strengths, 315

ProCESS trial, 187

Processus vaginalis, 1873

Procoagulant states. See also Hemostasis

acquired

antiphospholipid antibody syndrome, 77

heparin-induced thrombocytopenia (HIT), 77–78

inflammatory bowel disease (IBD), 76

malignancy, 75

trauma, 76–77

inherited

disseminated intravascular coagulation (DIC), 80

dysfibrinogenemia, 79

elevated procoagulant factors, 80

fibrinolysis, defective, 79

high risk for thrombosis, defects with, 78–79, 78t

lipoprotein, 79–80

lower risk for thrombosis, defects with, 79

Proctocolectomy, 1087

with Brooke ileostomy, 1088–1089

with ileal pouch-anal anastomosis, 1089–1090, 1089f, 1090f

Progastrin, 716

Prognostic nutritional index (PNI), 24

Progression-free survival (PFS), 277

Progressive preoperative pneumoperitoneum, 1247

Proinsulin syndrome, 849

Prolactin, excess levels of, 1405

Prolactinomas, 1403, 1405, 1411. See also Pituitary adenomas

medical therapy, 1412, 1412t

Prolene Hernia System (PHS), 1237

Prolonged POI (PPOI), 800

Pronephros, 1933

Proopiomelanocortin (POMC), 1385

Propagated activity, colonic, 1057

Properdin, 1267

Prophylactic palliation, 276

Propofol, 245

Propylthiouracil (PTU), 187

Prostaglandin E2

, 721

Prostaglandins, 110

Prostaglandin synthetase inhibitors, for hypercalcemia, 1368

Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), 1101

Prosthetic bridging repair, 1250

Prosthetic bypass, 1698–1699

Prosthetic graft infections, 1610

by Staphylococcus epidermidis, 1610, 1610f

Protease serine 1 (PRSS1), 847

Protein, 23, 181

deficiency of, 63, 78

metabolism, 14, 14t, 15f

serum levels, in nutritional status assessment, 24–25, 25t

wound healing, effect on, 63

Protein C, 78

Protein digestion and absorption, 778–779

Protein disulfide isomerase (PDI), 69

Protein electrophoresis, 1276

Protein S, 71

3382

deficiency, 78

Proteolysis, 218

Proteolytic enzymes, 775, 846

Prothrombin complex concentrate (PCC), 475, 489

Prothrombin G20210A polymorphism, 79

Prothrombin time, 976

Protocol for frostbite injury, 217f

Proto-fangs, 498

Proton pump inhibitors (PPIs), 184, 728–729

gastrinoma, 907

peptic ulcer disease, 1072

Proto-oncogenes, 272, 1094

Proto-oncogene smoothened (SMO), 2005

Proximal femur, 451–453

Prune-belly syndrome (PBS), 1945, 1945f

P-selectin glycoprotein ligand-1 (PSGL-1), 72, 73

Pseudoaneurysms, 1566, 1658, 1768

carotid artery, 1632

treatment of, 1606, 1606f

Pseudo-Cushing syndrome, 1388

Pseudocysts, pancreatic, 860t, 868–869, 868f

Pseudodiverticula, 1162

Pseudohernia, 1232

Pseudohyponatremia, 202

Pseudohypoparathyroidism, 1369

Pseudomonas aeruginosa, 221

Pseudomyxoma peritonei (PMP), 1206, 1207

Psoas sign, 1200t

Psychiatric medications, 298

Psychological General Well-Being Index, 682

Pubococcygeus muscle, 1054

Puborectalis muscle, 1053, 1172

Pulmonary artery catheter (PAC), 155, 161, 171, 490

Pulmonary artery hypertension (PAH), and lung transplantation, 590

Pulmonary artery occlusion pressure (PAOP), 171

Pulmonary complications in noncardiac surgery, 302, 303t

perioperative management, 305

preoperative evaluation, 303

prior to lung cancer resection, 303

risk stratification, 302–303

surgical considerations, 304

Pulmonary contusion, 398

in children, 466

Pulmonary disease, 252

Pulmonary embolectomy, 1782

Pulmonary embolism (PE), 483, 1714, 1778

diagnosis of, 1604

and pregnancy, 486

Pulmonary hypoplasia, 1862, 1862f

Pulmonary infection, 221

Pulmonary lymphomas, 1436

Pulmonary mechanics, 174

Pulmonary metastasis, resection of, 1437–1441

clinical presentation and diagnosis, 1437–1439, 1437f, 1438f

criteria for resection, 1439, 1439t

histologic subtypes, 1440t

historical background, 1437, 1437f

3383

preoperative evaluation, 1439–1440

results, 1440–1441, 1441t

surgical technique, 1440

Pulmonary sequestration (PS), 1466, 1466f, 1847, 1848f

Pulmonary system, 1811

Pulmonary transplantation, 587–603

bilateral, 598–599, 598f

complications, 599–602, 600t

contraindications, 588–592, 589t, 591f

donor management, 593–594, 594f

donor pool, 595–596, 595f

donor selection, 593, 593t

future considerations, 603

gastroesophageal reflux, 602–603

immunosuppression, 599

indications, 588, 588t

lung preservation, 594–595

operative technique, 597–599

outcomes, 599

primary graft dysfunction, 600

single, 597–598, 598f

transplantation operation, 596–597, 596f, 597f

Pulmonary vascular beds, 1810

Pulse contour analysis, 173

Pulsed dye laser (PDL), 230

Pulseless disease, 1638

Pulse oximeter, 255

Pulse volume recordings (PVR), 1592–1593

Pulsus paradoxus, 151, 1578

Pulsus parvus et tardus, 1507

Pupillometry, 363

Purpura fulminans, 78

Purulent pericarditis, 1577

Pyloric stenosis, 1904–1905, 1904f, 1905f

Pyloroplasty, 705–706, 706f

Pylorus preserving pancreatoduodenectomy (PPPD), 875

Pyoderma gangrenosum, peristomal, 812, 812f

Pyoderma gangrenosum, ulcerative colitis and, 1084

Pyogenic liver abscess, 930, 931f, 1918

Pyomyositis, 140

Pyruvate kinase deficiency, 1276

Q

Qsymia, 741

Quadriparesis, 363

Quality, definition, 323

Quality-of-Life (QOL) scale, 682

Quantitative analysis of twin studies, 42

Quincke pulse, 1510

R

Rabbit antithymocyte globulin (rATG), 521

Race, burn injury and, 215

Radiation enteritis, 797

Radiation-induced pericarditis, 1578

Radiation therapy, 1987, 2005, 2006

in breast cancer, 1324

in cancer management, 277–279 (see also Oncology)

3384

in ductal carcinoma in situ, 1312, 1313t

in esophageal cancer, 709

Radiofrequency ablation (RFA), 556, 1792

for splenic disorders, 1286

RAGE molecule, 117

Raloxifene, 1325

for breast cancer, 1311

Ramipril, 1677

Ramstedt pyloromyotomy, 1905, 1905f

Randomized Evaluation of Normal versus Augmented Level Renal Replacement (RENAL) study, 185

Range-of-motion (ROM), 451

Ranitidine, 670

Ranolazine, 1526

Ranson criteria, acute pancreatitis, 863

Rapamycin, 521, 599

Rapid air evacuation, 348

Rapid response team (RRT), 329–330, 330t

Rapid sequence intubation (RSI), 355

hypotension and, 355

hypoxemia and, 355

vs. non-RSI, 355

Ras proteins, 881

Rathke cysts, 1404

Rattlesnakes, 496, 497

Ravitch procedure, 1454, 1455f–1456f

Ray amputation, 1707–1708

Raynaud disease, 1638

Raynaud phenomenon, 1638

Receptive relaxation, 785

Reconstructive breast surgery, 2037

Recovery protocols, enhanced, 261

Rectal biopsy, 1898–1899, 1899f

Rectal bleeding, anal fissure and, 1181

Rectal cancer, 1136. See also Colorectal cancer (CRC)

adjuvant chemoradiation for, 1146–1147

adjuvant chemotherapy for, 1147

clinical staging, 1137–1139, 1138f, 1139f

early-stage, local excision for, 1139–1141, 1140f

minimally invasive surgery for, 1144–1146

open versus laparoscopic rectal resections, 1145t

outcomes of treatment in, 1147–1448

rectum, anatomy of, 1136–1137, 1137f

transabdominal resection for, 1141

abdominoperineal excision, 1144, 1144f

sphincter saving procedures, 1142–1144, 1142f, 1143f

total mesorectal excision, 1141–1142, 1142f

treatment selection, 1148–1449

Rectal myectomy, 1902

Rectal prolapse, 1187–1189, 1914, 1915f

evaluation, 1188, 1188f

management, 1188–1189

Delorme plication, 1188, 1190f

perineal rectosigmoidectomy, 1188, 1189f

transabdominal rectopexy, 1188, 1191f

ventral rectopexy, 1189

pathophysiology, 1187–1188

Rectovaginal fistula, 1185–1187, 1185f, 1185t, 1186f, 1186t

3385

causes, 1185, 1185t

classification, 1185, 1185f, 1186t

clinical manifestations, 1185

management, 1186

endorectal advancement of anorectal flap, 1185–1186, 1186f

Rectovaginal fistula, in Crohn disease, 822, 823f

Rectum, 1051. See also Anorectal disorders

anatomy, 420, 1052–1053, 1172, 1173f

arterial blood supply, 1054

diagnostics, 420–421, 420f, 421f

embryology of, 1051

epidemiology, 420

Rectus abdominis muscle rotation flap, 1451, 1453f

Rectusial veins, 1223

Recurrent laryngeal nerve (RLN), 1341

injury to, 135

Red blood cell (RBC), 356

Refeeding syndrome, 37

Reflux-induced respiratory symptoms, pathophysiology of, 666

Regulatory T cells, 526

Rehabilitation, 348–349

Reliability adjustment, 317

REMATCH Trial, 1541

Renal acidosis, 209

Renal agenesis, 1934

Renal anomalies, 1883

Renal arteries, 1601–1602, 1601f, 1602f

Renal artery aneurysm (RAA), 1667–1668

Renal artery occlusive disease, 1662–1667

Renal artery stenosis (RAS), 547, 1665t

direct assessment of, 1602, 1602f

indirect assessment of, 1601

Renal artery thrombosis, 547

Renal compensation, 210

Renal dysfunction

acute kidney injury

defining, 307

prevention of, 307–308

perioperative management, 308–309

preoperative evaluation, 307

risk stratification, 307

Renal failure, 1727

with calcineurin inhibitors, 524

hypocalcemia, 206

nutritional support in, 38

Renal hypoperfusion, 156

Renal insufficiency and failure, 252–253

Renal natriuretic peptide, 197

Renal outer medullary potassium (ROMK) channel, 196

Renal prostaglandins, 197

Renal replacement therapy (RRT), 185, 309

Renal : systemic renin index (RSRI), 1664

Renal transplantation, 541–551

classic acute cell-mediated rejection and, 550

complications, 547–548, 548f

deceased donors, 543

donor kidneys, 544

3386

future prospects, 551

and hyperacute rejection, 549

immunology of, 541–542

immunosuppression, 549

immunosuppressive complications, 550–551, 551f

living donors, 542–543

procedure, 544–547, 544t, 546f

rejection, 549–550

Renal tubular acidosis (RTA), 209

Renal vein renin ratio (RVRR), 1663

Renal/visceral artery occlusive disease and, 1760–1761

Renin, 154, 1386

Renin–angiotensin system, 196, 1662f

Renovascular hypertension (RVH)

