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02:0902:09, 28 February 2026 Mastectomy (hist | edit) [4,409 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Options''' == * Simple/total mastectomy - complete removal of mammary gland, including NAC * Modified radical - simple mastectomy + complete axillary lymph node dissection == '''Preparation''' == * Mark side * Imaging in theatre * Consider need for blue dye/lymphoscintigraphy == '''Simple mastectomy''' == * '''Principles''' ** Resection of all glandular tissue of the breast ** Dissection down to pectoralis fascia * '''Pitfalls''' ** Skin flaps too thick or th...") Tag: Visual edit
02:0802:08, 28 February 2026 Sentinel lymph node biopsy (hist | edit) [2,900 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Goal:''' == * To stage the axilla == '''Principles:''' == * Dual localisation * Aim for 1-3 nodes == '''Pitfalls:''' == * Inadequate nodal harvest * Taking more nodes than is necessary == '''SLNB localisation techniques''' == * '''<sup>99m</sup>Tc-labeled sulphur colloid combined with intra-op gamma probe''' ** Considered safe in pregnancy ** <24 hours pre-op * '''Blue dye - 3-5mL''' ** Can use either '''patent blue/isosulfan blue''' (50mg in 2mL, diluted u...") Tag: Visual edit
02:0802:08, 28 February 2026 Breast wide local excision (hist | edit) [2,584 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Principles''' == * Localisation technique for non-palpable tumours * Clear margin of tissue around the lesion 1cm * Always consider SLNB == '''Pitfalls''' == * Inadequate margins * Failure to resect down to fascia * Poor planning of incision * Inadequate orientation/imaging of specimen == '''Tumour localisation techniques''' == * If palpable, can use palpation guidance * If non-palpable, need hookwire (also radioactive seed localisation) * >3cm nonpalpable le...") Tag: Visual edit
02:0702:07, 28 February 2026 Gynaecomastia (hist | edit) [3,827 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Benign proliferation of the glandular tissue of the male breast. == '''Aetiology''' == * '''Most commonly:''' ** Physiological high serum oestradiol to testosterone (25%) *** Neonates *** Puberty *** Elderly ** Drugs (20%) *** Spironolactone *** Recreational including THC *** Oestrogens *** Etc. ** No detectable abnormality (25%) ** Increased oestrogens: (10%) *** Cirrhosis/malnutrition *** Testicular tumours *** Hyperthyroidism ** Decreased androgens: (10%) *** Hyp...") Tag: Visual edit
02:0702:07, 28 February 2026 Breast abscess (hist | edit) [6,090 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "Localised collection of inflammatory exudate in the breast tissue. == '''Risk factors''' == * Obese * Smokers * Maternal age >30 years * First pregnancy * Problems with breastfeeding == '''Pathophysiology''' == * Complication of mastitis (cellulitis with breast parenchymal inflammation and swelling) * Mastitis can develop in two ways ** Lactational infections *** Something inhibits milk drainage (nipple trauma and oedema, dehydration and inspissation, oversupply, fee...") Tag: Visual edit
02:0602:06, 28 February 2026 Fibrocystic disease (hist | edit) [1,158 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " A spectrum of clinical, mammographic and histologic findings. Called 'not useful clinically' by multiple sources, as it refers to a heterogenous group of diseases and is found to some extent in the majority of women. Probably just an archaic term to be avoided - use the specific pathological correlate instead. == Epidemiology == * Common in 30-50yo women * Lasts until menopause == Pathophysiology == * Exaggerated response of breast stroma and epithelium to various c...") Tag: Visual edit
02:0602:06, 28 February 2026 Benign breast lesions (hist | edit) [13,643 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Progression''' == * Mild ductal hyperplasia -> florid ductal hyperplasia -> atypical ductal hyperplasia -> DCIS * Columnar cell change -> columnar hyperplasia -> flat epithelial atypia * Fibroadenoma -> complex/giant fibroadenoma == '''Non-proliferative''' (RR of lifetime breast cancer ~1.2-1.4x) == === '''Breast cysts''' === ** Pathophysiology *** Fluid-filled, round or ovoid masses derived from the terminal duct lobular unit, lined with epithelium *** Appear...") Tag: Visual edit
