in cancer management, 279–282

clinical trials, 285–286

for esophageal cancer, 709

screening, 283–284

staging (traditional/genetic), 282–283

surveillance, 284–285, 285t

therapeutic agents, 280t–282t

Chest. See also Chest wall

injury, 448

pediatric patients, 1844–1867

radiograph, 149, 394, 2013

Chest wall

anatomy, 1446–1447, 1447f–1449f

benign bony/cartilaginous tumors, 1449t, 1450, 1450f

benign soft tissue tumors, 1449, 1449t

congenital abnormalities

pectus excavatum and pectus carinatum, 1451, 1454–1456, 1454f–1456f

Poland syndrome, 1457, 1458f

sternal clefts, 1456–1457, 1457f

deformities, 1844–1845

malignant bony/cartilaginous tumors, 1449t, 1450–1451, 1451f

malignant soft tissue tumors, 1449t, 1450

metastatic tumors, 1451

reconstruction, 1451, 1452f–1453f

sarcoma, 2018f

thoracic outlet syndrome, 1457–1459

tumors, 1449, 1449t

in children, 1855

Chicken-wire capillaries, 1961

Chief cells, 722

Chiladiti syndrome, 797

Chilblain, 511

Child abuse, 470

Childhood ascites, 1913–1914, 1914t

Childhood tumors, 1947

classification of childhood, 1947

incidence of, 1947–1948

percentage distribution by age, 1948

Child passenger restraints, 470

Children

burn injury in, 214

fluid management in, 458t

mediastinal tumors in, 1478, 1478t

Child–Turcotte–Pugh (CTP) score, 305t, 957, 957t, 976, 976t

Chimerism, 526–527

Chlamydia trachomatis, 1193

Chlorhexidine, 188

as skin surgical site preparation, 143

Chloride deficiency, 211

Chlorothiazide, 1926

Cholangiocarcinoma, 556, 1028–1029

Cholangiography

for bile duct stricture by chronic pancreatitis, 1030

cholangiocarcinoma, 1041

gallbladder cancer, 1034–1035, 1036f

for primary sclerosing cholangitis, 1028, 1028f

Cholangiohepatitis, 1031, 1031f

3292

Cholangitis, 133, 133t

choledocholithiasis and, 1012, 1012f

Cholecystectomy, 1984

for acute cholecystitis, 1001–1002

indications for, 999t

asymptomatic patients, 999–1000

symptomatic patients, 1000

laparoscopic, 1003

complications, 1004–1005

contraindications to, 1003

technique, 1003–1004, 1004f, 1005f

trocar placement for, 1004f

open, 1004–1005

Cholecystitis

acute, 1000–1002

cholecystectomy, 1001–1002

imaging and diagnosis, 1000–1001, 1001f

medical treatment, 1001

Murphy sign, 1000

percutaneous cholecystostomy, 1002, 1003f

right upper quadrant (RUQ) pain, 1000

treatment, 1001–1002

chronic, 1003

during pregnancy, 1007

Cholecystoenteric fistulae, 1006

Cholecystokinin (CCK), 741, 773, 845, 846, 873, 997

Cholecystosphincter of Oddi reflex allows, 997

Choledochal cyst, 1922f

Choledochal cystic disease

anatomy, 1923–1924

clinical presentation, 1924

complications, 1925

diagnosis, 1924

outcome, 1925

pathophysiology, 1924

treatment, 1925

Choledochoduodenostomy, 1030

Choledocholithiasis, 1007, 1985

and acute cholangitis, 1012, 1012f

classification and etiology, 1007

