Radiology i
Manual of SURGERY Essential Cases in Surgery
Manual of SURGERY Essential Cases in Surgery
Sumit Chhikara (Late) MBBS Anupam Kumar Singh MBBS Sandeep Kumar Thakur MBBS Pardeep Gupta MBBS
JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi
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[email protected] Manual of Surgery © 2005, Sumit Chhikara (Late), Anupam Kumar Singh, Sandeep Kumar Thakur, Pardeep Gupta All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher. This book has been published in good faith that the material provided by authors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and authors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only. First Edition : 2005 ISBN 81-8061-442-5 Typeset at JPBMP typesetting unit Printed at Gopsons Papers Ltd., A 14, Section 60, Noida
Dedicated to the fond memories of Dr Sumit Chhikara (6-11-1981 to 23-4-2004)
Preface This book we emphatically state has been written to fill in a need. When we, the authors of this book, started preparing for our final professionals, we found that despite reading standard textbooks and standard clinical manuals, there was something lacking in our preparation. The elusive something was that we had no insight as to how to answer the grilling question of anatomy and physiology that our surgeons used to ask with cases or the differential diagnoses (in order of importance) or the relevant investigations which we were required to order. The need drove us to myriad textbooks, our lecture notes, our hospital experiences, college handouts, anatomy and physiology books to synthesize and consolidate how the ‘Theory of Surgery’ is translated into ‘Clinical Practice’ and most importantly how we could handle the grossly overrated clinical cases without mortification. So, please use this book as an adjuvant to your textbooks, look it up before presenting your cases in wards, brush it again before your ward leavings, and digest it before professionals and we have no doubt whatsoever that you will succeed with flying colours. This book has been result of our sweat and tears. Destiny snatched one of our dear friends and one of the authors, Dr Sumit Chhikara from us during the publication itself. This book is dedicated to him and his loving memories which will remain with us till end of time. Best of luck to all of you. Sumit Chhikara (Late) Anupam Kumar Singh Sandeep Kumar Thakur Pardeep Gupta
Acknowledgements Our special thanks to: Dr Gautam Choudhary Dr Jasvinder Singh MS Surg (Std) MAMC Dr Anuj Deep Dangi MS Surg (Std) MAMC Dr Vivek Mangla MS Surg (Std) MAMC Dr Deepak Gupta MS Surg (Std), Rohtak Dr Sandeep Gupta MBBS Dr Arvind Chaurasia MBBS MAMC Dr Satish Kumar MBBS UCMS Dr Ashish Kakkar MBBS Dr Sajjan Singh Manana MD Peds (Std) MAMC Pankaj 5th Sem, MAMC Vikram 5th Sem, MAMC Dr Arvind Dubas MBBS MAMC Dr Sandeep MD (Std) Patel Chest Dr Manoj Sanwal Dr Santosh Kumar MBBS MAMC Pritesh Kumar Singh 5th Sem, MAMC Chandra Mohan 7th Sem, MAMC Dr Vikas Mor MBBS MAMC Dr Vikas Bhatia 5th Sem, MAMC Dr Surender Dabas MS Surg (Std) LHMC Last but not the least, Mr JP Vij, Chairman and Managing Director and Mr Tarun Duneja, General Manager (Publishing) for their unfailing cooperation.
Contents 1. Parotid Swellings
1
2. Ca Oral Cavity
8
3. Thyroid Gland
26
4. Neck Swellings
54
5. Carcinoma Breast
60
6. Lymphoma
80
7. Abdominal Lump
95
8. Obstructive Jaundice
110
9. Burst Abdomen and Incisional Hernia
133
10. Metastases in Liver
135
11. D/Δ Δ of Gastric Outlet Obstruction
138
12. Stomas
142
13. Hernia
148
14. Benign Hyperplasia Prostate
159
15. Varicose Veins
184
16. Peripheral Vascular Disease
200
17. Scrotal Swellings
218
18. Leg Ulcers
233
19. Examination of a Swelling
243
20. Radiology and Minor OT Procedures
253
Index
275