02:0502:05, 28 February 2026 Breast cancer genetics (hist | edit) [5,040 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Epidemiology == * Associated with 5-10% of all breast cancers, but 25% of cases in women <30yo * Overall rare (BRCA found in 0.1% of USA population, and up to 1% of Ashkenazi Jews) * Estimate individual risk of carrying mutation with <nowiki>https://canrisk.org/canrisk_tool/</nowiki> == List of syndromes and associated lifetime cancer risk == * TP53 - 85% * BRCA 1 and 2 - 70% * PALB - 55% * ATM - 50% * PJS - 45% * Cowden syndrome - 40% * CDH1 - 35% * NF1 - 30% * CH...") Tag: Visual edit
02:0402:04, 28 February 2026 Breast lymphoma (hist | edit) [619 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) * Rare T cell NHL that develops in capsular tissue * Usually in textured implants, rather than smooth * 1:3,000 to 1:30,000 * Pathophysiology ** Potentially related to chronic subacute infection/biofilm, and sustained T cell response * Usually presents as a delayed-onset painless seroma 3-14 years after implantation * Evaluate with MRI, cytology CD30+, capsular or LN biopsy * Treatment: ** Removal of i...") Tag: Visual edit
02:0402:04, 28 February 2026 Prophylactic mastectomy (hist | edit) [448 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "(in the setting of breast cancer susceptibility gene) == Indications == * Patient preference, plus * Confirmed deleterious mutation in a breast cancer susceptibility gene ** BRCA ** TP53 ** PTEN ** CDH1 ** STK11 * Or ** Strong family history ** History of thoracic radiation == Evidence == * Reduces the risk of developing cancer by >90% Reasonable to offer it if the above conditions are met, without too much controversy Category:Breast") Tag: Visual edit
02:0302:03, 28 February 2026 Contralateral prophylactic mastectomy (hist | edit) [900 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " (for patients who have had breast cancer on one side) == Rationale == * Reduce the risk of contralateral breast cancer ** If no BRCA: about 0.4-1% per year cumulative risk over their lifetime ** If BRCA: 10-25% (but might be much higher) * Ease of follow-up * Reduce anxiety * Desire for symmetry == Key discussion points: == * No survival benefit if high-risk conditions are not present * Rationalise perceived vs actual risks * Doesn't change the risk of current cance...") Tag: Visual edit
02:0202:02, 28 February 2026 LCIS (hist | edit) [2,123 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "A non-invasive lesion that arises from the lobules and terminal ducts of the breast. == Pathophysiology == * Recognised by its conformity to the outline of the normal lobule, with expanded and filled acini * Variant - pleomorphic LCIS - a distinct, more aggressive subtype ** Shows nuclear pleomorphism compared with classic LCIS ** One or more lobules are distended by discohesive cells with irregularly-shaped, high-grade nuclei ** May or may not be associated with comed...") Tag: Visual edit
02:0202:02, 28 February 2026 DCIS (hist | edit) [7,984 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Pre-invasive breast malignancy, remaining confined within the ductal system == Epidemiology == * Accounts for 25% of all newly-diagnosed breast cancers == Risk factors == * Essentially the same as for invasive breast cancer == Pathophysiology == * Discrete spaces filled with malignant cells, usually with a recognisable basal cell layer composed of presumably normal myoepithelial cells * Spreads along the 'galactophoric tree' and often is continuous along the branc...") Tag: Visual edit
02:0102:01, 28 February 2026 Recurrent breast cancer (hist | edit) [1,952 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Patterns''' == * Local recurrence ** True recurrence - at lumpectomy site ** Marginal miss - recurrence close to but not within the boost volume ** Elsewhere recurrence - different quadrant to original procedure * Regional recurrence - draining lymph nodes - axillary, infraclavicular, supraclavicular, internal mammary * Metastatic disease == '''Predicting recurrence''' == * See entry under 'breast cancer' == '''Scenarios''' == * '''Ipsilateral breast tumour r...") Tag: Visual edit
