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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5302_Библиотеки_им_академика_М_И_Перельмана
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Hidradenitis Suppurativa
Definition: Chronic skin condition characterized by the formation of
painful lumps under the skin, often in areas with sweat glands.
Pathophysiology: Inflammation of hair follicles and sweat glands, leading
to abscess formation.
Signs and Symptoms: Painful lumps, abscesses, tunnels under the skin,
scarring.
Causes/Risk Factors: Genetics, smoking, obesity, hormonal factors.
Medical Management: Antibiotics, anti-inflammatory medications, warm
compresses.
Surgical Management: Incision and drainage of abscesses, wide excision
in severe cases.
Prognosis: Chronic condition with periods of exacerbation and remission;
requires long-term management.
Interesting Fact: Hidradenitis suppurativa can significantly impact the
quality of life and often requires a multidisciplinary approach for
management.
Hirschsprung’s Disease
Definition: Congenital condition where certain portions of the colon lack
nerve cells, leading to obstruction.
Pathophysiology: Absence of ganglion cells in the myenteric plexus of the
affected colon segment.
Signs and Symptoms: Delayed passage of meconium in newborns, chronic
constipation, abdominal distension.
Causes/Risk Factors: Genetic mutations, usually sporadic.
Medical Management: Rectal irrigations, dietary modifications,
supportive care.
Surgical Management: Bowel resection, pull-through procedure.
Prognosis: Good with surgical correction; can have long-term bowel
function issues.
Interesting Fact: Hirschsprung’s disease is often diagnosed in infancy and
requires surgical intervention to restore normal bowel function.
Hydrocele
Definition: Accumulation of fluid in the sac around the testes, causing
scrotal swelling.
Pathophysiology: Imbalance between fluid production and absorption in
the scrotum.
Signs and Symptoms: Scrotal swelling, discomfort, feeling of heaviness.
Causes/Risk Factors: Injury, infection, congenital defects.
Medical Management: Observation, aspiration (draining fluid with a
needle), surgery for persistent cases.
Surgical Management: Hydrocelectomy (surgical removal of the
hydrocele sac).
Prognosis: Excellent; recurrence is rare after successful surgery.
Interesting Fact: Hydroceles can occur at any age and may resolve
spontaneously in infants but often require surgery in adults.
Hydronephrosis
Definition: Swelling of the kidney due to the backup of urine, often
caused by an obstruction in the urinary tract.
Pathophysiology: Obstruction of urine flow, leading to dilation and
swelling of the renal pelvis and calyces.
Signs and Symptoms: Flank pain, urinary urgency, frequency, hematuria
(blood in urine).
Causes/Risk Factors: Kidney stones, tumors, urinary tract infections,
congenital abnormalities.
Medical Management: Treating underlying causes, relieving obstruction,
pain management.
Surgical Management: Ureteral stent placement, nephrostomy tube
insertion, surgical correction of underlying causes.
Prognosis: Good with timely intervention; may lead to kidney damage if
untreated.
Interesting Fact: Hydronephrosis can be a temporary condition if the
underlying cause is identified and treated promptly.
Hyperparathyroidism-Jaw Tumor Syndrome
Definition: Hyperparathyroidism-jaw tumor syndrome is a rare genetic
disorder characterized by the overactivity of parathyroid glands and the
development of tumors in the jaw and other bones.
Pathophysiology: Genetic mutations cause overactivity of parathyroid
glands and bone tumors.
Signs and Symptoms: High calcium levels, jaw tumors, kidney stones, and
bone pain.
Causes/Risk Factors: Genetic mutations (CDC73 gene mutations).
Medical Management: Managing hypercalcemia, surgery to remove
tumors and affected parathyroid glands.
Surgical Management: Parathyroidectomy and removal of jaw tumors,
often involving complex procedures.
Prognosis: Prognosis depends on the extent of the disease and the success
of surgical interventions.
