hepatitis B virus infection and, 935

laboratory evaluations, 939t

life support systems, 940–941

liver transplantation, 940

management, 940

nutritional support in, 38

prognosis, 941, 941t

transjugular liver biopsy, 940

Liver fibrosis, 943–945, 944f, 945f, 947. See also Cirrhosis

Liver procurement, 533–535

Liver transplantation, 966, 1970

acute liver failure and, 940

hepatic failure and, 936

hepatic malignancies and, 975, 992

for hilar cholangiocarcinoma, 1043–1044

primary sclerosing cholangitis and, 1029

Lloyd–Davis position, 1144

Lobar emphysema, 1467, 1467f

Lobectomy, 1847

Lobular carcinoma in situ (LCIS), 1305–1306

pleomorphic, 1305

and risk for breast cancer, 1306, 1306t

Local anesthetics, 246–247, 246t

Localized pancreatic head resection with lateral pancreaticojejunostomy (LR-LPJ), 874–875

Locoregional recurrence, 276

Loeys–Dietz syndrome, and thoracic aneurysms, 1565, 1565t

Look AHEAD study, 740

Lorazepam, 245

Lorcaserin, 740, 741

Lorenz Bar insertion (Nuss procedure), 1846, 1846f

Low anterior resection (LAR), 1143, 1143f

Low anterior resection syndrome (LARS), 1143

Low-density lipoproteins (LDLs), 11, 1522

Lower esophageal sphincter (LES), 651–653, 651f, 652f, 656, 656f, 662

characteristics of, 651–652

relaxation, 656

Lower extremity

amputations, 1704–1715

graft infections, 1617

Low-molecular-weight heparin (LMWH), 75, 180, 253, 1779

Lumbar hernia, 1254, 1254t, 1255f

Lundh test, 847

Lung, 533

benign tumors of, 1441, 1441t

blood flow, 1862

congenital cystic disease of, 1847–1851

congenital malformations of, 1465–1466

bronchogenic cysts, 1467

congenital cystic adenomatoid malformation (CCAM), 1467, 1467f, 1467t

lobar emphysema, 1467, 1467f

pulmonary sequestration, 1466, 1466f

stages of lung development, 1465–1466, 1466t

embryology, 1861

extralobar sequestrations, 1847

intralobar sequestrations, 1847

malignant tumors, 1853f, 1854

measurements, 1812f

3349

metastatic tumors, 1851

pediatric primary tumors, 1852, 1852t

procurement, 536–537

rhabdomyosarcomas, 1852t, 1854

teratomas, 1854, 1855f

Lung abscesses, 1459, 1462f

Lung allocation score (LAS), 588, 590–591, 590t

critically ill patients, 592

Lung cancer, 1417–1441

epidemiology, 1417–1418

neuroendocrine tumors, 1433–1436

adenoid cystic carcinomas, 1435–1436, 1436f

bronchial gland carcinomas, 1435

carcinoid tumors, 1433–1434, 1433f, 1434f

large cell neuroendocrine carcinoma, 1434, 1434f

mucoepidermoid carcinomas, 1436

mucous gland adenomas, 1436

small cell lung cancer, 1434–1435

non-small cell lung cancer, 1420–1433

pathologic classification, 1418, 1418t

pulmonary metastasis, resection of, 1437–1441

resection, 303

tumor biology, 1418–1420

Lung volume reduction surgery (LVRS), 1462–1463, 1464f

Lupus anticoagulant/antiphospholipid syndrome, 77

Lymphadenectomy, 275–276, 762t

Lymphadenitis, 1840–1841

Lymphadenopathy, 1232

Lymphangiomas of spleen, 1283

Lymphatic malformations (LMs), 1842, 1842f, 1851

Lymph node biopsy, sentinel, 1998–2000

Lymph node sampling, 1967

Lymphocytes

B lymphocytes, 94

T lymphocytes, 95–97

Lymphocytic hypophysitis, 1404

Lymphogranuloma venereum (LGV), 1193

Lymphoid tissue, 775

nonaggregated and aggregated, 775, 776f

Lymphomas, 1854

small bowel, 834–835

Lymphomatous polyposis of colon, 1107, 1108f

Lymphotactin, 104

Lynch syndrome, 1094, 1099, 1129

Lysyl-bradykinin (kallidin), 112

Lysyl oxidase, 60

M

Macroautophagy, 118

Macroglossia, 1842

Macrophages, in wound healing, 58, 59f

Magnesium

hypermagnesemia, 207

hypomagnesemia, 207

role in wound healing, 63

Magnetic resonance angiography (MRA), 1624, 1778, 2013, 2032

