By Alan G. Chalmers MBChB, MRCP, FRCR (auth.), John Brittenden, Damian J.M. Tolan (eds.)
Radiology of the put up Surgical Abdomen offers a accomplished assessment of all stomach operations related to the gastrointestinal tract, pancreas, hepatobiliary and genitourinary platforms. every one bankruptcy is absolutely illustrated with artists' drawings and radiological photos of standard publish operative anatomy. The issues linked to every one process are defined along imaging examples. Written by way of specialists within the box, Radiology of the submit Surgical Abdomen presents the reader with key instructing issues emphasising differentiation among general post-operative anatomy and complications.
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Additional info for Radiology of the Post Surgical Abdomen
G. Chalmers et al. a b Fig. 34 Small bowel injury post–laparoscopic right hemicolectomy. (a) Normal CT appearances of the anastomosis (white arrow) but with increased density of the fat within the central small bowel mesentery (black arrows). (b) A more cephalad image shows pneumoperitoneum and a large collection (C) within the lesser sac. At subsequent laparotomy, a perforated jejunal loop was identified some distance from the anastomosis and considered secondary to laparoscopic bowel injury As already mentioned, vascular injury is a feared complication although, if controlled at the time, it does not always necessitate immediate conversion to open laparotomy.
Edema in the abdominal wall, hematoma, seroma, and cellulitis are frequently encountered in the immediate postoperative period. Infected wounds are generally managed without any need for imaging, but superficial discrete collections are readily assessed by ultrasound. Necrotizing fasciitis is a life-threatening condition, which requires immediate and aggressive surgical intervention. If untreated, the condition is associated with mortality rates of up to 75%. Necrotizing fasciitis involves the skin, subcutaneous tissues, and fascia and occurs either spontaneously or following surgery.
If the kink is within the soft tissues, this is more problematic. If lots of wire is looped within the collection, then it may be possible to withdraw the wire so that this kink lies “outside” the patient. It may then be possible to advance a thinner more flexible dilator or the plastic sheath of the puncture needle across the kink into the collection, without displacing the wire, to allow safe exchange for a new wire. Where this maneuver fails, a new puncture of the collection will be required.
Radiology of the Post Surgical Abdomen by Alan G. Chalmers MBChB, MRCP, FRCR (auth.), John Brittenden, Damian J.M. Tolan (eds.)