arterial reconstructive surgery for, 1665

arteriosclerosis and, 1664

endovascular renal revascularization, 1666–1667, 1666f, 1666t

fibromuscular dysplasia and, 1664–1665, 1664f, 1667

indications for renal revascularization, 1665t

medical management of, 1664

pathophysiology of, 1662

Reoxygenation, 278

Reperfusion injury, 121–122

Repopulation, tumor, 278

Rescue therapies, 176

Resection. See also Oncology

curative, 274–275

extent of, 275–276

Reserpine, 512

Resistance to APC, 79

Resistive index (RI), 1602

Respiratory acidosis

clinical features, 211

compensatory mechanisms, 212

definition, 211

treatment, 212

Respiratory alkalosis

clinical features, 211

compensatory mechanisms, 211

definition, 211

treatment, 211

Respiratory compensation, 210

Respiratory failure, nutritional support in, 38

Respiratory papillomatosis, 1855

Respiratory quotient (RQ), 174

Respiratory symptoms (RS), 657

Respiratory system, 1806

embryology, 1855

Response Evaluation Criteria in Solid Tumors (RECIST), 277

Restaged cancer, 282

Rest pain, 1687

Restrictive cardiomyopathy, 1580

Resuscitation

endpoints of, 160–161

of patients, 220

Resuscitation Outcomes Consortium (ROC), 354

Resuscitative endovascular balloon occlusion of aorta (REBOA), 356–358

3387

benefits of, 358

device, 347

performance of, 357f

Resuscitative strategy, 159

Resuscitative thoracotomy (RT), 441

Reteplase, 1527

Retinol-binding protein (RBP), as nutrition biomarker, 25, 25t

Retinopathy of prematurity (ROP), 1817

Retrobulbar hematoma, 377

Retrocolic Roux limbs, 742

Retrograde open mesenteric stenting (ROMS), 1653

Retrograde urethrography (RUG), 429

Retroperitoneal hematomas, 407

Return to intended oncologic treatment (RIOT), 277

Revascularization, 2050

Revised Cardiac Risk Index, 299, 300t

Rex shunt, 957

Reye syndrome, 939

Reynolds pentad, 1012

Rhabdoid tumor, 1956

Rhabdomyolysis, 152

Rhabdomyomas, 1516

Rhabdomyosarcomas, 637, 1516

alveolar, 1963

biologic features, 1963

clinical group assessment, 1964

diagnosis, 1963–1964

embryonic, 1963

epidemiology, 1962–1963

future directions, 1966

genetic risk, 1962–1963

lung, 1852t, 1854

microscopic image, 1963f

pathology, 1963

pleomorphic, 1963

presentation, 1963–1964

risk status, 1964

staging, 1964

surgical–histopathologic clinical grouping system, 1964t

tnm pretreatment staging system, 1964t

treatment, 1965–1966

Rheumatoid arthritis (RA), 2053

Rhinoplasty, 2057–2059

Rhinorockets, 376

Rhinosinusitis, 632

Rib fractures, 394–395, 395f

treatment of, 395–396, 396f

Ribs, 1446, 1447f

embryology of, 1844

Richmond Agitation-Sedation Scale (RASS), 178

Richter hernia, 1227, 1227f

Rifampin, in prosthetic graft infections, 1616

Rifaximin, in hepatic encephalopathy, 954

RIFLE (risk, injury, failure, loss, end-stage), 307

Right ventricular assist device (RVAD), 1540. See also Mechanical circulatory support (MCS)

Rimonabant (Acomplia), 741

Ringer solution, lactated, 159

3388

Risk stratification

cardiovascular system, 299–300, 300t

hepatic dysfunction, 305–306

renal dysfunction, 307

Ritonavir, 948

Rituximab, 524

in immune thrombocytopenic purpura, 1274

Rivaroxaban, 180, 474

Rockall risk scoring system, GI hemorrhage, 1065, 1066t

Rocuronium, 243, 355

Rokitansky–Aschoff sinuses, 1046

Romiplostim, 1274

Ross–Konno procedure, 1493

Rotavirus, 1897

Rous sarcoma virus (RSV), 270

Roux-en-Y biliary-enteric anastomosis, 412

Roux-en-Y choledochojejunostomy, 565, 1030, 1031

Roux-en-Y configuration, 617

Roux-en-Y cystojejunostomy, 869

Roux-en-Y gastrojejunal reconstruction, 742, 742f

Roux-en-Y hepaticojejunostomy, 570, 1031

Rovsing sign, 1200t

Royal College of Obstetricians and Gynaecologists, 485

Rubber band ligation, of hemorrhoid, 1179, 1179f

S

Sacral agenesis, 1883

Sacral dysplasia, 1883

Sacral nerve stimulation (SNS), 1061, 1192

Sacrococcygeal teratomas (SCT), 1810, 1831–1832

S-adenosylmethionine (SAMe), 945

Safety attitudes questionnaire (SAQ), 325

Safety rounds, 325, 326f

Salivary tumors, 635, 635t, 636f–637f

Salmon calcitonin, 1368

Salmonella, 1758

Santorini duct, 1925

Saphena varix, 1232

Saphenous vein stripping/ablation, 1792

Sarcomas, 2010

histologic grading of, 2015

liver, in children, 1917

lung, in children, 1854

osteogenic, 1851–1852

soft-tissue, in pediatric patients, 1852

Scald burns, 214, 215

Scaphocephaly, 2065

Scarff–Bloom-Richardson scoring system, 1316

Scarpa fascia, 1213

Schistosomiasis, 933, 933f

Schwannomas, 1854

Sciatic hernia, 1255, 1256f

Scientific Registry of Transplant Recipients (SRTR), 321, 553, 591

Sclerosants, 1072

Sclerotherapy, 1791

for hemorrhoids, 1179

Scorpions, 504

Scottish Intercollegiate Guidelines Network (SIGN), 1072

3389

Scrotum, anomalies of, 1942–1944

SeccaTM procedure, 1191

Secondary hyperparathyroidism, 205

Secondary megaureters, 1937

Second-hit phenomenon, 157

Secretin, 773, 845, 846, 997

Secretin test, 847, 847t

Secretory component, 776

Secretory vesicles, neutrophil granules and, 89, 90t

Sedation

analgesia, 248, 248t

and paralysis, 178

scales, 178

Segmental arm pressures, 1597, 1598f

Segmental contractions, colonic, 1057

Selective Digestive Decontamination (SDD), 188

Selective estrogen receptor modulator (SERM), for breast cancer, 1305, 1311, 1312