for thoracoabdominal aortic aneurysms, 1719–1720

for vascular trauma, 436

3350

Magnetic resonance cholangiopancreatography (MRCP), 1984

CBD stones, 1008, 1009f

chronic pancreatitis, 872

hilar cholangiocarcinoma, 1041, 1042f

pancreatic disease, 857

Magnetic resonance imaging (MRI), 1769, 1948, 1980, 1992

acute cholecystitis, 1001, 1001f

bowel obstruction, 789

breast disease, 1296–1297, 1308

Crohn disease, 813, 813f

gallbladder cancer, 1035, 1036f

hepatic neoplasms, 977

hilar cholangiocarcinoma, 1041, 1042f

ligamentous injuries, 484

pancreatic cancer, 887

pancreatic endocrine neoplasms, 902–903

pheochromocytoma, 1395, 1395f

pituitary tumors, 1407–1408

rectal cancer staging, 1138–1139, 1139f

thoracic aortic aneurysm, 1566

ulcerative colitis, 1084–1085, 1085f

vascular infection, 1612–1613

vascular trauma, 436

Magnetic resonance venography (MRV), 1778

Maintenance electrolyte therapy, 200

Maintenance fluid therapy, 200

Major Adverse Cardiac Event (MACE), 299

Major histocompatibility complex (MHC), 94, 519, 541, 775

Marjolins ulcer, 235

Male breast cancer, 1329–1330

Malignant fibrous histiocytomas (MFHs), 1450

Malignant masquerade, 1048

Malignant mesenchymal tumors, 1917

Malignant neoplasms, 697–701, 698f

diagnosis, 698–699

neoadjuvant therapy, 699–701

staging, 699, 699t

Malignant obstruction, 796–797, 797f, 797t

Malignant pleural mesothelioma (MPM), 1470–1472, 1470f, 1471t

Mallampati score, 630

Mallory bodies, alcoholic hepatitis, 946, 946f

Mallory–Weiss tears, 1063, 1074

Malnutrition. See also Nutrition

inflammation and, 27

and preoperative nutritional support, 32

starvation and, 27, 27t

wound healing, impact on, 63

Malrotation, midgut

anatomy, 1893–1894

clinical presentation, 1894

complications, 1895–1896

correction of, 1896f

diagnosis, 1894, 1895f

embryology, 1892–1893, 1892f, 1893f

incomplete rotation, 1893–1894, 1893f

nonrotation, 1893, 1893f

normal fixation, 1893f

3351

normal rotation, 1892f

results, 1895–1896

treatment, 1894–1895

Mammalian target of rapamycin (mTOR), 581

Mammography, 1295

BI-RADS classification of abnormalities, 1307, 1308t

microcalcifications, 1295, 1296f

screening, 1306–1308

soft tissue masses, 1295, 1296f

Mandible fractures, 382–383, 384f

Mandibular condyle fractures, 383

Mandibular subluxation, 386

Manganese

daily requirements of, 24t

deficiency of, 23

MAPK pathway, 1122

MAPK pathway inhibition, 2001

Marcus Gunn pupil, 1407

Marfan syndrome, 1565

inguinal hernias and, 1874

pectus excavatum and, 1845

and thoracic aneurysms, 1565, 1565f, 1565t

Marginal artery of Drummond, 1672

Marlex methylmethacrylate sandwich technique, for chest wall reconstruction, 1451, 1452f

Marshall multiple organ dysfunction syndrome, 171t

Massive hernia, 1247

Massive transfusion protocol (MTP), 344, 345, 345f

Mastalgia. See Breast pain

Mast cells, 98

Mastectomy, 1312, 1322–1323, 1322f, 1323f

nipple-sparing, 1322

partial, 1319–1320, 1319f, 1320t

radical, 1324

skin-sparing, 1322, 1323f

Mastitis, 1303

Mastodynia. See Breast pain

Mastopexy, 2047, 2047f

Matrix metalloproteinases (MMPs), 1225, 1564, 1717–1718

Maxillofacial injuries, 376–384

fractures, 378–384, 380f

and nasal intubation, 378

ocular injury, 381

oral intubation and, 378

soft tissue injuries, 377–378, 378f, 379f

treatment of, 376, 377f

Maximum tolerated dose (MTD), 278, 285

Mayer–Rokitansky–Kusterhauser syndrome, 1945

Mayo Severity Index Calculator, ulcerative colitis, 1084t

MC1R gene mutation, 1991

McVay (Cooper ligament) repair, 1234, 1236f

Mean arterial pressure (MAP), 155, 489

Mechanical circulatory support (MCS)