02:0102:01, 28 February 2026 Inflammatory breast cancer (hist | edit) [3,865 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " ''A clinicopathologic subtype of invasive breast cancer, featuring rapidly aggressive cancer along with diffuse erythema and oedema.'' == Epidemiology == * Rare - 1-5% of all breast cancers * Often seen <1 year after negative screening mammogram == Pathophysiology == * No unique histologic subtype, molecular markers or genetic signature to account for inflammatory phenotype * Mostly ductal, but can be lobular * More likely to display aggressive features - high-grade...") Tag: Visual edit
02:0002:00, 28 February 2026 Breast cancer (hist | edit) [58,347 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== '''Epidemiology''' == * Second only to lung cancer for cancer-related deaths * 2 million cases worldwide annually * Recently decreasing incidence, probably due to screening and decreased use of HRT == '''Risk factors''' == === '''Un-modifiable''' === ** Increasing age *** Rare in women <20yo *** Steadily increases with age, up to 1 in 8 by age 80 ** Female sex *** <1% occurs in men *** Masses in men are more likely to be non-cancerous than cancerous ** Reproductiv...") Tag: Visual edit
01:5701:57, 28 February 2026 Paget disease of the nipple (hist | edit) [1,650 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Eczema-like changes in the skin of the NAC, in association with an underlying breast cancer == Epidemiology == * Accounts for <1% of breast malignancies * 90% of patients with Paget disease have an underlying breast carcinoma == Pathophysiology == * Paget cell - large, pale-staining cell with round or oval nuclei and large nucleoli located between the normal keratinocytes of the nipple epidermis * Theories of development ** Epidermotropic - perhaps more likely - Pag...") Tag: Visual edit
01:5701:57, 28 February 2026 Breast screening (hist | edit) [4,296 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Breast self-examination == * Failed to show reduction in mortality amongst women of average risk * De-emphasised in modern guidelines, but still should be valued == Clinical breast examination == * Effectiveness depends on technique and time spent on examination == Mammography == * See below for BreastScreen recommendations * Primary imaging modality * Mediolateral oblique projection and craniocaudal projection * Appears to be most effective for 60-70 year olds *...") Tag: Visual edit
01:5601:56, 28 February 2026 Nipple discharge (hist | edit) [4,163 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Accounts for 5% of all breast clinic referrals, but is usually innocent == '''Aetiology''' == === Pathological (suspicious) === ** Cancer (4-5%) ** Solitary intra-ductal papilloma (60-80%) ** Subareolar duct ectasia (20%) ** Infection === Physiological - galactorrhoea - mostly secondary to hyperprolactinaemia/drug-induced - generally copious, milky bilateral discharge === ** Primary pituitary tumour ** Hypothyroidism ** Medication - primarily antipsychotics, antide...") Tag: Visual edit
01:5501:55, 28 February 2026 Mastalgia (hist | edit) [1,561 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Not typically a sign of cancer Can be hard to find a diagnosis, quite vague symptoms == '''History''' == * Establish timeline * Aggravating/alleviating factors * Unilateral or both breasts * Cyclical/related to menstrual cycle ** Cyclical is more reassuring - almost physiological ** Tender nodularity is quite reassuring (this is what used to be called fibrocystic disease) * Aim is to differentiate between mastalgia and chest wall pain ** Chest wall pain is unilateral...") Tag: Visual edit
01:5501:55, 28 February 2026 Suspicious breast lesion (hist | edit) [1,581 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Principles == * Any suspicious palpable breast mass requires additional imaging and diagnostic biopsy * '''Triple test''' - the combination of clinical, radiological and pathological evaluation of a breast lump ** Should be used for all solid breast lumps or asymmetric localised nodularity ** Clinical history and examination, mammogram (if >40yo) and USS, non-excisional biopsy (usually core) ** Sensitivity of 99.6% for cancer ** Companion recommends scoring all comp...") Tag: Visual edit
