74 Pyelonephritis 381
Case 75 Renal cancer 384
Case 76 Renal colic 387
Case 77 Renal trauma 390
Case 78 Testicular cancer 393
Case 79 Testicular torsion 395
Case 80 Urinary retention 398
Chapter 9 Vascular surgery 401
Case 81 Abdominal aortic aneurysm 401
Case 82 Acute limb ischaemia 406
Case 83 Carotid artery disease 412
Case 84 Chronic limb ischaemia 417
Case 85 Chronic venous insufficiency 422
Case 86 Deep venous thrombosis 427
Case 87 Diabetic foot 432
Case 88 Lymphoedema 438
Case 89 Type B aortic dissection 444
Case 90 Varicose veins 449
Index of conditions 455
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ABOUT THE EDITORS
Dr Samuel Chee
MBBS (Hons)
Samuel Chee is an Australian junior doctor with a keen interest in orthopaedic surgery,
trauma and teaching. He completed his MBBS from Monash University, Australia in 2018, and
is currently studying for his MTrauma (Orth) at the University of Newcastle, Australia. He is
also an adjunct lecturer for Monash University, providing teaching to medical students at The
Alfred Hospital.
Dr Manda Raz
MBBS (Hons)
Manda Raz is an Australian doctor affiliated with Peninsula Health in Melbourne, with a broad
interest in academia, research and acute care medicine. He completed his MBBS from Monash
University, Australia. Dr Raz is the recipient of several scholarships, awards and medals for his
academic achievements and contribution to empirical research and clinical governance. He
is also the author and editor of multiple books and reference works spanning a number of
clinical, legal and administrative specialties, and is currently studying for his MBioethics.
Dr Asiri Arachchi
MBBS Dip Surg Anatomy FRACS (General Surgery)
Asiri Arachchi is a general surgeon, researcher and academician, and is currently pursuing
subspecialty fellowship training in colorectal surgery. He has an interest in teaching and
mentoring doctors and students.
viii
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