adverse events, 1546

bleeding, 1546

device malfunction and thrombosis, 1547

infections, 1547

intracranial bleeding and thromboembolism, 1546–1547

3352

RV failure, 1546

arrhythmias and, 1545–1546

for cardiac failure, 1540–1559

cardiac support devices for, 1540, 1541f–1542f

coagulation parameters and, 1544–1545

contraindications to, 1543

coronary artery disease and, 1545

devices, for long-term MCS, 1553

HeartMate III LVAD, 1557, 1558f

HeartMate II LVAD, 1554–1555, 1555f

HVAD, 1556–1557, 1557f

Jarvik 2000, 1555–1556, 1555f

MVAD, 1557, 1558f

rotary pumps, 1553–1554

rotary pumps with centrifugal flow design, 1556, 1556f

devices, for short-term MCS

extracorporeal life support, 1549–1551

IABP, 1549, 1551f

future directions, 1559

indications for, 1540–1542

bridge to recovery (BTR), 1540

bridge to transplantation (BTT), 1540–1541

destination therapy (DT), 1541

INTERMACS registry, 1547–1548, 1547f–1548f, 1549t, 1550t

and intracardiac shunts, 1546

liver function and, 1544

and nutrition, 1545

patient selection, 1543–1545

percutaneous short-term MCS devices, 1551–1553

CentriMag VAD, 1553, 1554f

Impella left ventricular assist device, 1552, 1553f

Tandem Heart pVAD centrifugal pump, 1551–1552, 1552f

pulmonary function and, 1544

renal function and, 1543–1544

right-sided heart failure and, 1544

timing of implant, 1542

cardiogenic shock and acute heart failure, 1542–1543

chronic heart failure, 1543, 1544f

total artificial hearts

Syncardia total artificial heart, 1557, 1559f

valvular heart disease and, 1545

weaning patients from

long-term MCS, 1549

short-term MCS, 1548

Mechanical ligation, of bleeding vessels, 1072

Mechanical obstruction, definition, 782

Mechanism of injury (MVC), 363

Meckel diverticulum, 1077–1078

anatomy, 1907

clinical presentation, 1908–1909

cystic duplications, 1911–1912

distal gastrointestinal tract, 1909

embryology, 1907

esophagus, 1909

foreign bodies, 1909

gastrointestinal hemorrhage, 1909, 1910t, 1911

as incidental finding, 1908–1909

3353

intestinal duplication, 1911, 1912f

signs and symptoms of, 1908, 1908t

treatment, 1909

tubular duplications, 1912

Meconium ileus, 1889

clinical presentation, 1890

diagnosis, 1890, 1891f

diagnostic evaluation, 1889–1890, 1890f

pathophysiology, 1889, 1889f

postoperative care, 1891

radiograph of, 1891f

results, 1891

treatment

nonoperative, 1890–1891

operative, 1891

Meconium ileus equivalent, 1889

Meconium plug syndrome, 1891–1892

Medialization, for massive abdominal hernias, 1250

Median arcuate ligament syndrome (MALS), 1656, 1656f

Mediastinal tumors, 1854–1855, 1855f

Mediastinitis, 1478

Mediastinum, 1475, 1475f, 1476f

anterior mediastinal masses, 1475–1478, 1475t, 1476t, 1477f

cysts of, 1849, 1851

middle mediastinal masses, 1478, 1478t

pediatric, 1478, 1478t

posterior lesions, 1478

subdivisions, 1475, 1475f

Medical comorbidity

anemia, 296

frailty, 296–297, 297t

obesity/obstructive sleep apnea, 296

preoperative functional status, 296

Medical error, nonpunitive response to, 326

Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC), 764

Mediterranean anemia, 1276

Mediterranean diets, 739

Medullary thyroid carcinoma (MTC), 1353–1354, 1354t, 1380, 1380f

Medulloblastomas, 1111

Megamitochondria, alcoholic hepatitis, 946

Megaureter, 1937

Meissner plexus, 773, 1051, 1056

MEK inhibitors, 2001

Melanocortin-4 receptor (MC4R), 741

Melanoma

canal, 1196

chemotherapy, 2001

classification, 1992–1994

clinical and pathologic staging, 1995

clinical diagnosis, 1992–1994

etiology, 2002

genetic component, 1991

metastasis to small bowel, 837, 837f

microstaging, 1994–1995

prognostic factors, 1995

risk factors, 1991–1992

stage groupings, 1997t

3354

surgery, 2002

surgical excision, 1997t

surgical margins, 1998t

survival rates, 1995t

treatment, 1995

Melena, 1063. See also Gastrointestinal (GI) hemorrhage

Membrane attack complex (MAC), 92

Membrane cofactor protein (MCP), 94

Memory T-cell, 520

Memphis modification, 1249

Meningiomas, 1404, 1407–1408

Menstrual cycle, and mammary gland, 1293

Meperidine, 864

Mercaptopurine (6-MP)