Selective Oral Decontamination (SOD), 188

Selective relaxant binding agents, 244

Selective serotonin reuptake inhibitors (SSRI), 297, 299t

Selective visceral arteriography, in GI bleeding, 1070, 1070f

Selenium

daily requirements of, 24t

deficiency of, 23

supplementation, 37

Self-expanding metallic stent (SEMS), 797

Self-regulated learning, 3. See also Dreyfus model, for skill development

and lifelong learning, relationship between, 4, 4t

phases in, 3

adjustment, 4

assessment, 4

learning, 4

planning, 3–4

in surgery education, 7

Semiessential amino acids, 182

Semilunar line, 1216

Sengstaken–Blakemore tube, 960, 960f, 1074

Sentinel lymph node biopsy (SLNB), 1317–1318

Seprafilm, 791

Sepsis

aortic infection and, 1615

guidelines, 187

metabolic adaptations to, 30–31

Septic shock, 152

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

Serafini hernia, 1257

Serine protease inhibitor (SERPIN), 78

Serine protease inhibitor, kazal type 1 (SPINK1), 847

Serotonin, 845

Serotonin release assay, 77

Serous cystadenomas, pancreatic, 883

Serrated polyposis syndrome, 1096, 1098f

Serum amyloid A (SAA), 120

Serum analysis, 233

Serum-to-ascitic fluid albumin gradient (SAG), 967

Sessile serrated adenoma (SSA), 1093, 1096, 1099f, 1106–1107

Sheep thyroid extract, 740

3390

Shock

causes of, 150t

compensatory responses to, loss of, 156

compensatory responses to, organ-specific

cardiac and microvascular response, 154

genetic regulation of response, 156

hepatic response, 156

immunoinflammatory response, 155–156

neuroendocrine response, 154–155

pulmonary response, 156

renal response, 156

complications of

abdominal compartment syndrome (ACS), 157

coagulopathy, 158

hypothermia, 157–158

ischemia–reperfusion injury, 157

multiple organ dysfunction syndrome (MODS), 157

second-hit phenomena, 157

evaluation of, 148–149, 148t

hemodynamic patterns in, 151t

monitors

arterial wave contour analysis, 161–162

bedside ultrasound and echocardiography, 162

central venous pressure (CVP), 161

pulmonary artery catheter (PAC), 161

overview, 147–148

pharmaceutical support, 162t

corticosteroids, 164

future therapies, 164

inotropes and vasopressors, 162–163

metabolites and electrolytes, 164

vasodilators, 163–164

treatment

fluid therapy, 158–159

permissive hypotension, 159

resuscitation, endpoints of, 160–161

transfusion, 159–160

types of

cardiogenic shock, 149–151

distributive shock, 152

extracardiac obstructive shock, 151

hypoadrenal shock, 153

hypovolemia, physiologic response to, 153, 153f

hypovolemic shock, 149

neurogenic shock, 152–153

rapid response, 153–154

septic shock, 152

sustained response, 154

traumatic shock, 152

SHOCK-IABP Trial, 1549

Shock resuscitation algorithm, 155

Short bowel syndrome, and nutritional support, 39

Short Form 36 (SF-36) instrument, 682

Short-gut syndrome, 1369

Shouldice repair, 1234, 1235f

Shunts, for variceal bleeding, 962–965

distal splenorenal shunt, 963, 964f

3391

end-to-side portacaval shunts, 962, 962f

interposition mesocaval shunt, 963, 963f

partially diverting shunts, 962–963, 963f, 964f

portacaval Sarfeh shunt, 963, 964f

selective shunts, 963, 964f

side-to-side portacaval shunts, 962, 963f

totally diverting shunts, 962, 963f

Sialadenitis, 633

uncomplicated, 633

Sibutramine, 740

Sickle cell anemia, 1267, 1276–1277

Sick syndrome, 187

Sigmoid colon, 1052

Sigmoidoscopy, 1101

Sigmoid volvulus, 1052

Silvadene (silver sulfadiazine), 222

Silver-impregnated grafts, 1616

Silver nitrate, 222

Simeprevir, 947

Simethicone, 790

Simple Endoscopic Score for Crohn disease (SES-CD), 814

Simplified Acute Physiology Score (SAPS), 170

Simultaneous kidney–pancreas transplants (SPK), 610, 611

Single-balloon enteroscopy, for small bowel tumors, 830

Single-incision approach to laparoscopic cholecystectomy (SILS), 1004

robotic SILS, 1004, 1006f

Single-incision laparoscopic (SILS) appendectomy, 1205–1206

Single-nucleotide polymorphisms (SNPs), 42, 156

Single photon emission tomography (SPECT) scanning, for vascular infection, 1613

Single port laparoscopic surgery (SPLS), for colorectal cancer, 1134–1135

Single-shot techniques, 247

Sinonasal tumors, 637–638, 638f

Sinonasal undifferentiated carcinoma (SNUC), 637

Sinusitis, 632, 633f

complications of, 633t

Sinus venosus defects, 1482. See also Atrial septal defect (ASD)

SIOP therapy, 1957

Sirolimus, 521, 624, 1527

Sirolimus–FKBP12 complex, 521

Sistrunk procedure, 1341

Sitz marker study, 1058–1059, 1058f

Skeletal fixation, 2050

Skin alternatives, 227

Skin and soft tissue infections (SSTI), 137–138

broad-spectrum antimicrobial therapy, 139

diagnosis/differentiation, NSTI and nonnecrotizing infections, 138–139

necrotizing soft tissue infections (NSTI), 139–140

pyomyositis, 140

Skin grafting, 2035

Skin integrity, 1816

Skin lesions, 1993f

Skull fracture, 371

closed depressed, 371

depressed, 371t

Sleeve gastrectomy, 744, 744f, 751

Slipping rib syndrome, 1847

Slow continuous ultrafiltration (SCUF), 185

3392

SMAD proteins, 60

Small bowel atresia, 1878f

Small bowel disease, 819–820

Small bowel obstruction (SBO)

management of, 797–799, 798t, 799t

Small bowel tumors, 827–837

benign, 830

capsule endoscopy, 829

clinical presentation, 828, 829t

complications from, 829t

diagnosis, 828–829

epidemiology, 827

exploratory laparoscopy, 830

malignant, 830, 831f

gastrointestinal stromal tumor, 835–836

lymphoma, 834–835

neuroendocrine tumors, 830–833

small bowel adenocarcinomas, 833–834

metastatic tumors, 837, 837f

pathogenesis, 827–828

predisposing risk factors

celiac disease, 828

Crohn disease, 828

dietary and lifestyle factors, 828

familial adenomatous polyposis, 828

hereditary nonpolyposis colorectal cancer, 828

Peutz–Jeghers syndrome, 828

small bowel enteroscopy, 829

double-ballon enteroscopy, 829–830

single-balloon enteroscopy, 830

spiral enteroscopy, 830

Small cell lung cancer, 1434–1435

Small intestine, 770–780

anatomy and embryology, 770

auerbach plexus, 772

digestion and absorption, 776–780, 777f

duodenum, 770–771

immunoglobulin secretion, 775–776

immunology, 774–776

jejunum and ileum, 771

microbiota, 780

microscopic anatomy, 772–774

motility, 774

mucosa, 772

physiology, 773–774, 773f

sodium absorption in, 777f

submucosa, 772–773

villus, 776f

Small intestine submucosa (SIS), 1797

Smoke detectors and carbon monoxide detectors, 470

Smoking, 1677, 1688f

abdominal aortic aneurysms and, 1734–1735

aortic aneurysms and, 1567

and chronic pancreatitis, 870

and colorectal cancer, 1118

and coronary artery disease, 1522

and pancreatic cancer, 879

3393

Smoking cessation, benefits of, 303

Smooth endoplasmic reticulum (SER), 779

Snakebite, 496–502, 497f, 497t, 498f, 498t, 499f, 501f, 502f

Soave procedure, 1901–1902, 1901f

Societe Internationale d’Oncologie Pediatrique (SIOP), 1947

Society of Thoracic Surgeons (STS) Measurement Taskforce, 316

Socioeconomic status (SES) and burns, 215

Sodium, 23, 195

concentration and water balance, 195

content in adult, 192

and water

cerebral salt wasting (CSW), 202

hypernatremia, 203, 203f, 203t

hyponatremia, 202

pseudohyponatremia, 202

syndrome of inappropriate antidiuretic hormone (SiADH), 202

Sodium dependent hexose transporter (SGLUT-1), 778

Sodium morrhuate, 1072

Sodium retention, in cirrhosis, 951

Sofosbuvir, 947

Soft-tissue sarcomas

clinical presentation, 2012, 2013f

cytogenetic abnormalities in, 2012t

diagnosis, 2012

diagnostic biopsy, 2014

distribution, 2011f

epidemiology, 2010

pathologic classification, 2014–2015

pediatric, 1852

radiation-associated, 2011f

staging, 2015–2017

treatment, 2017–2021

SOLESTA, 1061

Solid organ injuries, in children, 467–469, 467t, 468f

Solid organ transplant

antimetabolite drugs in, 522

immune response to, 518–520, 519f

immunosuppression induction, 520

treating rejection in, 522–524

Solid-pseudopapillary tumors (SPTs), 884–885

Solitary kidney, 1935

Solitary rectal ulcer syndrome (SRUS), 1187–1188

Somatosensory-evoked potentials (SSEPs), 1720

Somatostatin, 114, 718, 773, 840, 845, 849–850, 865, 1074

exogenous administration, 850

secretion and action, 849–850

in variceal bleeding, 959

Somatostatin analogs (SSAs), in acromegaly, 1412–1413

Somatostatinoma, 900t, 910, 910t

Somatostatin receptor scintigraphy (SRS)

in multiple endocrine neoplasia type I, 1379, 1379f

pancreatic endocrine neoplasms, 903–904, 903f

Somatotroph adenomas. See Growth hormone-secreting adenomas

Sonic Hedgehog (SHh), 944

Sorafenib, 2021

Sorbitol, 802

Source control, definition, 129

3394

Sphincter of Oddi, 851, 997

stenosis of, 1031

Sphingomyelinase D, 503

Sphingomyelins, 14

Spiders, 502–503, 503f

Spigelian hernia, 1254

Spina bifida, 1833

Spinal cord injury

and cerebrovascular injury, 466

in children, 461–466

without radiographic abnormality, 466

Spinal cord stimulation (SCS), 1704

Spinal shock, definition, 153

Spinal trauma, in elderly patient, 476

Spiral enteroscopy (SE), small bowel tumors, 830

Spironolactone, in ascites, 967

Splanchnic artery aneurysms, 1657–1662

Splanchnic ischemia, 157

Splanchnic vascular disease, 1648

anatomy, 1648–1649, 1649t

physiology, 1648–1649

Splanchnic vein thrombosis, 1653

Spleen, 1262–1287

abscess of, 1283–1284

accessory, 1266

anatomy, 413

cysts of, 1283, 1283f

diagnostics, 413

embryology and anatomy, 1263–1266

anatomic relations, 1263, 1263f

ligaments, 1264–1265, 1265f

microanatomy, 1265–1266, 1266f

surface of spleen, 1264f

vascular anatomy, 1264, 1265f

epidemiology, 413

history of surgery for, 1262–1263, 1263f

metastatic disease to, 1279

OIS-AAST grading scale, 413t

pathophysiology

hypersplenism, 1268, 1268t

hyposplenism, 1267–1268, 1268t

physiology, 1266–1267, 1266t

surgical treatment (see Splenectomy)