01:5401:54, 28 February 2026 Breast biopsy techniques (hist | edit) [4,163 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == FNA == * Technique ** 21-23-gauge needle, 10mL syringe, USS ** Clean skin, fix the lump between thumb and forefinger, and put the needle tip into the lesion ** Generate negative pressure and move the tip back and forth within the lesion ** Remove the needle ** Make a smear of aspirate on the glass slide and spray it with a fixative * Does not differentiate non-invasive lesions from invasive, if malignant cells are identified * Can have a role in proving multi-focal...") Tag: Visual edit
01:5301:53, 28 February 2026 Breast imaging (hist | edit) [7,094 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== '''Mammogram''' == ** Situations where it is difficult to get images/interpret *** <4cm breast tissue when compressed *** Usually possible to get some images in a man, although not always, and not always useful *** '''Sensitivity limited by breast density'''. Difficult to read in women <30yo. Useful only with high suspicion of malignancy in 30-40yo (start off with mammogram, then try MRI if too dense). Higher fat content is helpful for reading mammograms. **** 95% se...") Tag: Visual edit
01:5201:52, 28 February 2026 Breast history and exam (hist | edit) [2,233 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''History''' == * '''HPC''' ** Lump *** Changes with cycle ** Mastalgia *** See separate topic ** Nipple discharge ** Change in shape ** Skin changes ** Cancer symptoms *** Constitutional symptoms *** Bone pain *** Weight loss *** Respiratory changes * '''Systems history''' ** Age ** Reproductive history *** Age at menarche *** Age at menopause *** Pregnancies including age at first full-term pregnancy *** Breastfeeding ** HRT and COCP ** History of breast disease...") Tag: Visual edit
01:3001:30, 28 February 2026 Hepaticojejunostomy (hist | edit) [1,913 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Indications == * Part of the biliary tree has been excised * Part of the tree has been damaged * Definitive drainage procedure is required == Principles == * 40cm alimentary limb * Retrocolic biliary limb == Technique == * Right subcostal incision * Explore ** Check for accessory RHA arising from SMA in the lateral border of hepatoduodenal ligament * Cholecystectomy ** Dissect Calot's, ligate and divide cystic artery and duct ** Expose junction of CBD and cystic...") Tag: Visual edit
01:3001:30, 28 February 2026 Liver implantation (hist | edit) [2,306 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Recipient hepatectomy: == * Bilateral subcostal incision (2-3cm lower if patient has ascites) with midline extension (right more laterally) * Divide and ligate round ligament * Divide falciform ligament towards suprahepatic vena cava * Place mechanical retractor * Left coronary and triangular ligaments divided * Reflect segments II and III to right and gastrohepatic ligament divided * CHA divided and clamped with bulldog (need to clamp common hepatic artery first to...") Tag: Visual edit
01:2901:29, 28 February 2026 Donor hepatectomy (hist | edit) [1,860 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "* Supine, both arms tucked * Drape chest, abdomen, proximal thighs * Midline incision from suprasternal notch or xiphoid process to pubis * Balfour to expose abdomen +/- sternal retractors if chest is opened * Explore for contraindications to explant, and evaluate liver (size and parenchymal quality) ** Look for sharp edges, smooth surface with appearance of scratching marks, and brownish surface colour * Abdominal dissection ** Divide round ligament between two heavy si...") Tag: Visual edit
01:2901:29, 28 February 2026 Distal pancreatectomy (hist | edit) [1,840 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Indications == * Chronic inflammation * Trauma * Tumour == Principles == * Conventionally includes splenectomy - best option for non-HPB surgeons * Conservative distal pancreatectomy is spleen-sparing - can be done for low-grade endocrine tumours * Splenic vaccinations beforehand == Technique for distal pancreatectomy and splenectomy == * Transverse subcostal incision * Expose pancreas by separating omentum from transverse mesocolon and entering lesser sac * F...") Tag: Visual edit