in Crohn disease, 816t, 817

in ulcerative colitis, 1086

MERCURY trial, 1139

Merkel cell carcinoma (MCC), 2006, 2006f

Mesenchymal hamartomas, 1916

Mesenchymal stem cells (MSC), 233, 527

Mesenteric arterial stenosis, detection of, 1600–1601

Mesenteric arteries, evaluation of, 1600–1601

Mesenteric cysts, 1912

Mesenteric vein thrombosis (MVT), 1653

Meshing, 226

Mesocolic hernias, 1894

Mesonephros, 1933

Mesothelioma, 1470–1472, 1470f, 1471t

Metabolic acidosis

acute metabolic acidosis

clinical features of, 209

treatment of, 210

anion gap, 208

bicarbonate, nonrenal loss of, 209

diabetic ketoacidosis, 210, 210f

ketoacidosis, 209

lactic acidosis, 209

mechanisms of, 208–209

organic acid production, 209

renal acidosis, 209

renal compensation, 210

respiratory compensation, 210

Metabolic alkalosis, 210–211

clinical features, 211

respiratory compensation for, 211

treatment, 211

Metabolic bone disease, 1822

Metabolic disease, 738

adipocytes and, 48–50, 50f

cellular stress responses and, 48, 49f

diabetes, 51–52

mediators of, 50–51, 51f

nutrient excess and, 47–48

obesity and, 47–48

pathophysiology of, 47–50

portal overflow and liver disease, 51

visceral adipose tissue (VAT) and, 50

3355

Metabolic energy expenditure, 26, 26t

Metabolic equivalents (MET), 296, 296t

Metabolic rate, and obesity, 45–46

Metabolic requirements

and assessment, 181–182

for ICU patients, 181–182

Metabolic thrift, 42

Metabolism, 47

biotransformation, 18

carbohydrate, 8–11

cellular energy generation, 14–18

cholesterol, 13–14

fatty acid, 11–13

heme and porphyrin, 18, 19f

intermediary, 8

lipid, 11

metal, 18–19

and nutrition

enteral nutrition, 182

immunonutrition, 182

metabolic requirements and assessment, 181–182

protein, 14

Metabolites, 164

Metalloproteases (MMP), 64

Metal metabolism, 18–19

Metanephros, 1933

MetaPlus study, 183

Metastatic lung tumors, 1851

Metformin, 299t

Methamphetamine, causing burn, 216

Methicillin-resistant Staphylococcus aureus (MRSA), 137, 188

Methotrexate, 1325

in Crohn disease, 816t, 817

in ulcerative colitis, 1086

Methylenetetrahydrofolate reductase (MTHFR), 79

Methylxanthines, 741

Metoclopramide, 670

Metyrapone, in Cushing disease, 1414t

Mexican beaded lizard (Heloderma horridum), 502

Micafungin (FK463), 1618

Microbial arteritis, 1609

Microbiome, 47

Microlithiasis, 861

Micronutrients

administration of, during critical illness, 37

wound healing, role in, 63

Microparticles (MP), 72

Microsatellite instability (MSI), 1094, 1095f, 1120

Microsatellite instability high (MSI-H) phenotype, 756

Microvascular tissue transfer, 2036

Microvilli, 772

Midazolam, 245–246, 355

Midgut

anatomy, 1893–1894

embryology, 1892–1893, 1892f, 1893f

incomplete rotation, 1893–1894, 1893f

malrotation, 1892–1896

3356

nonrotation, 1893, 1893f

normal fixation, 1893f

normal rotation, 1892f

volvulus, 1894–1895

Midodrine, in hepatorenal syndrome, 952

Mifepristone, in Cushing disease, 1414t

Mifflin–St. Jeor equation, 26

Migrating motor complex (MMC), 774

Migrating myoelectric complex (MMC), 997

Mild traumatic brain injury (MTBI), 460

Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTER), 348

Milk–alkali syndrome, 1367

Millipedes, 504

Milrinone, 1863

Minerals, 182

Minimally invasive direct coronary bypass (MIDCAB), 1533

Minimally invasive esophagectomy (MIE), 701, 703

Minimally invasive retroperitoneal pancreatectomy (MIRP), 137

Minnesota tube, 960, 1074

Mirizzi syndrome, 1030

Mitogen-activated protein kinases (MAPK), 97

Mitomycin, 1208

Mitomycin C, 735

Mitophagy, 119

Mitotane, in Cushing disease, 1414t

Mitral annulus, 1505

Mitral regurgitation (MR), 1512–1514

diagnosis, 1512

imaging, 1512

natural history, 1512

pathophysiology, 1512

prevalence and etiology, 1512

severity, 1512t

treatment, 1512–1514, 1513f, 1514f

Mitral stenosis (MS), 1510–1512

diagnosis, 1510–1511

imaging, 1511

natural history, 1511

pathophysiology, 1510

prevalence and etiology, 1510

severity, 1511t

treatment, 1511

MV replacement (MVR), 1512

open mitral commissurotomy, 1511–1512

percutaneous balloon mitral valvuloplasty, 1511

Mitral valve (MV), 1505

Mixed acid-base disorders, 212

Mobile intensive care unit, 352

Model for end-stage liver disease (MELD) score, 305, 305t, 553, 957, 977

Modified radical mastectomy, 1324

Mohs micrographic surgical technique, 2004, 2004f

Mojave rattlesnake (Crotalus scutulatus), 500

Molybdenum

daily requirements of, 24t

deficiency of, 23

Mondor disease, 1302, 1302f

Monoamine oxidase inhibitors, 299t

3357

Monocyte chemotactic protein-1 (MCP-1), 75

Monocyte influx, 74

Mononuclear phagocytes, 93–94

activation, 94

antigen presentation, 94

phagocytosis, 94

recruitment, 94

Monosodium urate (MSU), 116

Monospot test, 939

Montgomery glands, 1291

Morgagni hernia, 1865, 1865f

Mortality Probability Model (MPM), 170

MOSAIC trial, 1136

Mosapride, 802

Moschcowitz syndrome. See Thrombotic thrombocytopenia purpura (ITP)