trauma, 1270–1273, 1270f–1272f, 1270t

treatment, 413–415, 414f, 415f

vascular disorders of, 1282

Splenectomy, 414, 1269

diagnostic, 1281–1282, 1281t

iatrogenic, 1269, 1280–1281

incidental, 1280

indications for, 1269–1270, 1269t

autoimmune/erythrocyte disorders, 1269, 1273–1277

hypersplenism, 1269, 1277–1280

miscellaneous, 1282–1284

trauma of spleen, 1270–1273, 1270f–1272f

vascular disorders, 1282

infections after, 1286–1287

3395

laparoscopy, 1286

operative technique, 1284–1286, 1284t, 1285f

partial, 1286

sequelae of, 1286–1287

Splenic artery, 1264, 1265f

Splenic artery aneurysms, 1282, 1657–1658, 1657f, 1658f

Splenic rupture, atraumatic, 1273

Splenic sinuses, 1266

Splenic vein, 1264, 1265f

Splenic vein thrombosis, 957, 1282

Splenophrenic ligaments, 1265

Spontaneous bacterial peritonitis, 968–969, 969t

Spontaneous breathing trials (SBT), 178

Sporadic hepatoblastoma, 1968

S100 proteins, 115–116

SpyGlass cholangioscopy, 1029

Squamous cell carcinoma (SCC), 629, 638, 699, 1991

anal canal, 1195–1196, 1197t

oral cavity, oropharynx, larynx, 639t

ulcerative, 2003f

Stab wound (SW), 403

and ureteral injuries, 425–426

Stalk effect, 1405

Stamm gastrostomies, 37

Standard resuscitation (SR), 344

Staphylococcus aureus, 221, 1303, 1348, 1773, 1840, 1865

Staphylococcus epidermidis, 1816

Stapled hemorrhoidopexy, 1180, 1180f

Starvation, 27

metabolic response to, 27, 27t

in surgical patient, 27

State Surgical Care and Outcomes Assessment Program (SCOAP), Washington, 132

Statins, 299t, 301, 1735

in myocardial infarction, 1525

Steatorrhea, pancreatic, 847

and intestinal steatorrhea, 847–848, 848t

Stenosis of sphincter of Oddi, 1031

Stereotactic body radiation therapy (SBRT), 279

Stereotactic core biopsy, 1297–1298

Sternal clefts, 1456–1457, 1457f, 1847

Sternocleidomastoid neck incision, 386

Sternothyroid muscles, 1341

Steroids, 178, 298, 299t, 522

in Crohn disease, 816–817, 816t

side effects of, 522

Stevens–Johnson syndrome, 940

Stewart–Treves syndrome, 276

St. Jude Medical Epic Valve, 1508, 1509f

St. Jude Medical Regent Valve, 1508, 1508f

Stochastic effects, 1979

Stomach, 712, 713f

anatomy, 417

arterial blood supply of, 713f

blunt injury, 417–418

diagnostics, 417–418

lymphatic drainage of, 714f

treatment, 418

3396

vagal innervation of, 714f

Stool tests, for colorectal cancer, 1126

Strength exercise, 234

Streptococcus pneumoniae, 969, 1286, 1469, 1865

Streptococcus pyogenes, 1348

Streptomyces hygroscopicus, 521

Stress

carbohydrate metabolism during, 29

lipid metabolism during, 29

metabolic response to, 27–32

neuroendocrine and cytokine-mediated response to, 27–29, 28f

protein metabolism during, 29

substrate metabolism changes during, 29

wound healing, effect on, 65

Stress gastritis, 735–737, 1073–1074

Stress gastrointestinal bleeding prophylaxis, 183–184

Stress hormones, 154, 181

Stress proteins, 92

Stress response, 119–120

chronic inflammation, 122

reperfusion injury, 121–122

systemic inflammatory response syndrome (SIRS), 122

Stress test, 1524

Strictureplasty, 818–819

Strictures, in Crohn disease, 818–819, 818f

Stroke

and carotid bifurcation occlusive disease, 1623, 1623f

clinical manifestations of, 1624

pathogenesis of, 1623–1624

Stroke volume, reduced, 154

Stroke volume variability (SVV), 201

Stromal cell–derived factor-1 (SDF-1), 104

Structural measures of quality. See also Surgical care quality measurement

limitations of, 315

strengths, 314

ST-segment elevation myocardial infarction (STEMI), 1522, 1523

Subacute thyroiditis, 1348

Subarachnoid hemorrhage, CT scan, 365

Subcutaneous emphysema, 396

Subdural hematomas, 372

acute, 365

head injury and, 371–372

Sublay prosthetic repair, 1250–1251, 1251f

Submucosal polyps, 1107–1109, 1108f

Substance abuse, 228

Substance P, 845

Succinate dehydrogenase (SDH), 767

Succinylcholine, 243, 243t, 309, 355

Sucrose disaccharides, 778

Sugar-free chewing gums, 802

Sugiura procedure, 965–966, 966f

Sulbactam, 130

Sulfamethoxazole, 550, 573

Sulfamylon, 222

Sulfotransferases, 18

Sulindac, 1105

Sump syndrome, 1011–1012

3397

Sunitinib, 767, 2021

Superficial spreading melanoma (SSM), 1992

Superficial vein thrombophlebitis (SVT), 1778

Superior laryngeal nerve (SLN), 1342

Superior mesenteric artery (SMA), 275, 616, 771, 851–852, 1648–1649, 1892–1894

aneurysm, 1659–1660, 1660f

Superior mesenteric vein (SMV), 771, 954

Superior vena cava (SVC), 172

Superior vena cava (SVC) syndrome, 1478–1479

Supernumerary kidney, 1934

Supine hypotensive syndrome, 483

Supplemental oxygen, in perioperative period, 143

Supplemental parenteral nutrition, 183

Suprarenal abdominal aortic aneurysms, 1757–1758

Supravesical fossa, 1219

Supravesical hernia, 1255, 1256f

Surgeon in cancer management, 273–274

curative resection, 274–275

diagnosis and staging, 274

palliative surgery, 275

surgical intent, 274

Surgery

and accidental injury, differences between, 30, 30t

nutritional support in, 32 (see also Nutritional support)

physiologic responses to, 29–30

Surgery Education programs, 7

Surgical airways, 1472

Surgical Care Improvement Program (SCIP), 169, 313, 315, 320, 328t

Surgical care quality measurement

choice of right measure, 316

composite measures, 315–316

limitations, 316

strengths, 316

current measures, 313–314, 314t

development of measures, 317–318

individual quality measures

outcomes, 315

process of care, 315

structure, 314–315

Surgical complications, grading of, 291t

Surgical hand antisepsis, 143

Surgical infections. See also Complicated intra-abdominal infection (cIAI); Surgical site infections (SSI)