Interesting Fact: Hyperparathyroidism-jaw tumor syndrome is extremely
rare, with only a few documented cases worldwide.
Incarcerated Hernia
Definition: Hernia in which abdominal contents become trapped and
cannot be pushed back into the abdomen.
Pathophysiology: Hernia opening narrows, trapping the contents.
Signs and Symptoms: Severe pain, swelling, redness, nausea, vomiting.
Causes/Risk Factors: Weakness in the abdominal wall, obesity, previous
surgery.
Medical Management: IV fluids, pain management, and hernia reduction
(if possible).
Surgical Management: Emergency hernia repair, sometimes involving
resection of damaged tissue.
Prognosis: Good with prompt intervention; can be life-threatening if
untreated.
Interesting Fact: Incarcerated hernias require urgent surgical attention to
prevent complications such as strangulation and tissue necrosis.
Inflammatory Bowel Disease (IBD)
Definition: Chronic inflammation of the digestive tract, including Crohn’s
disease and ulcerative colitis.
Pathophysiology: Immune system dysfunction, genetic and environmental
factors.
Signs and Symptoms: Diarrhea, abdominal pain, weight loss, fatigue.
Causes/Risk Factors: Genetic predisposition, environmental factors,
dysregulated immune response.
Medical Management: Anti-inflammatory medications,
immunosuppressants, biologics.
Surgical Management: Surgery for complications like strictures, fistulas,
or intractable symptoms.
Prognosis: Variable, often relapsing and remitting.
Interesting Fact: IBD is more common in developed countries and among
individuals of Ashkenazi Jewish descent.
Inguinal Hernia
Definition: Hernia that occurs in the inguinal canal, often in the groin
area.
Pathophysiology: Weakness in the inguinal canal allows abdominal
contents to protrude.
Signs and Symptoms: Bulge in the groin, discomfort, pain, especially
when lifting.
Causes/Risk Factors: Muscle weakness, heavy lifting, chronic coughing,
male gender.
Medical Management: Supportive measures (truss). Surgical repair
(herniorrhaphy) is definitive.
Surgical Management: Repair using open or laparoscopic techniques,
often involving mesh placement.
Prognosis: Generally good with low recurrence rates post-surgery.
Interesting Fact: Inguinal hernias are more common in men due to the
natural weakness in the inguinal canal, a vestige from the testicular
descent in fetal development.
Intestinal Ischemia
Definition: Inadequate blood supply to the intestines, leading to tissue
damage and potential gangrene.
Pathophysiology: Occlusion or narrowing of mesenteric arteries or veins,
causing inadequate blood supply to the intestines.
Signs and Symptoms: Severe abdominal pain, tenderness, vomiting,
bloody stools, signs of shock.
Causes/Risk Factors: Atherosclerosis, embolism, thrombosis, mesenteric
venous thrombosis.
Medical Management: Intravenous fluids, anticoagulants, addressing
underlying causes.
Surgical Management: Revascularization procedures, bowel resection for
necrotic tissue.
Prognosis: Variable, depending on the extent of ischemia and timely
intervention.
Interesting Fact: Intestinal ischemia is a medical emergency and requires
immediate intervention to prevent bowel infarction.
Intestinal Lymphangiectasia
Definition: A disorder characterized by dilated lymphatic vessels in the
intestinal wall, leading to protein loss.
Pathophysiology: Abnormal development or obstruction of lymphatic
vessels.
Signs and Symptoms: Protein-losing enteropathy, diarrhea, malabsorption,
edema.
Causes/Risk Factors: Primary (congenital) or secondary (due to conditions
like Crohn’s disease).
Medical Management: Dietary modifications, nutritional supplements, and
medications to reduce inflammation.
Surgical Management: Not typically indicated; focused on managing
underlying causes.
Prognosis: Variable; depends on the extent of lymphatic involvement and
underlying conditions.
Interesting Fact: Intestinal lymphangiectasia is a rare disorder and often
requires a multidisciplinary approach for management.
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