Motilin, 774

Motor-evoked potentials (MEPs), 1720

Motor vehicle accident (MVA), 363f

Motor vehicle crash (MVC), 360, 465

Motor vehicle-related injuries, in pregnancy, 481–482

Motor vehicle traffic deaths, 340f

mTOR inhibitors, 521–522

side effects of, 522

Mucinous appendiceal carcinoma, 1207–1208, 1207f

Mucinous (colloid) carcinoma, 1316

Mucinous cystic neoplasms (MCNs), 883

Mucoceles of appendix, 1206, 1207f

Mucoepidermoid carcinomas, 635, 1436

Mucomyst, 221

Mucosa-associated lymphoid tissue (MALT), 775

lymphoma, 765

gastric, 765

high-grade, 765

low-grade, 765

non, 765–766, 765f, 766f

Mucosal atypia, 755

Mucous gland adenomas, 1436

Mucous glycoproteins, gallbladder, 997

Müllerian ducts, 1933

Müller sign, 1510

Multicystic dysplastic kidney (MCDK), 1934

Multidetector CT (MDCT), 1070–1071

for rectal cancer staging, 1138

Multimodality therapies, 2010

Multiple adenomatous polyps, 755

Multiple biliary papillomatosis, 1048

Multiple blood cultures, 1773

Multiple core needle biopsies, 1966, 1967

Multiple endocrine neoplasia type 1 (MEN1), 766, 1378–1379, 1379f

pancreatic endocrine neoplasms and, 901, 901t

Multiple endocrine neoplasia type 2 (MEN2), 1379–1381, 1381f

Multiple organ dysfunction syndrome (MODS), 152, 157, 171t

Multiple organ failure (MOF), 171t

Multipolar electrocoagulation (bicap) probes, 1072

Murphy sign, 1000

Muscle catabolism and wasting, 233

Muscle relaxants, 243–244, 243t, 244t

3358

Muscles of pelvic floor, 1172, 1174f

MutYH-associated polyposis (MAP), 1113–1114, 1114t

MYCN amplification, 1950

Mycobacterium avium-intracellulare-scrofulaceum (MAIS), 1841

Mycophenolate, 522

Mycophenolic acid (MPA), 522

Mycotic aneurysms, 1565–1566, 1609, 1758

clinical manifestations, 1773

definition, 1772

diagnosis, 1773

importance, 1772

pathogenesis, 1772–1773

treatment, 1773

Myelodysplastic syndrome (MDS), 1279, 1883

Myelomeningocele (MMC), 1833, 2067

Myeloperoxidase (MPO), 89

Myelosuppression, 522

MYH-associated polyposis, 1129

Myocardial bridging, 1498–1499

Myocardial perfusion, 151

Myopectineal orifice, 1213, 1213f

Myositis, 140

Myxomas, 1515–1516, 1515f

clinical characteristics, 1516

diagnosis, 1516

management, 1516

morphology, 1515–1516, 1515f

N

N-acetylcysteine, 1890–1891

NAFLD fibrosis score, 950

Naftidrofuryl, 1678

Naloxone, 299t

Naltrexone, 741

Narcotics, 248

Narrow band imaging (NBI), 654

Nasoduodenal tubes, 37

Nasogastric decompression, 790

Nasogastric tubes (NGTs), 37, 1067

Naso-orbital–ethmoid (NOE) fractures, 380–382

Nasopharyngeal carcinoma (NPC), 639

Nasopharynx, 639

Nathensen retractor, 678

National Burn Repository, 214

National Cancer Comprehensive Network, 638

National Center for Injury Prevention and Control, 335

National Comprehensive Cancer Network (NCCN), 1306, 1995

National CT Colonography Trial, 1102

National Emphysema Treatment Trial (NETT), 1463

National Health and Nutrition Examination Survey (NHANES), 739

National Healthcare Safety Network (NHSN), 141, 141t

National Health Interview Survey (NHIS), 739

National Highway Traffic Safety Administration, 470

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 1212

National Institutes of Health, 576

National Nosocomial Infections Surveillance System (NNIS), 141

National Pediatric Trauma Registry, 417

National Polyp Study (NPS), 1099, 1101, 1103

3359

National Quality Forum (NQF), 313, 327, 328t

National Surgical Quality Improvement Program (NSQIP), 76, 131, 291

National Toxicology Program, 522

National Traffic and Motor Vehicle Safety Act, 470

National Trauma Data Bank® (NTDB®), 403, 410, 433, 464–465, 477

National Wilms Tumor Study (NWTS), 1955, 1961

Natural anticoagulant mechanisms, 71, 71f

Natural killer cells, 273

Nausea and vomiting, 259

NCAA Concussion Study, 461

Neck, 386–392

anatomy, 386–387, 386f

contractures, 233

dissection, 641–642, 641f, 641t

injuries

blunt trauma, 388–389

complications, 392, 392t

exploration of, 388

initial management, 387, 387f

management of, 389

operative exploration, 389–392

penetrating trauma, 388

selective vs. mandatory exploration, 387–389

trachea and larynx, 390–391, 391f

vascular injury, 389–390, 390f

trauma, 440

Neck injuries

lymphatic malformations, 1833f

pediatric patients, 1837

airway obstruction, 1842–1843

congenital lesions of, 1837–1841

imaging for, 1837

vascular malformations of, 1841–1842

Necrolytic migratory erythema, 909

Necrotic collection, pancreas, 860t

Necrotizing enterocolitis (NEC)

clinical presentation, 1886, 1886f

complications, 1888

diagnosis, 1886, 1887f, 1887t

fulminant, 1888f

with gastroschisis, 1873

outcome, 1888–1889

pathophysiology, 1885–1886

results, 1888–1889

treatment

nonoperative, 1886–1887

operative, 1887–1888, 1888f, 1888t

Necrotizing pancreatitis, 859, 860t

Necrotizing soft tissue infections (NSTI), 138, 139–140

diagnostic imaging in, 140

microbiology of, 140

Negative predictive value (NPV), 1777

Negative-pressure wound therapy, 2033

Neisseria gonorrhoeae, 1192

Neisseria meningitides, 1287

Neisserian meningococcus, 1284

Nelson syndrome, 1414

3360

Neoadjuvant therapy, 2017–2021

for pancreatic cancer, 895–896, 895t

Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser fulguration, 709

Neonatal ascites, 1913–1914, 1913t

Neonatal cholestatic syndromes, 1919, 1919t

Neonatal hyperparathyroidism, 1378

Neonatal intestinal obstruction, 1875–1876, 1876t

Neoplastic mucosal polyps, colorectal, 1093–1094, 1094t

Neostigmine, 804, 1060

Nephrocalcinosis, 1372, 1372f

Nerve growth factor (NGF), 1950

Neuraxial blockade, 247

Neuroblastoma, 1854

biologic feature, 1949–146

diagnosis of, 1951–1952

epidemiology, 1948–1949

future directions, 1954

genetic risk, 1948–1949

pathology, 1949–1950

perinatal, 1951

presentation, 1950–1951

primary distribution, 1951f

risk, 1953–1954

staging, 1950–1952, 1952t

treatment of, 1952

Neurocutaneous melanocytosis (NCM), 1992

Neuroendocrine liver metastases, 987

Neuroendocrine tumors (NETs)