broad-spectrum antimicrobial therapy, 128, 129t

intra-abdominal infections

classification, 129

diagnosis, 129

treatment, 129–130

pathogen identification, 129

skin and soft tissue infections (SSTI), 137–138

broad-spectrum antimicrobial therapy, 139

classification, 138

diagnosis/differentiation, NSTI and nonnecrotizing infections, 138–139

necrotizing soft tissue infections (NSTI), 139–140

pyomyositis, 140

source control, 129

specific intra-abdominal infections

appendicitis, 130–132

3398

biliary infections, 132–133

clostridium difficile infection (CDI), 135

diverticulitis, 133–134

pancreatitis, 135–137

Surgical Infection Society, 415

and Infectious Disease Society of America, 1201

Surgical mortality, variation in, 290f

Surgical outcomes, cancer-related. See also Oncology

disease recurrence, 276–277

progression-free survival, 277

return to intended oncologic treatment (RIOT), 277

Surgical quality improvement

centers of excellence (COE), 319

outcome feedback, 321

pay for performance, 320–321

Surgical readmissions, 291t

Surgical site infections (SSI), 328

challenges in, 144

chlorhexidine as skin surgical site preparation, 143

colorectal surgery and, 143–144, 1130–1131

deep incisional, definition, 141t

definitions, 141, 141f, 141t

epidemiology, 140–141

normoglycemia maintenance, 143

normothermia maintenance, 143

prevention of, 142–143

removal of body hair, 143

risk factors for

basic SSI risk index, 141–142

superficial incisional, definition, 141t

supplemental oxygen, perioperative period, 143

surgical hand antisepsis, 143

treatment of, 144

Surgical wound infection, 307

Surveillance, Epidemiology, and End Results (SEER) program, 1947

Sustained low efficiency dialysis (SLED), 186

Swan–Ganz catheter, 790

Swanson metacarpophalangeal joint arthroplasty (SMPA), 2054

Sweat chloride test, 1889

Sweat gland carcinomas, 2006

Sweating, 198

Swenson procedure, 1902, 1902f

Swinging flashlight test, 1407

Swiss cheese model, 324

Swollen brain, 365

Syme amputation, 1709, 1711f

Synchronized intermittent mandatory ventilation (SIMV), 1812

Syncope, 1507

Syndactyly, 2052

Syndrome of inappropriate antidiuretic hormone (SiADH), 202

SYNERGY trial, 947

Syphilis, 1635

Systemic acidosis, 211

Systemic inflammatory response syndrome (SIRS), 122, 152, 217, 860

Systemic lupus erythematosus (SLE), 77

Systolic blood pressure (SBP), 155, 344

Systolic pressure variation (SPV), 258

3399

T

Tachycardia, 160

Tacrolimus, 521, 624

Tactical Combat Casualty Care Committee, 489

Tactical Field Care (TFC), 347

Taeniae coli, colon, 1051

Takayasu arteritis, 1638, 1640f

and thoracic aneurysms, 1566

Tamoxifen, 1325

for breast cancer, 1311

for breast pain, 1302

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

Tangential excision, 223

Tanner stages, of breast development, 1293, 1293f

Tar, causing burn, 216

Taussig–Bing anomaly, 1487

Taxanes, 1325

Taxonomy, 331

T-cell receptors (TCR), 519

99mTc pertechnetate, 1345

Technetium 99m, 547

Technetium-macroaggregated albumin (MAA) scanning, 952

Temozolomide, 1412

Tendinous arch, 1223

Tendo-achilles lengthening (TAL), 1708

Tenofovir, 936

Tension pneumothorax, 353, 396

signs and symptoms of, 396

Teratomas

fetal surgery for, 1831–1832

of liver, 1916

lung, 1854, 1855f

mediastinal, 1855f

sacrococcyteal, 1831–1832

Terlipressin, in hepatorenal syndrome, 952

Tertiary hyperparathyroidism, 205

Testicles

anomalies of, 1942–1944

torsion of, 1943, 1943f

undescended/cryptorchid, 1942–1943, 1942f

Tetany, 206

Tethered spinal cord syndromes, 1883

Tetracyclines, 1926

Tetralogy of Fallot (TOF), 1486–1487, 1486f

Texas Organ Sharing Alliance, 593

Thalassemia, 1276

The Children’s Oncology Group (COG), 1947

Thermal burn injuries, 229

Thienopyridines, 299t, 1527

Thoracic aortic aneurysm (TAAs), 1562, 1563f

degenerative, 1564–1565

diagnosis, 1566, 1566t

etiology and risk factors, 1564–1566, 1564t

genetically triggered, 1565, 1565f, 1565t

history, 1562

infectious and inflammatory, 1565–1566

management and natural history, 1566

aortic arch aneurysms, 1568, 1568f

3400

aortic root and ascending aortic aneurysms, 1567–1568, 1568f

descending thoracic aortic aneurysms, 1568–1569

endovascular therapy, 1569, 1570f

hybrid procedures, 1569–1570

medical management, 1566

open surgical management, 1567

surgical indications, 1566–1567

outcomes and complications, 1570–1571

prevalence and classification, 1564

traumatic pseudoaneurysm, 1566

Thoracic aortic dissection

classification, 1571

Debakey system, 1571, 1571f

Stanford system, 1571

diagnosis, 1572

etiology and risk factors, 1571–1572

history, 1571

management and natural history, 1572

endovascular therapy, 1572, 1573f

type A aortic dissection, 1572, 1572f

outcomes and complications, 1572–1573

prevalence, 1571

Thoracic cavity, 441

Thoracic ectopia cordis, 1847

Thoracic endovascular aneurysm repair (TEVAR), 1569, 1570f

complications, 1570–1571

contraindications to, 1569

planning for, 1569

for type A and B aortic dissections, 1572, 1573f

Thoracic esophageal injury, 401, 401f

Thoracic outlet syndrome (TOS), 1457–1459, 1459f, 1639

Adson maneuver, 1457, 1459f

neurogenic, 1457–1458, 1459f

postoperative complications, 1458

rehabilitation, 1458–1459

surgical approach, 1458, 1460f, 1461f

vascular, 1457

Thoracic trauma, 394–402

ED thoracotomy vs. operative thoracotomy, 401–402, 401f

initial imaging, 394

injuries, 394–401

Thoracic tumors, 1851–1855

Thoracoabdominal aortic aneurysms (TAAA), 1717

aortic dissection and, 1728–1729

classification, 1719f

clinical manifestations, 1718–1719, 1718f

complications, 1728, 1728t

delayed neurologic deficits, 1726–1727, 1727f

diagnostic imaging, 1719–1720, 1719f

elephant trunk technique for, 1723, 1724f, 1725

Thoracoabdominal aortic aneurysms (continued)

endovascular repair and, 1729

epidemiology, 1717

glomerular filtration rate, 1727–1728

neurologic outcomes, 1725–1727, 1725f–1727f

operative techniques, 1720–1725, 1720f–1724f

pathogenesis, 1717–1718

3401

postoperative management, 1725

preoperative evaluation, 1720

renal failure, 1727

surgical outcomes, 1725–1728

survival rates, 1718f

Thoracotomy, for intralobar sequestration, 1847

Three-hit hypothesis, pancreatitis, 871, 871f

Thrifty gene hypothesis, 42

Thrifty phenotype hypothesis, 42

Thrombectomy, 570

Thrombi, 74

Thrombin, 69

Thrombocytopenia

in cirrhosis, 950

dilutional, 158

Thrombocytosis, 1968

Thrombolytic therapy, 1782

Thrombomodulin (TM), 71

Thrombophlebitis of thoracoepigastric vein, 1302, 1302f

Thromboplastin, 14

Thrombopoietin, 950

Thromboprophylaxis, 75

Thrombosed external hemorrhoids, 1180, 1181f

Thrombosis, 1623

cell adhesion molecules, 72–74

high risk for, 78–79, 78t

leukocytes and thrombosis, 74–75

lower risk for, 79

Thrombotic thrombocytopenia purpura (ITP), 1274–1275

Thumb duplication, 2053

Thymic cysts, 1840, 1851

Thymomas, 1475–1476

Masaoka staging system for, 1476t

resection, 1476, 1477f

Thyroglobulin, 1344

Thyroglobulin autoantibodies (TgAbs), 1344

Thyroglossal duct cysts (TGDCs), 1341, 1840, 1840f

Thyroid abnormalities, 187

Thyroid autoantibodies, 1344

Thyroid cancer, 1351

classification, 1351

external beam radiotherapy, 1356

lymphadenectomy, 1355

metastatic, 1356

molecular markers, 1352

preoperative ultrasound, 1355

radioiodine therapy, 1355–1356

thyroidectomy, 1355

thyroid-stimulating hormone suppression, 1356

Thyroidectomy, 1355, 1356

complications, 1358–1359, 1358t

technique, 1356–1358, 1356f, 1357f

Thyroid gland, 1340–1359

anatomy, 1341

airway relationships, 1341

Cernea classification, 1342f

fascial relationships, 1341

3402

lymphatic relationships, 1342, 1342f

muscular relationships, 1341

neurologic relationships, 1341–1342, 1341f, 1342f

parathyroid relationships, 1342–1343

vascular relationships, 1341

congenital abnormalities, 1340–1341

embryology, 1340

functional disorders

hyperthyroidism, 1346–1347

hypothyroidism, 1347

thyroiditis, 1347–1348

imaging techniques, 1344

computed tomography, 1346, 1346f

cross-sectional imaging, 1346

magnetic resonance imaging, 1346

nuclear medicine, 1345

positron emission tomography, 1345–1346

ultrasonography, 1344–1345, 1345f

laboratory tests, 1344

calcitonin, 1344

free thyroxine and free triiodothyronine, 1344

thyroglobulin, 1344

thyroid autoantibodies, 1344

thyroid-stimulating hormone, 1344

total thyroxine and total triiodothyronine, 1344

lingual, 1340

malignancies, 1351–1356

metastases to, 1355

nodular disease

nontoxic multinodular goiter, 1348–1349

solitary thyroid nodule, 1349–1351

physiology

thyroid hormone, action of, 1344

thyroid hormone, production of, 1343–1344

surgery, 1356–1359 (see also Thyroidectomy)

Thyroid hormone, 741

action of, 1344

metabolism, 1343f

production of, 1343–1344

Thyroiditis, 1347–1348

Thyroid lymphomas, 1354–1355

Thyroid nodule, solitary, 1349–1350, 1349f

Thyroid sheath, 1341

Thyroid-stimulating hormone (TSH), 1340, 1344

Thyrotroph adenomas. See TSH-secreting adenomas

Thyroxine, 1343–1344

Ticlopidine (Ticlid), 1527

TIGR Matrix Surgical Mesh®, 1229

Time to progression (TTP), 285

Tissue damage, and stress response, 31

Tissue expanders, 1247

Tissue expansion, 231

Tissue factor pathway inhibitor (TFPI), 71

Tissue inhibitors of MMPs (TIMPs), 1225, 1564

Tissue plasminogen activator (tPA), 71, 398, 791

Tissue plasminogen inhibitor, 1527

Tissue typing, 577

3403

T lymphocytes, 95–97

TNF-α, 101–102, 102f

TNM classification, 2015

Tobacco and cancer, 270, 270t

Toe Transfer, 2048, 2049f

Tolazoline, 512

Tolbutamide response test, 850

Toll-interleukin-1 receptor (TIR), 116

Toll-like receptor 4 (TLR4), 947

Toll-like receptors (TLR), 116–117, 1816

Tolvaptan, 202

Tolypocladium inflatum, 521

Tonicity of body fluids, 194–195

Torsion of testicle, 1943, 1943f

Torso vascular injury, 434

Total artificial heart (TAH), 1540, 1557, 1559f. See also Mechanical circulatory support (MCS)

Total body surface area (TBSA), 219, 220

Total body water (TBW), 192, 193t

Total colonic aganglionosis, 1904

Totally endoscopic coronary artery bypass (TECAB), 1534

Totally extraperitoneal laparoscopic repair (TEP repair), 1238–1240

Total mesorectal excision (TME), 1133, 1141–1142, 1142f

Total pancreatectomy (TP), for chronic pancreatitis, 871, 875–876

Total parenteral nutrition (TPN), 469, 998

acute pancreatitis, 865

administration routes, 37

complications with use of, 33, 33t, 34

composition of standard TPN solution, 34, 34t

considerations, 33–34

for infants, 1873

preoperative, 32

timing of initiation of, 33

Total sympathectomy, 247

Total urinary nitrogen (TUN), 26

Toupet fundoplication, 677, 680

Tourniquet, usage of, 354, 356

Toxic adenoma, 1347

Toxic colitis, in Crohn disease, 820

Toxic exposures, 2010

Toxic megacolon, ulcerative colitis and, 1086–1087

Toxic multinodular goiter (MNG), 1347

Toxic shock syndrome (TSS), 97, 1369

TP53 gene, 881, 1122

TPN. See Total parenteral nutrition

TP with islet autotransplantation (TPIAT), 875–876

Trace elements

daily requirements of, 24t

role of, 23

wound healing, role in, 63

Trachea, 1472

anatomy, 1472, 1472f

benign lesions of, 1472–1474, 1474f

Tracheal intubation, 353

Tracheobronchial foreign body (TFB) aspiration, 1464

Tracheobronchial injury, 400

treatment of, 400–401

Tracheobronchial tree, 1860

3404

Tracheoesophageal displacement index (TEDI), 1832

Tracheoesophageal fistula (TEF), 1855–1859, 1856f

with esophageal atresia, 1858

Tracheoinnominate artery fistula, management of, 1472, 1473f

Tracheomalacia, 1474–1475, 1859

and airway stents, 1475, 1475t

Tracheostomy, 387, 1472

complications, 1472, 1473f, 1474f

Traditional serrated adenoma (TSA), 1093, 1096

Trametinib, 2001

Tranexamic acid (TXA), 347, 1535

Transabdominal preperitoneal repair (TAPP), 1237, 1238, 1239f

Transanal–transabdominal proctectomy, 1146

Transarterial chemoembolization (TACE), 556, 832

Transatlantic Inter-Society Consensus (TASCII) criteria, for critical limb ischemia, 65