clinical presentation, 1007, 1007f

diagnostic studies

biochemical liver profile, 1008

cholangiography, 1008–1009, 1009f

computed tomography, 1008, 1009f

magnetic resonance imaging, 1008, 1009f

ultrasonography, 1008, 1009f

intrahepatic stones, 1012–1013

management, 1009–1010, 1010f

endoscopic approach, 1010

laparoscopic approach, 1010–1011

open approach, 1011–1012

percutaneous approach, 1010

predictors of, 1007–1008, 1008t

primary CBD stones, 1007

secondary CBD stones, 1007

Cholelithiasis, 133, 751, 996. See also Gallstones

3293

Cholestasis, 948

neonatal, 1919t

Cholestatic jaundice, 1919f

Cholesterol, 996

Cholesterol esterase, 846

Cholesterol gallstones, 998, 998f

cholesterol crystallization, 999

cholesterol supersaturation, 998–999, 998f, 999f

gallbladder absorption/secretion, 999

gallbladder motility, 999

Cholesterol metabolism, 13–14, 13f

Cholesterol polyps (cholesterolosis), 1046

Chondromas, 1450

Chondrosarcomas, 1450–1451

Chordae tendineae, 1506

Chordee, 1940

Christmas tree deformity, 1877

Chromaffin cells, 1383

Chromium

daily requirements of, 24t

deficiency of, 23

Chromogranin A, 850, 902

Chromogranins, 832

Chromosomal instability (CIN), 1120

Chrondrosarcomas, 2027

Chronic cholecystitis, 1000

Chronic granulomatous disease (CGD), 92, 1918

Chronic lymphocytic leukemia (CLL), 1277–1278, 1277f

Chronic mesenteric ischemia (CMI)

management, 1654–1656, 1654f–1655f

symptoms, 1654

Chronic myelogenous leukemia (CML), 280, 1278

Chronic obstructive pulmonary disease (COPD), 473, 666, 1462–1463

and lung transplantation, 589

Chronic venous disease

anatomy, 1784–1785

diagnostic evaluation, 1787–1789

etiology, 1785–1787

pathophysiology, 1785–1787

physiology, 1785

signs and symptoms, 1787

surgical therapy, 1791

Chronic venous insufficiency (CVI), 1779

evaluation of, 1604–1605, 1605f

Chronic venous insufficiency, treatment of, 1791t

Chvostek sign, 207, 1368

Chylomicrons, 11, 779

Chylothorax, 1867

Chymotrypsin, 846

Cigarette smoking, 303. See also Smoking

and gastric ulceration, 734

wound healing, effect on, 65–66

Cilostazol, 1678

Circulation monitors, 258

Circumferential resection margin (CRM), 1123

Circumflex coronary artery, 1519

Cirrhosis, 305, 943, 1074

3294

alcoholic, 946–947, 946f

cholestasis and, 948

classification of, 944t, 945–950

complications

hepatic encephalopathy, 953–954, 953t

pulmonary, 952–953

renal, 950–952

definition, 943

diagnosis, 950

end-stage, 946f

etiology, 946–950, 948t

evolution of, 944f

gut microflora in, role of, 945

immune/inflammatory, 948–949

macronodular pattern, 945–946

metabolic disorders and, 949

micronodular pattern, 945

mixed pattern, 946

NASH-related, 947

pathophysiology, 943–945, 945f

physical findings in, 950t

portal hypertension and, 943 (see also Portal hypertension)