of lungs, 1433

adenoid cystic carcinomas, 1435–1436, 1436f

bronchial gland carcinomas, 1435

carcinoid tumors, 1433–1434, 1433f, 1434f

large cell neuroendocrine carcinoma, 1434, 1434f

mucoepidermoid carcinomas, 1436

mucous gland adenomas, 1436

small cell lung cancer, 1434–1435

of small bowel, 830–833, 831t, 832t, 833f

Neurofibromas, 1854

Neurofibromatosis (NF-1), pancreatic endocrine neoplasms and, 901–902, 901t

Neurogenic bladder, 1945–1946, 1946f

Neurogenic shock, 152–153

Neurogenic tumors, 1854

Neurologic imaging, indications for, 364t. See also Head trauma/head injury

Neuromuscular blockade (NMB), 178

Neuronal intestinal dysplasia, 1897

Neuron-specific enolase, 902

Neuropeptides, 113–114

Neurotensin, 774

Neutrophil endothelial traps, 74

Neutrophils, 72

neutrophil extracellular traps (NET), 93

neutrophil granules and secretory vesicles, 89, 90t

oxidative burst and oxidant metabolites, 91–93, 91t

phagocytosis, 88

recruitment, 87–88

regulation of neutrophil activity, 93

New England Journal of Medicine, 662

3361

Nexium, 670

Niacin, 780

Nicotinamide adenine dinucleotide (NADH), 946

Nicotinamide adenine dinucleotide phosphate (NADPH), 89, 91

Nielsen test, 1598, 1599f

Niemann–Pick disease, 558

Nigro Protocol, for squamous cell cancer of anal canal, 1196, 1197t

Nipple-areolar reconstruction, 2043

Nipple discharge, 1302–1303, 1303f

causes, 1303

clinical evaluation, 1302

ductography and ductoscopy, 1303, 1303f

terminal duct excision, 1303

Nipple-sparing mastectomies, 1322

Nissen fundoplication, 668

laparoscopic, 677–680, 678t

transthoracic, 680, 680t

Nitrate, in coronary artery disease, 1526

Nitric oxide, 114–115, 197

in cirrhosis and portal hypertension, 955

Nitrogen balance

calculation of, 26

as nutrition biomarker, 25–26

Nitroglycerin, 164

Nitroglycerin ointment, in anal fissure treatment, 1181

Nitroprusside, 164

Nivolumab, 273

N-nitroso carcinogens, 756

Nonaccidental trauma, in children, 470

Nonalcoholic fatty liver disease (NAFLD), 557, 945, 947

and cirrhosis, 947

two-hit model, 947

Nonalcoholic steatohepatitis (NASH), 305, 552, 945, 947

Nonatherosclerotic mesenteric arterial occlusive disease, 1653

Noncommunicating hydrocele, 1875

Noncompressible torso hemorrhage (NCTH), 440–441

Nonerosive disease (NERD), 660

Non-Hodgkin lymphoma, 765, 1278, 1854

Nonimmune fetal hydrops, 1831

Nonocclusive mesenteric ischemia (NOMI), 1652f, 1653–1654

Nonmelanoma skin tumors

basal cell carcinoma, 2002

squamous cell carcinoma, 1992

Nonreversed saphenous vein grafts, 1698

Nonrhabdomyosarcoma soft tissue sarcoma

biologic features, 1966

characteristics, 1966t

diagnosis, 1967

epidemiology, 1966

pathology, 1966

presentation, 1967

staging, 1967

treatment, 1967

Non-small cell lung cancer (NSCLC), 1418

adjuvant therapy, 1427–1429, 1427t, 1428t

cervical mediastinoscopy, 1422–1423

chest CT in, 1420, 1422

3362

diagnosis, 1420–1424, 1423f, 1424f

FDG–PET imaging, 1420

IASLC Lung Cancer Staging Project, 1423t

metastatic sites, 1420

Mountain–Dresler lymph node map, 1422t

needle aspiration techniques, 1422

neoadjuvant therapy, 1429–1432, 1431t

pulmonary resection for, 1425–1427, 1426f

postoperative complications after, 1425t

sleeve lobectomy, 1426

sublobar resection, 1426, 1427t

survival after, 1427

recurrence, 1427

risk assessment, 1424–1425, 1425f

stage III disease, treatment of, 1429–1432

superior sulcus tumors, 1432–1433, 1433f

thoracentesis, 1422

TNM classification for staging system of

6th ed., 1419t

7th ed., 1421t

tumor biology, 1418–1420

Nonsteroidal anti-inflammatory drugs (NSAIDs), 99, 298, 299t, 725, 1778

colorectal cancer risk, prevention of, 1105

and peptic ulcer disease, 1071–1072

for pericarditis, 1577

and risk of GI hemorrhage, 1063

and wound healing, 65

Non–ST-segment elevation myocardial infarction (NSTEMI), 1522, 1523

Norepinephrine, 163

in acute liver failure, 940

in hepatorenal syndrome, 952

Normal saline (NS), 366

Normal water exchange/electrolyte exchange, 197–198

Normocapnea, 354

Normoglycemia maintenance during surgery, 143

Normoglycemic in intensive care evaluation survival using glucose algorithm regulation (NICE –