Transcapillary refill, 154

Transcranial Doppler (TCD), 1625

Transcutaneous oxygen, measurements of, 1606, 1606f

Transdermal narcotic delivery, 262

Transduodenal sphincteroplasty, 1030

Transesophageal echocardiography (TEE), 258, 1720

thoracic aortic aneurysm, 1566

Transferrin, as nutrition biomarker, 25, 25t

Transforming growth factor alpha (TGFa), 59

Transforming growth factor-b (TGF-b), 57, 108, 791

Transforming growth factor beta 1 (TGF-b1), 944

Transfusion, 159–160, 160t. See also Shock

autotransfusion, 160

ICU patient and, 180–181

type O (universal donor) blood, 160

type-specific blood, 160

Transfusion requirements in Critical Care (TRICC) trial, 180

Transhiatal esophagectomy (THE), 703

Transient hypoparathyroidism, 206

Transient ischemic attack (TIA), 1622

Transient relaxations of the lower esophageal sphincter (TLESR), 661–662

Transjugular intrahepatic portosystemic shunt (TIPS), 558, 560, 950

for ascites, 968

for variceal bleeding, 960–962, 961f

Transmetatarsal amputation, 1708–1709, 1710f

Transoral laser microsurgery (TLM), 640

Transplantation

cardiac, 575–585

candidate evaluation, 576

complications, 582–583, 582f, 583f, 584t

contraindications to, 577t

current issues, 584–585

donor selection and management, 576–577

ethics, 584

heart procurement, 578

historical perspective, 575–576

immunosuppression, 581–582, 582t

indications for, 576t

matching donor to recipient, 577

operative recipient management, 578–581, 578f, 579f, 580f

outcomes, 583–584

recipient management, 577–578

3405

stratifying risk and survival results, 576t

survival, 584f

hepatic, 552–573, 1923

acute rejection, 573

anesthetic management, 558

anhepatic phase and implantation, 561–564, 561f, 562f, 564f, 565f

antibody-mediated rejection, 571

auxiliary liver transplantation, 568, 569f

cell-mediated rejection, 571–572, 572f

chronic rejection, 572

complications, 568

contraindications to, 553–554

disease-specific indications and outcomes, 554–558, 554f, 555f

hepatic artery thrombosis, 569–570

immunosuppression induction, 572–573

indications for, 552–553

inferior vena cava stenosis, 570–571

intra-abdominal sepsis, 571

intracranial hemorrhage and, 554

intraoperative management, 558–559

King’s college criteria for, 557t

living donor liver transplantation, 566–568, 567f

MELD and PELD score, 553t

neurologic complications, 571

portal vein thrombosis, 570

postoperative hemorrhage, 568–569

postrevascularization phase, 565

recipient hepatectomy, 559–561, 560f

split liver transplantation, 565, 566f

surgical technique, 559, 559f

urgent listing criteria for, 553t

islet, 622

complications, 624

donor selection, 623

future of, 625

graft failure, 624–625

history of, 622

immunosuppression, 624

metabolic control, 624

patient selection, 622–623

perioperative care, 623–624

transplant techniques, 623, 623f

pancreas, 610, 610f, 616t

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

Banff classification, 620t

complications, 618–619

deceased donor pancreas allocation, 614

and diabetes mellitus, 621–622

donor evaluation, 614–615, 615t

evaluation and screening, 612–613

future of, 625

graft failure rates for, 619f

graft survival, 621f

immunosuppression, 618

living donor kidney-pancreas transplantation, 611, 612f

patient selection, 611

procurement technique, 615–616

3406

recipient operation, 617–618

recurrent autoimmunity, 620–621

rejection diagnosis and treatment, 619

solitary, 621

pulmonary, 587–603

bilateral, 598–599, 598f

complications, 599–602, 600t

contraindications, 588–592, 589t, 591f

donor management, 593–594, 594f

donor pool, 595–596, 595f

donor selection, 593, 593t

future considerations, 603

gastroesophageal reflux, 602–603

immunosuppression, 599

indications, 588, 588t

lung preservation, 594–595

operative technique, 597–599

outcomes, 599

primary graft dysfunction, 600

single, 597–598, 598f

transplantation operation, 596–597, 596f, 597f

Transplantation (continued)