01:2901:29, 28 February 2026 Pancreaticoduodenectomy (hist | edit) [5,408 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Resection of: == * Distal stomach * Duodenal loop and DJ flexure * Distal CBD * Head and uncinate process of pancreas == History == * First described 1909 (Kausch) * First successful resection 1935 (Whipple) * First performed in one stage 1941 (Trimble) == Pre-op: == * No absolute upper age limit, but need to be very careful >75yo == Controversies == * Pylorus-preserving (conservative) vs non-pylorus-preserving (conventional) ** No RCTs have suggested superio...") Tag: Visual edit
01:2801:28, 28 February 2026 Pringle manoeuvre (hist | edit) [868 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Technique == * Finger through the Foramen of Winslow, and pinch the portal triad * Then make a diathermy window through lesser omentum, taking care to avoid right gastric artery and accessory left hepatic artery * A vascular clamp or tape can then be applied ** Tape can be controlled using a Rummel tourniquet: length of tubing, make a loop with silk ligature, then pass the two ends of the tape through the loop and tighten the tubing * Failure to control bleeding wit...") Tag: Visual edit
01:2701:27, 28 February 2026 Pancreatic exposure (hist | edit) [864 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Incision * Bilateral subcostal or curved transverse incision midway between umbilicus and xiphoid Whole pancreas * Requires both mobilisation of the duodenum and entry into the lesser sac * Kocher's: mobilise the duodenal loop and pancreatic head * Anterior exposure of the pancreas by entering the lesser sac through the greater or lesser omentum, and take down the congenital adhesions between posterior stomach and pancreas ** Superior and inferior borders of pancre...") Tag: Visual edit
01:2501:25, 28 February 2026 Percutaneous transhepatic cholangiography (hist | edit) [4,540 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "PTC == Indications == * Benign biliary strictures * Biliary ductal injuries and leaks * Decompression of cholangitis * Biliary duct biopsy * Stone removal * Palliation of malignant biliary obstruction * Occasional endoluminal therapies such as radiation, photodynamic therapy, and drug infusion == Contraindications == * Absolute ** Significant coagulopathy that cannot be corrected (platelets < 50 or INR >1.7) * Relative ** Diffuse polycystic liver disease ** Hepatic c...") Tag: Visual edit
01:2401:24, 28 February 2026 Liver abscess/hydatid (hist | edit) [737 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Abscess drainage == * Aspirate with a needle to confirm location * Incise into the cavity and clean it out * Drain == Hydatid drainage == * Four weeks of albendazole prior * Have available a scolicidal agent to wash out the cyst and kill remaining scolices - absolute alcohol * Sterile black towels to pack off the surrounding tissues * Warn anaesthetist of risk of anaphylaxis * Gently separate the cyst from its fibrinous adhesions to surrounding tissues so you have...") Tag: Visual edit
01:2301:23, 28 February 2026 Liver resection (hist | edit) [5,164 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Principles''' == * It is possible to remove any single segment with jeopardising blood supply or biliary or venous drainage to the rest of the liver, but sometimes it is easier to remove more than just the involved segment * Most blood loss comes from hepatic veins - operate with a low central venous pressure (central line, mild Trendelenburg, fluid restriction, and venodilators if necessary, aiming central venous pressure <5mmHg) * To decrease mortality, minim...") Tag: Visual edit
01:2201:22, 28 February 2026 CBD exploration (hist | edit) [3,136 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== Conditions favouring CBDE: == * CBD diameter <7mm * Stone location distal to cystic duct/CBD confluence * Cystic duct diameter >4mm * Fewer than 6-8 CBD stones * Stones smaller than 10mm * Lateral entrance of cystic duct to CBD == '''Technique''' for trans-cystic == * Consider cystic duct dilation with a balloon * Insert raytec to help catch stones once removed * Duct access and clearance ** '''Choledochoscopy''' *** Dissect down to bottom of cystic duct and make a...") Tag: Visual edit
01:2101:21, 28 February 2026 Pancreatic endocrine insufficiency (hist | edit) [403 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == Pathophysiology == * Destruction or removal of 85% of islet cell mass is necessary before endocrine insufficiency becomes clinically apparent in the form of diabetes * 20-50% of patients will develop it after pancreatic resection, but hard to predict who * Total pancreatectomy unquestionably leads to brittle diabetes, due to the lack of glucagon to balance exogenous insulin") Tag: Visual edit