SUGAR), 186

Normosol®, 354

Normothermia maintenance during surgery, 143

Norwood procedure for hypoplastic left-heart syndrome, 1500f, 1501

Noxious stimuli, 362

Nuclear factor of activation and transcription (NFAT), 519

Nuclear medicine imaging, thyroid gland, 1345

Nucleic acids, in diet, 23

Nucleic acid testing (NAT), 532

Null cell adenomas, 1404. See also Pituitary adenomas

Nuss procedure, 1454, 1846, 1846f

Nutrition. See also Enteral nutrition; Nutritional support; Total parenteral nutrition (TPN)

access routes for, 33–38

assessment of, 23–26

anthropometric measurements and nutritional indices, 24–25

indirect calorimetry, 26

metabolic energy expenditure, 26

nitrogen balance, 25–26

subjective global assessment, 24

macro- and micronutrient in, selection of, 36–37

metabolic response and, 222

3363

metabolism and (see Metabolism)

and postoperative complications, 31

routes of administration, 37–38

for specific indications

acute pancreatitis, 183

obesity, 183

stress gastrointestinal bleeding prophylaxis, 183–184

Nutritional indices, 24

Nutritional risk index (NRI), 24

Nutritional support

bariatric surgery and, 38

in critical care, 32–33

in elective surgery, 32

enterocutaneous fistulas and, 39

geriatric patients and, 39

in heart failure, 38

in infectious processes and fever, 38

in liver failure, 38

postoperative ileus and, 39

radiation and chemotherapy enteritis and, 39

in renal failure, 38

in respiratory failure, 38

short bowel syndrome and, 39

thermal injury and, 39

Nyquist limit, 1586

O

Obesity, 20, 42, 183, 252, 296, 738–752

and cancer, 52

definition, 738

diagnosis, 738–739

dietary risk factors and, 271–272

environment, role of, 43, 43f

epidemiology, 739

epigenetic mechanisms and, 42–43

genetics and, 42–43

and liver cancer, 947

liver disease associated with, 51

medical management, 739–741

and metabolic disease, 47–48, 738 (see also Metabolic disease)