renal, 541–551

classic acute cell-mediated rejection and, 550

complications, 547–548, 548f

deceased donors, 543

donor kidneys, 544

future prospects, 551

hyperacute rejection, 549

immunology of, 541–542

immunosuppression, 549

immunosuppressive complications, 550–551, 551f

living donors, 542–543

procedure, 544–547, 544t, 546f

rejection, 549–550

Transport, long-distance, 348

Transposition of great arteries (TGA), 1488–1491, 1488f

arterial switch operation, 1489, 1490f

dextro-TGA (d-TGA), 1488

levo-TGA (l-TGA), 1488

Mustard operation, 1489, 1489f

Rastelli procedure, 1489, 1491f

Transpulmonary pressure, 176

Transthoracic echocardiography (TTE), 155

Transversalis fascia, 1219, 1220f

Transverse colon, 1052

Transverse rectus abdominis myocutaneous (TRAM) flap, 1323, 1324, 2040f

Trastuzumab emtansine (T-DM1), for breast cancer, 1325

Trastuzumab, for breast cancer, 1325

Trastuzumab for Gastric Cancer (ToGA), 764

Trauma and trauma care, 76–77, 2047

biomechanics of injury, 340–342, 341t, 342t

burden of disease, 335

death, changing patterns of, 335–339, 337t

early hospital care and priorities, 344–345

field triage decisions and early priorities, 342–344, 342t

injuries, 335

3407

intracavity hemorrhage control, 349

wars and, 346–349, 346t

Trauma associated coagulopathy (TAC), 344

Trauma systems, 456–457

inclusive, 457

Traumatic brain injury (TBI), 337, 346, 354, 360, 456

causes of, 360

in children, 460–461, 460f, 462t, 463t

evaluation and treatment of, 368f

and geriatric trauma, 475

management of, 366

and postinjury management, 491–492, 491t

prehospital evaluation and treatment of, 367f

Traumatic infected aneurysms, 1609

Traumatic shock, 152

Tregs, 526

Trellis balloon occlusion catheter, 1782

Trench foot, 511

Triad syndrome, 1945

Triage, 354–355

overtriage, 355

undertriage, 355

Triangle of Calot, 1003

Tricarboxylic acid cycle. See Citric acid cycle

Tricuspic atresia, 1819

Tricuspid valve disease, 1514–1515

Tricyclic antidepressants, in irritable bowel syndrome, 1059

Triiodothyronine, 1343–1344

Trimethoprim, 550, 573

Trimodality therapy, 279

Triolein breath test, 847

Trisomy 21, 1876

TRK receptors, 1950

Trousseau sign, 206, 1368

Truncus arteriosus, 1491–1492, 1491f

Collett and Edwards classification, 1492t

persistent, 1491

Van Praagh and Van Praagh classification, 1492t

Truss, 1232

Trypsin, 779, 846, 860

Trypsinogen, 848

TSH-secreting adenomas, 1404, 1406. See also Pituitary adenomas

Tubercle of Zuckerkandl, 1340, 1341–1342, 1342f

Tuberculosis, 1635

Tuberculous pericarditis, 1577

Tuberous sclerosis, 1935

Tube thoracostomy, 353

Tubular duplications, 1912

Tubulovesicles, 720

Tuftsin, 1267

Tumor infiltrating lymphocytes (TIL), 273

Tumor necrosis factor- a (TNF-a), 717

Tumor suppressor genes, 272

Tunica vaginalis, 1873, 1875

Turcot syndrome, 1099

Turkish saddle, 1402

Turner syndrome, and thoracic aneurysms, 1565

3408

Tween-80, 1890

Twin-reversed arterial perfusion (TRAP) sequence, 1834

Twin-to-twin transfusion syndrome (TTTS), 1834

Type 1 diabetes, 608–609

Type 2 diabetes, 608–609

Type O (universal donor) blood, 160

Type-specific blood, 160

Tyrosine kinase inhibitors (TKI), 767, 2021

U

UK Flexible Sigmoidoscopy Screening Trial, 1101

UK Small Aneurysm Trial, 1610

Ulcerative colitis (UC), 1082–1090

clinical features, 1083

cutaneous, 1084, 1084f

hepatobiliary, 1083

musculoskeletal, 1084

ophthalmologic, 1083–1084

and Crohn disease, 1082, 1083t

diagnosis, 1084–1085

differential diagnosis, 1085

endoscopic evaluation, 1085

epidemiology, 1082

etiology and risk factors

environmental factors, 1082–1083, 1083f

genetics, 1082, 1082t

imaging studies, 1084–1085, 1085f

Mayo Severity Index Calculator, 1084t

medical management

aminosalicylic acid compounds, 1085

biologic immunomodulator agents, 1086

corticosteroids, 1085

immunomodulators, 1085

mercaptopurine, 1086

methotrexate, 1086

pathology

macroscopic appearance, 1085, 1086f

microscopic appearance, 1085

surgery, indications for, 1086

carcinoma/dysplasia, 1087

extraintestinal manifestations, 1087

fulminant colitis, 1087

recalcitrance to medical management, 1087

toxic megacolon, 1086–1087

uncontrolled bleeding, 1087

surgical management, 1087

abdominal colectomy with Brooke ileostomy, 1087–1088, 1088f

Brooke ileostomy, 1087, 1087f

proctocolectomy with Brooke ileostomy, 1088–1089

proctocolectomy with ileal pouch-anal anastomosis, 1089–1090, 1089f, 1090f

proctocolectomy with Koch pouch, 1090

Ulcer disease

drug treatment, 728

operative treatment, 729–734, 729f–733f, 732t

Ultrasonic assisted liposuction (UAL), 2060

Ultrasonography (US), 1584, 1975, 1980, 1982

acute cholecystitis, 1000, 1001f

appendicitis, 1201

3409

bilateral high-grade ICA stenosis, 1591–1592

B-mode, 1585

breast, 1295–1296

carotid and vertebral arteries, 1587

carotid stenosis, classification of, 1590–1591, 1591t

CBD stones, 1008, 1009f

CCA and ECA stenosis, 1592

CCA waveforms, 1587–1588, 1587f, 1588f

cholangiocarcinoma, 1041

chronic venous insufficiency, 1604–1605, 1605f

color flow, 1586, 1586f

deep venous thrombosis, 1602–1604, 1603f

for diverticular disease, 1166

Doppler, 1585–1586

duplex, 1584–1585

external carotid artery, 1590

grayscale image, 1585

hepatic neoplasms, 977

ICA waveforms, 1588–1589, 1589f

lower extremity arterial disease, 1592

mesenteric arteries, 1600–1601

pancreatic cancer, 886

pancreatic disease, 857

pneumothorax, 396

prenatal, 1833

sample volume, 1585

scan head, 1585

stented carotid arteries, 1592

techniques

ankle–brachial index, 1593–1594, 1593t

Doppler analog waveform analysis, 1595

exercise testing, 1595

peripheral artery duplex scanning, 1595–1596, 1596f

segmental leg pressures, 1594–1595, 1594f

thyroid gland, 1345, 1345f

transducers, 1585

vascular infection, 1612

vascular trauma, 436

vertebral artery, 1589–1590, 1591f

Ultrasound-based transient elastography, 950

Umbilical anomalies, 1908

Umbilical hernias, 306, 1245–1246

differential diagnosis, 1245, 1245f

laparoscopic approach for, 1246

management, 1245–1246

Mayo repair of, 1246f

predisposing factors, 1245

Uncoupling protein (UCP), 45–46

Undescended/cryptorchid testicle, 1942–1943, 1942f

Unfractionated heparin (UFH), 180

Union for International Cancer Control (UICC), 283

United National Organ Sharing (UNOS), 557

United Network for Organ Sharing (UNOS), 543, 957, 1970

United States Preventive Services Task Force (USPSTF), 284

Univentricular heart, 1499, 1499f, 1501

University of Southern California (USC), 668

protocol for video esophagram studies, 674t

3410

Van Nuys Prognostic Index (USC/VNPI), 1313

Upper esophageal sphincter (UES), 644, 657

Upper extremity arterial disease

aneurysms, 1639, 1641f

angiography, 1643, 1643f

atherosclerosis and, 1638

cause of, 1639

conditions and risks for, 1640t

etiology, 1638–1639, 1640f

history, 1639–1642

laboratory and noninvasive testing, 1642–1643, 1642f, 1643f

management, 1643–1646, 1644f–1646f

manifestations of, 1639f

physical examination, 1639–1642

presentation, 1638

Upper extremity duplex scanning, 1599–1600, 1599f, 1600t

Upper extremity segmental pressures, 1597, 1598f

Upper gastrointestinal series, pancreatic disease, 857

Upper respiratory infection (URI), 632

Urachal abnormality, 1939

Urea cycle, 14, 15f

Uremic pericarditis, 1577

Ureter, 425–428, 427f, 428f

anomalies of, 1935–1939

ectopic, 1936, 1936f

Ureteral duplication, 1935–1936

Ureterocele, 1936–1937, 1936f, 1937f

Ureterohydronephrosis, graft infection and, 1612

Ureteroneocystostomy, 427

Ureteropelvic junction (UPJ), 423

Ureteropelvic junction obstruction (UPJO), 1934, 1935, 1935f, 1936f

Ureterovesical junction (UVJ), 423

Urethra, anomalies of, 1940–1941

Uric acid, 115

Uridine diphosphate glucuronyl transferase (UDPGT), 1822

Urinary nitrogen, 23

Urinary obstruction, 1833–1834

Urine osmolality, 194

Urine specific gravity, 201

Urine urea nitrogen (UUN), 26

Urodilatin, 197

Urogenital sinus anomalies, 1945

Ursodeoxycholic acid (ursodiol), 948, 999

U.S. Food and Drug Administration, 521

U.S. Multi-Society Task Force on Colorectal Cancer (USMTF), 1100, 1103, 1104t

U.S. Preventative Services Task Force (USPSTF), 1306

on screening for colorectal cancer, 1100, 1100t

U.S. Special Forces Soldiers, 356

Usual interstitial pneumonia (UIP), 589

Uterine rupture, in pregnancy, 485

Uveitis, ulcerative colitis and, 1083–1084

V

Vaccination, hepatitis A virus, 934

VACTERL association, 1857, 1883

Vacuolating cytotoxin A (VacA), 726

Vagina, anomalies of, 1944–1946

Vagotomy, 722, 756

3411

Vague epigastric, 755

Valacyclovir, 1193

Valproic acid, 1926

Valve prostheses, 1514–1515

biologic, 1515

mechanical, 1515

Valve repair, 1796

Valves of Houston, 1172

Valvular heart disease

aortic regurgitation, 1509–1510

aortic stenosis, 1506–1509

mitral regurgitation, 1512–1514

mitral stenosis, 1510–1512

tricuspid valve disease, 1514–1515

valvular anatomy, 1505–1506, 1506f, 1507f

Valvuloplasty technique, 1795

Vanishing bile duct syndrome, 523, 572

Vanishing testicle syndrome, 1942

Van Nuys Prognostic Index (VNPI), 1313

Varicella zoster immune globin, 939

Varicella zoster virus (VZV), 939

Varicocele, 1944

Vascular catheter–related infections, 229

Vascular cellular adhesion molecule 1 (VCAM-1), 88

Vascular ectasias, 1076

Vascular endothelial growth factor (VEGF), 59, 271, 791

Vascular endothelium, 72

Vascular infections, 1609–1619

Vascular lesions, of pediatric liver, 1914–1916

Vascular malformation, 2066

Vascular rings, 1496–1498, 1859–1860

Vascular trauma, 432–442

background, 432

civilian population, 433–434

diagnosis of, 434–437, 435f

epidemiology of, 432–434

lower extremity, 439–440

management, 437–442, 441f, 442f

extremity trauma, 438–440

mechanisms, 432–434

military-specific applications, 433

operative management, 442

physical examination, 434–436

postoperative management, 439

soft signs of, 434, 437

surgery, 438t

and topical hemostatic agents, 438t

Vascular trauma (continued)