01:2101:21, 28 February 2026 Haemosuccus pancreaticus (hist | edit) [403 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Bleeding from the pancreatic duct through the ampulla of Vater * As opposed to haemobilia, which is bleeding into the hepatobiliary tree == Aetiology == === Pancreatic === ** Acute and chronic pancreatitis ** PDAC ** Pancreatic duct stones ** Iatrogenic - instrumentation of PD === Vascular structures === ** Splenic artery pseudoaneurysms ** Hepatic artery pseudoaneurysms Category:Pancreas") Tag: Visual edit
01:2101:21, 28 February 2026 Non-insulinoma pancreatogenous hypoglycaemia syndrome (hist | edit) [1,033 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " NIPHS == Epidemiology == * Usually a disease of infancy, but in rare cases identified in adults == Pathophysiology == * Excessive pancreatic B cell function, with associated pathologic changes including pancreatic islet cell hyperplasia and dysplasia, and histologic identification of B cells budding from and in apposition to pancreatic ductal structures * A recognised complication of bariatric surgery, especially RYGB == Presentation == * Hallmark is post-prandial...") Tag: Visual edit
01:2001:20, 28 February 2026 Pancreatic fistula (hist | edit) [417 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "An abnormal connection between pancreatic tissue and an adjacent or distant space/organ/skin * Characterised by leakage of pancreatic fluid as a consequence of disrupted pancreatic ducts == Initial evaluation - consider: == * Symptoms * Location of fistula * Complications == Indications for intervention: == * Significant symptoms * Infected pancreatic necrosis Otherwise, supportive care Category:Pancreas") Tag: Visual edit
01:2001:20, 28 February 2026 Annular pancreas (hist | edit) [441 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Aberrant migration of the ventral pancreatic bud, leading to circumferential or near-circumferential pancreas tissue surrounding D2 == Risk factors == * Associated with other congenital defects - Down syndrome, malrotation, intestinal atresia, cardiac malformations == Complications == * Obstruction ** Dividing the pancreatic tissue will likely lead to pancreatic fistula formation ** Treat with surgical bypass Category:Pancreas") Tag: Visual edit
01:1901:19, 28 February 2026 Pancreas divisum (hist | edit) [2,957 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "Failure of the dorsal and ventral ducts to fuse during embryogenesis * Leads to partial obstruction of the main pancreatic duct at the minor papilla, leading to chronic back pressure * May cause relapsing acute or chronic pancreatitis == '''Epidemiology''' == * Most common variant of dominant dorsal duct anatomy * As common as left-handedness - 10% == '''Pathophysiology''' == * Controversial as to whether it actually causes pancreatitis ** Could outflow obstruction...") Tag: Visual edit
01:1901:19, 28 February 2026 Heterotopic/ectopic pancreas (hist | edit) [813 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Functioning pancreatic tissue in an abnormal anatomic location == Epidemiology == * Found in 0.5-14% of autopsy specimens * Can arise anywhere in foregut * Most common location is within the stomach, typically along the antral greater curvature * Also within duodenum and Meckel's == Presentation == * Typically vague abdominal pain * Can cause bowel obstruction by intussusception, bleeding and ulceration * Reports of pancreatitis, islet cell tumours, and pancreatic a...") Tag: Visual edit
01:1801:18, 28 February 2026 Pancreatic neuroendocrine tumours (hist | edit) [11,168 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "'''Pancreatic neuroendocrine tumours/neoplasms (PNETs)''' * Rare malignancies arising from pluripotent cells within the pancreas (not the same origin as GIT NETs) * Tend to be more indolent than pancreatic adenocarcinoma * Can secrete a variety of peptide hormones, although >50% are non-functioning * Previously called 'islet cell tumours' == '''Epidemiology''' == * Accounts for <3% of pancreatic neoplasms * Accounts for 75% of all gastroenteropancreatic NETs * Inciden...") Tag: Visual edit