venous outflow obstruction and, 949–950

viral hepatitis and, 947–948

Wilson disease and, 949

Cisatracurium, 243t

Cisplatin (Platinol), 280t, 735, 1325

Citric acid cycle, 8, 14–16, 16f, 17f

Clamp-and-go technique, 1717

Clark electrode, 361, 369

Claudication

in aortoiliac disease, 1672, 1674

critical limb ischemia and, 1687

Clavien–Dindo classification, 291t

Clear cell sarcoma, 961, 1955

Cleft lip and palate, 2062

Cleveland Clinic Florida Fecal Incontinence Score (CCF-FIS), 1060, 1060t

Clindamycin, 130

Clinical breast examination (CBE), 1294–1295, 1295f, 1306

Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage (CRASH-2) trial, 348

Clinical transplant immunology, 518–527

cell surface receptor blockade, 520

clinical therapeutics, 521–522

immunosuppressive therapy, 524–526, 525f

leukocyte depletion, 521

scientific basis, 518–520

tolerance, 526–527

treating rejection, 522–524, 523f, 524f

Cloaca, 1051

embryology, 1881f

Cloacogenic carcinoma, 1196

Clonorchis sinensis, 1031

Clopidogrel (Plavix), 544, 1527

Cloquet hernia, 1257

Cloquet node, 1221

Closed-loop obstruction, 783, 785–786. See also Bowel obstruction

Clostridium difficile, 1056, 1085, 1897

3295

Clostridium difficile infection (CDI), 135

Clostridium septicum, 1611

c-Myc, 1122

Coagulation

definition, 69

factor deficiency, 80–81

homeostasis, 344

Coagulopathy, 158, 199, 307

prevention/Treatment of, 347–348

in TBI, 491

Cobalamin, 780

Coenzyme A reductase inhibitors, 1735

COG hepatoblastoma, 1968

Cold challenge testing, 1598, 1599f

Cold immersion foot, 511

Cold injury, 511–514, 513f, 513t

treatment, 512–514

Cold ischemia time, 537

ColDx, 1125

Colic artery aneurysm, 1660–1661

Colitis cystica profunda, 1109

Collaborative groups, hospital-based, 330

Collagen, 59–60, 63

Collagenolysis, 75

Collateralization, 1648–1649

Collis gastroplasty, 680

Colloid oncotic pressure, 193

Colloids, 159, 199

Colon, 1051

anatomy, 1051–1052, 1052f

arterial blood supply, 1054, 1054f

diagnostics, 419

disorders, 1057–1060

embryology of, 1051

epidemiology, 419

lymphatic drainage, 1055

neural components, 1055–1056

OIS-AAST grading scale, 419t

physiology, 1056

absorption, 1056

colonic flora, 1056–1057

colonic motility, 1057

treatment, 419–420

venous drainage, 1055

Colon cancer. See also Colorectal cancer (CRC)

Colonic atresia, congenital, 1877–1878

Colonic diverticulosis, 1075–1076, 1075f

Colonic pseudo-obstruction, 1059–1060, 1060f

diagnosis, 803

etiologic factors, 803

management, 803–804, 803t

risk factors, 803

Colonic pseudopolyps, 811, 811f

Colonoscopy

for colorectal neoplasia, 1101–1102, 1126, 1128

for GI bleeding, 1069, 1078

ColoPrint, 1125

3296

Colorectal cancer (CRC), 1117–1155

colon cancer, treatment of

malignant colonic polyps, 1133, 1133f

postoperative adjuvant therapy, 1135–1136

surgery, 1133–1135, 1134f, 1135t

diagnosis, 1129–1130, 1986–1987

diagnostic evaluation, 1130, 1131f

symptoms and signs, 1130

differential diagnosis, 1130

emergencies related to, 1149–1150

epidemiology, 1117, 1118f, 1119f

histopathology and progression, 1122, 1122t

locally recurrent, treatment of, 1154–1155

metastasis

chemotherapy for, 1152–1154, 1153t

surgical treatment, 1152

molecular characteristics, 1120–1122, 1120f, 1121f

preoperative preparation, 1130–1132

principles of surgical treatment, 1132–1133

prognostic factors, 1125t

rectal cancer, treatment of, 1136–1149 (see also Rectal cancer)

risk factors, 1117–1120

screening and prevention, 1125

consequences of screening, 1129

dissemination of information, 1129

risk categories, 1127t–1128t, 1129

screening tests, 1126, 1126t, 1127t–1128t, 1128–1129

stage IV, treatment of, 1150, 1151f, 1152

staging and prognosis, 1122–1125, 1124t

nomogram, 1123, 1125f

TNM staging system, 1123, 1124t

surveillance after curative resection, 1150, 1151t

treatment, 1987

ulcerative colitis and, 1087

Colorectal liver metastases (CLM), 984, 986–987

imaging evaluation, 986

multidisciplinary treatment approach, 986f

surgical indication for, 986

Colorectal polyps, 1093. See also specific type

adenomas, management of, 1102–1104

anatomic distribution, 1098

classification, 1093–1094, 1094t

diagnosis, 1099–1102

barium enema, 1102

colonoscopy, 1101–1102

computed tomography colonography, 1102

fecal occult blood tests, 1100–1101, 1101f

sigmoidoscopy, 1101

stool DNA testing, 1102

disease states associated with, 1099

epidemiology, 1097–1098

guidelines for surveillance of adenomas, 1103–1104, 1104t

heredity, role of, 1098

histopathology and malignant potential, 1095–1097, 1096f–1099f

adenomatous polyps, 1095, 1097f

mucosal polyps of colon, 1095, 1096f

sessile serrated adenomas, 1096, 1099f

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