metabolic thrift and, 42

and multiple diseases, 739

and obesity, 51–52

physiology of

adipocyte physiology, 46–47

adipostat, 43–44

metabolic rate, 45–46

microbiome, 47

satiety and hunger, 44–45, 44f, 46f

and risk of colorectal cancer, 1118

surgical management, 741–752

wound healing, effect on, 63–64

Obesogenic environment, 42

Obstructive sleep apnea (OSA), 253, 296

Obturator hernia, 1254–1255

Obturator sign, 1200t

Octreotide, 774, 865, 1074

in variceal bleeding, 959

3364

Octreotide acetate, in acromegaly, 1413t

Octreotide LAR, in acromegaly, 1413t

123Iodine Scintigraphy, 1345

Office of Naval Research (ONR), 347

Ofloxacin, in spontaneous bacterial peritonitis, 969

Ogilvie syndrome. See Colonic pseudo-obstruction

Oil cysts, 1301, 1301f

Oligopeptides, 779

Ombitasvir, 948

Omega-three fatty acids, 181, 183

Omental cysts, 1912, 1913f

Omental flaps, 1451, 1453f

Omeprazole, 729

Omphalocele, 1870–1873, 1871f, 1872f, 1872t

Omphalomesenteric duct, 1907

Oncology

cancer immunology, 272–273

cell cycle, 272

chemotherapy in, 279–282

cancer biostatistics, 285

clinical trials, 285–286

screening, 283–284

staging (traditional/genetic), 282–283

surveillance, 284–285, 285t

therapeutic agents, 280t–282t

dietary risk factors and obesity, 271–272

environmental risk factors, 269, 270t

tobacco and cancer, 270, 270t

epidemiology, 265, 266t

genetic risk factors, 265

familial adenomatous polyposis (FAP), 269

familial cancer syndromes, 266, 268t

familial gastric cancer, 269

hereditary breast and ovarian syndrome (HBOC), 269

hereditary nonpolyposis colon cancer (HNPCC), 266–269, 268t, 269t

von Hippel–Lindau Disease (VHL), 269

radiation therapy

approaches, 279

delivery mechanism, 277

delivery modalities, 279

radiation therapy delivery, 279

tissue response to radiation, 277–279

resection, extent of

lymphadenectomy, 275–276

of metastatic disease, 276

pathologic margins, 275

surgeon in, 273–274

curative resection, 274–275

diagnosis and staging, 274

palliative surgery, 275

surgical intent, 274

surgical outcomes, cancer-related

disease recurrence, 276–277

progression-free survival, 277

return to intended oncologic treatment (RIOT), 277

viral risk factors, 270–271, 271t

hepatitis B (HBV)/hepatitis C viruses (HCV), 271

3365

human herpes virus 8 (HHV-8), 271

human papilloma virus (HPV), 271

Oncotype DX Colon Cancer Assay, 1123, 1125

Onlay prosthetic technique, 1250

Open-loop obstruction, 783, 786. See also Bowel obstruction

Open mitral commissurotomy (OMC), 1511–1512

Open necrosectomy, 866

Open pneumothorax, 400

Open reduction, internal fixation (ORIF), 469

Operational tolerance, 518

Operation Iraqi Freedom, 354

Operative interventions, burns

excision and grafting, 223–226

extremity treatment, 227

order of coverage, 226–227

skin alternatives, 227

Opioids (narcotics), 244

Oral anticoagulation, 78, 79

Oral cavity, 638–639, 638t

Oral contraceptives, 299t, 1926

Oral glucose tolerance test, 850

Oral hypoglycemic agents, 252

Orbital fractures, 382, 382f

Organ donation, 493, 530–531

deceased donation, 530

living donation, 530, 531f

Organ Donation Breakthrough Collaborative, 552

Organ donor work-up, 532t

Organic acid production, 209

Organic compounds, causing burn, 216

Organ Injury Scale (OIS), 423

Organ preservation, 537–538, 538t

Organ procurement

operation, 533–537, 533f, 534f, 537f, 538f, 539f

and preservation, 530–539, 532f

and transplantation network, 553

Organ procurement organization (OPO), 530, 614

Organ selection, 531–532

donor history, 532

Oriental cholangiohepatitis, 999

Orlistat (Xenical), 741

Oropharynx, 638t, 639–640, 640f

Orotracheal intubation, 387

Orthopedic Trauma Association (OTA), 445

Orthopedic trauma care, 444

Orthopedic trauma surgery, 448t

bleeding pelvis, 444–446, 445f, 445t

complicated pelvic injuries, 446–447

and complications, 453, 453f

essential damage control surgery, 447–448, 447f

hemorrhage, 444

limit disability, 450–454, 451f

pelvic packing, 446

polytrauma situations, 448

to save life, 444

to save limbs, 448–450, 448t, 449f

and vascular injuries, 449

3366

Osmolality of body fluids, 194, 195

Osmoreceptors, 196

Osmoregulation, 194, 195f

Osmo-sodium receptors, 196

Osmotic activity of body fluids, 193

Osteitis fibrosa cystica, 1372

Osteochondromas, of rib, 1450, 1450f

Osteocytic osteolysis, 1364

Osteogenic sarcoma, 1851–1852

Osteomas, 1110–1111

Osteoporosis and elderly patients, 475

Osteosarcoma, 2026t

Osteotomy, 387

Ostium primum, 1481. See also Atrial septal defect (ASD)

Ostium secundum, 1481. See also Atrial septal defect (ASD)

Outcome feedback, 321

Outcome measures. See also Surgical care quality measurement

limitations, 315

strengths, 315

Overfeeding, 26–27

Overweight, 20

Overwhelming postsplenectomy infection (OPSI), 415

Oxaliplatin, in colon cancer, 1135

Oxidative burst and oxidant metabolites, 91–93, 91t

Oxidative phosphorylation, 15–16, 17f

Oxygen

consumption, 160

delivery, 158

delivery and consumption, 170–171, 171t

effect, 278

utilization, 152

Oxygenation, 174, 219

monitors of, 255–256

Oxygenation Index (OI), 1813

Oxygen debt, 490

Oxygen dissociation curve, 180t, 1809f

Oxygen saturation monitoring, 676

Oxyntic glands, 715

Oxyntomodulin, 741

P

PA banding, 1484–1485

Packed red blood cells (PRBC), 345, 345f

Paclitaxel, 1325

Paget disease of breast, 1330–1331, 1331f

Paget–Schroetter syndrome, 1457

Pain, 228

chronic, 228

management

acute pain, 228

chronic pain/substance abuse, 228

postoperative, 261–263

metabolic response to, 31

pancreatic cancer, 885, 896–897

Painless thyroiditis, 1347

Palliative surgery, 275

Pancreas, 532, 840–858

anatomy, 415–416, 415f, 416f, 850, 851f

3367

blood supply, 851–853, 852f

body of pancreas, 851

ductal anatomy, 851

head and uncinate process, 851

innervation, 853, 854f

lymphatic drainage, 853, 853t

pancreatic cancer and, 854–856, 855f, 855t

pancreatic neck, 851

pancreatitis and, 856, 856f

surgical significance, 853–856

tail of pancreas, 851

trauma/pancreatic injury and, 856

venous drainage, 853

annular, 843–844, 843f

autodigestion of, 846–847

congenital anomalies, 842f, 843–844, 843f

cysts, 1927

diagnostics, 416–417, 416f

divisum, 842f, 843, 1926, 1926f, 1927

ductal anatomy, 1926f

embryology, 840–841, 841f, 843, 1925–1926, 1925f

endocrine

function, 848–850

structure, 845

tests, 850

endocrine lesions of, 1927–1929

epidemiology, 416

exocrine

function, 845–847

structure, 844–845, 844f

tests, 847–848

heterotopic, 844

imaging studies, 856

abdominal plain films, 856–857

computed tomography, 857

endoscopic retrograde cholangiopancreatography, 857–858

endoscopic ultrasound, 857

magnetic resonance cholangiopancreatography, 857

ultrasound, 857

upper gastrointestinal series, 857

juvenile adenocarcinoma of, 1927

neoplasms, 1927

OIS-AAST grading scale, 416t

pediatric, 1925–1929

physiology, 845–850

relationship to adjacent structures, 851

treatment, 417, 417f

Pancreas after kidney transplantation (PAK), 610, 611

Pancreas DRI (PDRI), 615

Pancreas procurement, 536

Pancreastatin, 850

Pancreas transplant alone (PTA), 610–612

Pancreas transplantation, 610, 610f, 616t

back-table preparation, 616–617, 616f, 617f

Banff classification, 620t

complications, 618–619

deceased donor pancreas allocation, 614

3368