SPLENIC TRAUMA

Kehr's sign - Characteristic sign of splenic rupture

X-ray features of splenic injury:
-Obliteration of splenic shadow,
- Obliteration of psoas shadow,
- Elevation of left diaphragm

SPLENECTOMY

PRODECURE DONE  IN:
-Hereditary spherocytosis,
-Portal hypertension,
-Hypersplenism

AMOEBIC LIVER ABSCESS

- trophozoites of the organism Entamoeba histolytica .

- most frequent extraintestinal manifestation of Entamoeba histolytica infection.

-Anchovy sauce pus (choclate coloured pus due to RBC lysis) .

Complication of amoebic liver abscess:
- Pleuro-pulmonary involvement,
- Rupture into pleural space etc.

PYOGENIC LIVER ABSCESS

- pocket of pus that forms in the liver due to a bacterial infection .

- Pus is a fluid composed of white blood cells and dead cells .

-most common route of infection: Infection through bile duct

- hematogenous route is 2'd most common route .
- most common  organism: E. coli .

HYDATID DISEASE

- ELISA is sensitive.

-Crumbled egg appearance.

- caused by Echinococcus 

HEPATOCELLULAR CARCINOMA

- primary malignancy of the liver .

- occurs predominantly in patients with underlying chronic liver disease and cirrhosis .

- most common cause of death in people with cirrhosis .

Predisposing factors:
- HBV,
- HCV
- Alcoholic liver disease .

-Commonest marker for HCC: AlphaFetoprotein

-Imaging  for screening HCC: USG
- Percutaneous biopsy (USG/ CT guided) can be diagnostic .

CHOLELITHIASIS

- presence of gallstones, which are concretions that form in the biliary tract, usually in the gallbladder.

 More serious complications

- cholecystitis 

- biliary tract obstruction 

- choledocholithiasis  ( stones in the bile ducts )

- cholangitis 

- gallstone pancreatitis 

- Meniscus sign (cholangiography)

RENAL CALCULI

MC stones: Calcium stones (75-85%)
Radiolucent stones: Uric acid
Stones MC in men: Calcium
Renal calculi overlies spine in lateral view

Stone hard to break in ESWL: Cysteine stones 

Stone which grow in infected urine: Struvite stone

Stone which grows in alkaline urine: Struvite stones

Stones MC in females: Struvite stones

Deitel's crisis:
-Renal colic,
-Swelling in loin &
-Disappearance of swelling with micturation

URINARY BLADDER Ca

- most common symptom is blood in the urine ( Painless hematuria ) .

- Pain circumstances: can occur during urination 

- most common type: Transitional cell Ca

URETHRA

HYPOSPADIAS

- birth defect (congenital condition) in which the opening of the urethra is on the underside of the penis instead of at the tip .

-Hooded prepuce,
- Meatal stenosis,
- Bifid scrotum
- Best time of surgery: 6-10 months of age

CARCINOMA SPECIAL

1.Most common type of anal Ca: Epidermoid Ca

2. Most common type of rectal Ca: AdenoCa 

3. Most common symptom of pancreatic Ca: Pain & weight loss 

4. Most common site of pancreatic tumour: Pancreatic head

5. Most common esophageal Ca: Squamous cell Ca

6. Most common site of adenoCa: Lower end

7. Most common site of squamous cell Ca: Middle third