Month: March 2019

Trauma Surgery

downloadTrauma surgery is the branch of surgical medicine that deals with treating injuries caused by an impact. for example, a trauma surgeon may be called to the emergency room to evaluate a patient who is a victim of a car crash.

Trauma Explained

Trauma is the injuries suffered when a person experiences a blunt force. You may also hear trauma referred to as a “major trauma.” Many trauma patients are the victims of car crashes, stabbings, and gunshot wounds. Trauma can also be caused by falls, crush type injuries, and pedestrians being struck by a car.

Traumatic injuries can affect internal organs, bones, the brain, and the other soft tissues of the body. No area of the body is immune to trauma, but trauma can range from minor (hitting your finger with a hammer) to major (being hit by a car traveling at a high rate of speed or falling off of a building).

Who Performs Trauma Surgery

In the case of severe trauma, such as a catastrophic car crash, the trauma surgeon may be one part of a surgical team that includes general surgeons (to repair internal abdominal injuries), vascular surgeons (to repair damage to blood vessels), orthopedic surgeons (to repair broken bones), and other surgeons as needed.

The trauma team will include not only one or more surgeons, but also the paramedics who stabilize and transport the patient, nurses, anesthetist, respiratory therapist, radiographer, and the support of the medical laboratory scientists, including the blood bank.

For surgeons, extensive education is required in order to practice in their chosen field. As with all physicians, they first graduate from college with a bachelor’s degree and enter medical school for four years. For general surgeons, five years of surgical training as a residency is required. For surgeons who want to specialize, the same five-year residency is completed, followed by additional years of training in the area of specialization. Trauma surgery fellowships are usually one to two years long. Trauma surgeons often also serve a critical care fellowship. They take their boards for a certification in Surgical Critical Care.

From the Emergency Room to Surgery

A trauma surgeon has a different set of skills and functions from an emergency room doctor. When you arrive in the emergency room for any complaint, the ER doctor will see you, stabilize your condition, examine you, and order tests and imaging studies. She will alert the specialists needed, which may include the trauma surgeon. The ER doctor’s function includes referring you for admission or discharging you with appropriate treatment and follow-up referrals.

If your condition requires trauma surgery, you will be handed off to the trauma surgeon, who will become your provider. She will not only perform the surgery but you will also be followed by her and her team through recovery, rehabilitation, and discharge. When you need emergency surgery, you may be treated at the facility where you arrived, or you may be transported to a facility that has the specialists needed for your condition. The trauma surgeon may not be available to examine you until you arrive at her facility.

The trauma surgeon is often the person responsible for prioritizing which of your injuries will be treated first and determining the order of the diagnostic and operative procedures needed.

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What is ERCP

What is ERCP?

Endoscopic Retrograde Cholangio Pancreatography (ERCP) is a method for getting into the bile duct and pancreas though the mouth. When invented over 40 years ago, ERCP was a breakthrough that allowed doctors to find local diseases. Today, most local diseases can be detected safely by non-invasive imaging tests such as Computed Tomography (CT), Magnetic Retrograde CholangioPancreatography (MRCP) scans and an endoscopic method of imaging called Endoscopic Ultrasound (EUS). ERCP is used mainly to treat diseases that have been detected by these means.ercp_medium

ERCP uses an endoscope, which is a long flexible narrow tube with a camera at the end. After the patient is sedated, the specialist passes the endoscope through the mouth and esophagus, to view the lining of the stomach and first part of the small intestine (the duodenum). The goal is to access the papilla of Vater, a small nipple in the duodenum. This papilla is the drainage hole for the bile and pancreatic duct, which bring digestive juices from the livergallbladder and pancreas. The doctor injects contrast dyes through the papilla into the ducts and takes X-rays to show lesions such as stones, strictures or blockages. Some of these can be treated right away with other instruments passed through the endoscope.

Hernia Basics

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Hernia Basic
A bulging of an organ or tissue through an abnormal opening.
Common
More than 200,000 US cases per year
Treatable by a medical professional
Usually self-diagnosable
Lab tests or imaging rarely required
Medium-term: resolves within months
Typically, a hernia involves the stomach or intestine.
Symptoms include a bulge, swelling, or pain. In some cases, there are no symptoms.
Treatment includes monitoring the condition. If needed, surgery can return tissue to its normal location and close the opening.
Ages affected
0-2 Common
3-5 Rare
6-13 Rare
14-18 Common
19-40 Common
41-60 Very common
60+ Very common
Genders affected
Males Very common
Females Common