treatment of, 438t

upper extremity, 439

Vasoactive intestinal peptide (VIP), 114, 716, 773, 785, 845, 846, 850

Vasoconstriction, 148, 154

Vasodilators, 163–164. See also Shock

nitroglycerin, 164

nitroprusside, 164

Vasogenic edema, 369

Vasopressin, 163

3412

secretion, 155

in variceal bleeding, 959

Vasopressors, inotropes and. See Inotropes and vasopressors

Vecuronium, 243, 355

VEDICO trial, 1793

Veins of Retzius, 954, 955f

Velocity time integral (VTI), 172

Velpeau hernia, 1257

Venom

composition of, 499t

duvernoy glands and, 498

Venomous lizards, 502

Veno-occlusive disease, 955

Venous Disease

Anticoagulants, 1778t

Categories, 1777

Diagnosis, 1777–1778

Incidence, 1777

Risk Factors, 1777

Venous filling index (VFI), 1604

Venous recovery time (VRT), 1605

Venous thromboembolism (VTE), 69, 75, 78t, 328

complications, 1780

pediatric trauma, 469–470

prevention of

chemical treatment of, 180

primary prophylaxis, treatment, 180

screening – secondary prevention, 179–180

prophylaxis in ICU, 178–179, 179t

superficial thrombophlebitis, 1782–1783

surgical procedures, 1781–1782

thrombolytic, 1781–1782

treatment, 1783–1784

Venous thrombosis (VT), 69

Venous ulcer wound care, 1796Û1797

Venous valve repair, 1794

Venous valve transplantation, 1795

Ventilation

and carbon-di-oxide removal, 174

liberation from, 178

monitors, 256–258

Ventilation Index, 1813

Ventilator

management

conventional modes, 176–177

liberation from ventilation, 178

ventilator-associated pneumonia (VAP), 177–178

modes and graphics, 174–175

strategies

inhalation injury, treatment for, 221

ventilator-associated pneumonia (VAP), 221

Ventilator-acquired pneumonia (VAP), 327, 328f

Ventilator-associated events (VAE), 177

Ventilator-associated pneumonia (VAP), 177–178, 221

Ventral abdominal wall hernias, 1244–1245

classification, 1244t

complications of hernia repair, 1257, 1257t

3413

bleeding, 1258

ileus, 1257

prosthetic complications, 1258

recurrence, 1257–1258

seromas, 1258

surgical site occurrences, 1258

epigastric hernias, 1246

incisional hernias, 1246–1247

massive hernia, 1247

parastomal hernia, 1252–1254

preoperative preparation, 1247–1248

treatment

component separation, 1248–1250

flaps and grafts, use of, 1251–1252

general principles, 1248, 1248f

nonprosthetic repairs, 1248

prosthetic repairs, 1250–1251, 1250f

umbilical and periumbilical hernias, 1245–1246

Zollinger classification, 1244t

Ventral Hernia Risk Score (VHRS), 1258, 1259f

Ventricular assist device (VAD), 577

Ventricular free wall rupture, 1524

Ventricular septal defects (VSDs), 1483–1485, 1483f, 1819

diagnosis, 1484

inlet defects, 1484

management, 1484–1485

outlet, 1484

perimembranous, 1484

trabecular, 1484

Ventriculostomy, 369

Ventriculostomy catheters, 368

Verner–Morrison syndrome. See VIPoma

Vertebral anomalies, 1883

Vertebral arteries, 1589–1590, 1591f

anatomy, 1633

disease, 1633–1634

endovascular management of, 1634

Vertebrobasilar disease

anatomy, 1633

atherosclerosis for, 1634

clinical findings, 1633

diagnostic evaluation, 1634

differential diagnosis, 1634

distribution of, 1634

open surgical treatment, 1634

pathogenesis, 1633

Vertical banded gastroplasty, 743, 743f

Vertical expandable prosthetic titanium rib (VEPTR), 1847

Very late antigen 4 (VLA-4), 88

Very low-density lipoproteins (VLDLs), 11, 51

Vesicoureteral reflux (VUR), 1934, 1937–1939, 1937f, 1938f

Veterans Affairs Total Parenteral Nutrition Cooperative Study Group, 32

Video-assisted airway insertion devices, 353

Video-assisted retroperitoneal débridement (VARD), 137, 866

Video-assisted thoracoscopic surgery (VATS), 1463, 1498, 1866, 1867f

Video capsule endoscopy, Crohn disease, 813–814, 814f

Viekira Pak (AbbVie), 948

3414

Viperidae family (snakes), 496

VIPoma, 900t, 908–909, 908t, 909f

diagnosis, 909

differential diagnosis, 909t

surgical excision, 909

Viral hepatitis, 555–556, 933, 934t, 976

and acute liver failure, 940

and cirrhosis, 947–948

hepatitis A virus, 933–934, 934f

hepatitis B virus, 934–936, 935f

hepatitis C virus, 936–937, 936f

hepatitis D virus, 937, 937f, 938f

hepatitis E virus, 938, 938f

Viral risk factors, cancer, 270–271, 271t

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

human herpes virus 8 (HHV-8), 271

human papilloma virus (HPV), 271

Virchow’s Triad, 486

Visceral adipose tissue (VAT), 50

Visceral adiposity, 738

Visceral and parietal collateral networks, 1673f

Visceral arteries, 1600–1601

Visceral pain, 262

Vital signs (VS), 155

Vitamin A deficiency, 63

Vitamin B1

(thiamine), 780

Vitamin B2

(riboflavin), 780

Vitamin B12

(cobalamin), 780

Vitamin C, 92, 780

deficiency, 63

Vitamin D, 1365, 1366f

deficiency, 1369

Vitamin D synthesis, 205f

Vitamin E supplementation, 63

Vitamins, 182

absorption, 780

daily requirements of, 24t

deficiencies, 182t

fat-soluble, 23

function of, 23

water-soluble, 23

wound healing, role in, 63

Vitelline duct, 1907

Volume abnormalities, correction of

volume deficits, 200

volume excess, 200

Volume substitution and insulin therapy in severe sepsis (VISEP) trial, 186

Volumetric diffusive respiration (VDR), 177

Volvulus, 797, 1894–1895

Von Hippel–Lindau (VHL) syndrome, 269, 1935

pancreatic endocrine neoplasms and, 901, 901t

von Recklinghausen syndrome, 1115

von Willebrand disease (vWD), 80, 81

von Willebrand factor (vWF), 56

VTE. See Venous thromboembolism

Vulnerable Elder Survey, 297

3415

W

Wakayama syndrome, 849

Waldeyer fascia, 1053

Walled-off necrosis, 860t, 868–869, 868f

Wandering spleen, 1284

Wangensteen-Rice invertogram, 1884

Warfarin, 77, 180

Wars and trauma, 346–349, 346t. See also Trauma and trauma care

coagulopathy, prevention/treatment of, 347–348

early hemorrhage control, 346–347

prevention, 346

rapid air evacuation/long-distance transport, 348

rehabilitation, 348–349

Wartime vascular injury, 432–433, 433f. See also Vascular trauma

Water retention, in cirrhosis, 951

Waterston shunt, 1487

WDHA syndrome, 908. See also VIPoma

Weight loss, 1968

Western Trauma Association, 414

Western Trauma Association Multicenter Study, 405

West-Nile virus, 524

Wharton jelly, 1870

Whipple triad, 905

White phosphorus, causing burn, 216

Wilms tumor

associated syndromes, 1955t

bilateral, 1960

biologic features, 1956

diagnosis, 1956–1957

epidemiology, 1954

future directions, 1960

genetic risk, 1954

microscopic examination of, 1956f

pathology, 1956

pediatric patients, 1852

presentation, 1956–1957

renal vein/inferior vena cava, 1960

staging, 1955t, 1956–1957

therapy, 1958t

treatment, 1957

Wilson disease, 558

and acute liver failure, 940

cirrhosis and, 949

Wireless capsule endoscopy, in GI bleeding, 1070

Wisconsin solution, 563

Wiskott–Aldrich syndrome, 1273, 1277

Witzel jejunostomy, 38

WNT signaling pathway, 1120–1121

Wolffian ducts, 1933

World Health Organization (WHO), 329

definition overweight, 738

and road traffic injuries, 423

subclassifies NPC, 639

surgical safety checklist, 330t

Wound

healing, 233, 307

infection, 138, 228, 1796

management, burns, 222–223

3416

Wound healing, 54

biofilm on, effects of, 61, 61f

chronic vs. acute wounds, 61, 61t, 62f

factors affecting, 61, 61t, 62f

age and gender, 62–63

alcohol and substance abuse, 66

chemotherapeutic drugs, 66–67

diabetes, 64, 64f

medications and dietary supplements, 65

nutrition, 63

obesity, 63–64

peripheral vascular disease, 65

radiation, 67

smoking, 65–66

stress, 65

nonhealing wounds, cost of, 54

normal, 54–60

hemostasis, 55–57, 57f

inflammatory phase, 57–58, 58f

phases of, 54, 55f, 55t, 56f

proliferative phase, 58–60, 59f

remodeling phase, 60, 60f

surgical technique and, 60–61

X

Xase complex, 70

Xeroderma pigmentosa, 1993

Xeroform, 223

Y

Yolk stalk, 1907, 1907f, 1908f

Young-Burgess Classification system, 469

Z

Zenker diverticulum, 644

Zinc, 19

daily requirements of, 24t

deficiency of, 23

wound healing, role in, 63

Ziv-aflibercept (Zaltrap), 280t

Zofran®, 508

Zollinger–Ellison syndrome, 718, 766, 1379, 1927–1928. See also Gastrinoma

Zona glomerulosa, 196

Z-plasty, 230, 230f

Zuplenz®, 508

Zygomaticomaxillary complex (ZMC) fractures, 379–380, 380f, 381f

Zymogen granules, 716, 844–845

3417

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39 Pulmonary Transplantation 942

40 Pancreas and Islet Transplantation 978

SECTION C: HEAD AND NECK 1012

41 Head and Neck 1013

SECTION D: ESOPHAGUS 1037

42 Esophageal Anatomy and Physiology and Gastroesophageal Reflux Disease 1038

43 Esophageal Tumors and Injury 1106

SECTION E: STOMACH AND DUODENUM 1145

44 Gastric Anatomy and Physiology 1146

45 Gastroduodenal Ulceration 1163

46 Management of Obesity 1183

47 Gastric Neoplasms 1204

SECTION F: SMALLINTESTINE 1229

48 Anatomy and Physiology of the Small Intestine 1230

49 Ileus and Bowel Obstruction 1247

50 Crohn Disease 1287

51 Small Bowel Tumors 1316

SECTION G: PANCREAS 1336

52 Pancreas Anatomy and Physiology 1337

53 Acute Pancreatitis 1365

54 Chronic Pancreatitis 1383

55 Neoplasms of Exocrine Pancreas 1397

56 Neoplasms of the Endocrine Pancreas 1425

SECTION H: HEPATOBILIARY AND PORTALVENOUS SYSTEM 1451

57 Hepatobiliary Anatomy 1452

58 Hepatic Infection and Acute Liver Failure 1472

59 Cirrhosis and Portal Hypertension 1493

60 Hepatic Neoplasms 1545

61 Calculous Biliary Disease 1576

62 Biliary Injuries and Strictures and Sclerosing Cholangitis 1604

63 Biliary Neoplasms 1631

SECTION I: COLON AND RECTUM 1659

64 Colon and Rectal Anatomy and Physiology 1660

65 Acute Gastrointestinal Hemorrhage 1678

66 Ulcerative Colitis 1708

67 Colonic Polyps and Polyposis Syndromes 1725

68 Colorectal Cancer 1760

69 Diverticular Disease 1829

70 Anorectal Disorders 1846

71 Diseases of Appendix 1888

SECTION J: HERNIA AND SPLEEN 1910

72 Abdominal Wall Hernias 1911

73 The Spleen 1982

SECTION K: SURGICALENDOCRINOLOGY 2030

74 Breast Disease 2031

75 Thyroid Gland 2112

76 Parathyroid Glands 2146

77 Adrenal Gland 2180

78 Pituitary Surgery 2208

SECTION L: LUNG 2230

79 Lung Neoplasms 2231

3419

80 Non-Neoplastic Thoracic Disease 2277

SECTION M: VASCULAR DISEASE 2325

81 Congenital Heart Disease 2326

82 Valvular Heart Disease and Cardiac Tumors 2364

83 Ischemic Heart Disease 2386

84 Mechanical Circulatory Support for Cardiac Failure 2418

85 Thoracic Aortic Aneurysms and Aortic Dissection 2448

86 Pericardium 2469

87 Vascular Diagnostics: The Noninvasive Vascular Laboratory 2483

88 Vascular Infection 2523

89 Cerebrovascular Disease 2544

90 Upper Extremity Arterial Disease 2569

91 Renal and Splanchnic Vascular Disease 2583

92 Aortoiliac Disease 2623

93 Peripheral Arterial Disease 2645

94 Lower Extremity Amputation 2673

95 Thoracoabdominal Aortic Aneurysms 2693

96 Abdominal Aortic Aneurysms 2716

97 Lower Extremity Aneurysms 2776

98 Venous Disease 2791

SECTION N: PEDIATRIC SURGERY 2841

99 Fetal, Neonatal, and Pediatric Physiology 2842

100 Fetal Intervention 2878

101 Pediatric Head and Neck 2896

102 The Pediatric Chest 2907

103 Pediatric Abdomen 2948

104 Pediatric Genitourinary System 3046

105 Childhood Tumors 3071

106 The Pregnant Patient 3118

SECTION O: SKIN AND SOFT TISSUE 3145

107 Cutaneous Neoplasms 3146

108 Sarcomas of Soft Tissue and Bone 3176

109 Plastic and Reconstructive Surgery 3208

Index 326