01:1501:15, 28 February 2026 Pancreatic lesions (hist | edit) [13,113 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "== '''Pancreatic cystic lesion differential''' == * '''Unilocular''' ** Pseudocyst ** IPMN ** Serous cystadenoma ** Simple pancreatic cyst ** Cystic neuroendocrine tumour of the pancreas * '''Diffuse pancreatic cysts''' ** In association with VHL, ADPKD, isolated poycystic disease of the pancreas, or pancreatic cystosis (in CF) * '''Macrocystic: multilocular''' ** Mucinous cystic neoplasm of the pancreas ** IPMN ** Serous cystadenoma ** Acinar cell cystadenocarcinoma **...") Tag: Visual edit
01:1301:13, 28 February 2026 Pancreatic cancer (hist | edit) [12,414 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "(Pancreatic ductal adenocarcinoma) == '''Epidemiology''' == * Increasing incidence - unknown reason * 3rd most common cause of cancer death in USA * Men more commonly affected * Mean age at diagnosis 72yo * 4000 cases annually in Australia. 10th most common, 4th most deadly. == '''Risk factors''' == * Genetic ** PRSS1 (familial pancreatitis) - 40% lifetime risk ** SPINK1 (familial pancreatitis) - 50x risk ** STK11 (Peutz-Jeghers) - 100x lifetime risk ** CDKN2A (famil...") Tag: Visual edit
01:1301:13, 28 February 2026 Elevated lipase (hist | edit) [1,346 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " Approach to elevated lipase: Note that lipase is not specific for pancreatic disease {| class="wikitable" |Pancreatic disease |- |Pancreatitis |- |Complications of pancreatitis (pseudocysts, abscess) |- |Trauma |- |Surgery |- |Endoscopic retrograde cholangiopancreatography (ERCP) |- |Ductal obstruction |- |Pancreatic carcinoma |- |Cystic fibrosis |- |Salivary disease |- |Infection |- |Trauma |- |Radiation |- |Ductal obstruction |- |Gastrointestinal disease |- |Perforat...") Tag: Visual edit
01:1201:12, 28 February 2026 Chronic pancreatitis (hist | edit) [8,086 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " ''Multifactorial, fibroinflammatory syndrome in which repetitive episodes of pancreatic inflammation lead to extensive fibrotic tissue replacement, resulting in chronic pain, exocrine and endocrine insufficiency, reduced QoL and a shorter life expectancy.'' * ''Spectrum: acute, recurrent acute, pancreatic insufficiency alone, autoimmune pancreatitis, and chronic pancreatitis. They have overlapping clinical features and patients may move between them'' == '''Aetiology''...") Tag: Visual edit
01:1101:11, 28 February 2026 Complicated pancreatitis (hist | edit) [17,351 bytes] SurgopaediaAdmin (talk | contribs) (Created page with " == '''Acute peripancreatic fluid collections / pancreatic pseudocyst''' == * Nomenclature: ** Acute peri-pancreatic fluid collection: extra-pancreatic fluid collection within first four weeks of onset of pancreatitis, with no associated necrosis ** Pseudocyst: APPFC which persists for >4 weeks, although histologically they can be present sooner * Pathogenesis ** Contains essentially pure pancreatic juice, with some cytokines and fibroblasts ** Some say that this impl...") Tag: Visual edit
01:1001:10, 28 February 2026 Acute pancreatitis (hist | edit) [14,615 bytes] SurgopaediaAdmin (talk | contribs) (Created page with "''Pancreatic inflammation secondary to inappropriate activation of enzymes and autodigestion'' == '''Epidemiology''' == * Increasing since 2000 * Up to 80% caused by gallstones/alcohol == '''Natural history''' == * 10-20% have a rapidly progressive inflammatory response - prolonged hospital stay, morbidity, mortality * Risk of death in severe pancreatitis 10-50%, especially with MODS * Mortality in the first two weeks is due to MODS * Mortality after two weeks is fro...") Tag: Visual edit
01:0201:02, 28 February 2026 Acute liver failure (hist | edit) [2,470 bytes] SurgopaediaAdmin (talk | contribs) (Created page with ""Sudden loss of hepatic function in a person without pre-existing liver disease" == Classification == * Fulminant - development of encephalopathy within 8/52 of development of symptoms * Subfulminant - have had liver disease for up to 26 weeks before encephalopathy == Causes == * Drugs - paracetamol, flucloxacillin, anaesthetic agents * Budd-Chiari * Malignancy * Fatty liver disease of pregnancy * Wilson's disease * HAV * Autoimmune hepatitis * Ischaemic hepatitis *...") Tag: Visual edit

28 February 2026