Surgery

SurgeryGeneral Surgery

Thyroid ultrasound

Thyroid ultrasound, also known as thyroid color Doppler flow imaging, is an examination that indirectly detects the thyroid gland using an ultrasound probe. Thyroid color ultrasound can display the morphology and structure of the thyroid gland. When the thyroid gland is diseased, many lesions can be detected by ultrasound examination, making it the preferred clinical method for diagnosing thyroid diseases. Interpretation of common abnormal results in thyroid ultrasound reports Rich blood flow signals within the thyroid gland: Both Graves' disease and early Hashimoto's thyroiditis can show rich blood flow signals within the thyroid gland. If there are rich blood flow signals within a nodule, it is necessary to be alert to the possibility of malignancy (thyroid cancer), but rich blood flow signals alone cannot determine that the nodule is malignant; other manifestations also need to be considered. Microcalcifications Microcalcifications refer to punctate hyperechoic foci ≤ 1 mm, which are specific indicators for diagnosing thyroid cancer. If microcalcifications are observed on ultrasound, thyroid cancer should be highly suspected, and further examinations, such as thyroid fine-needle aspiration biopsy, should be performed under the guidance of a doctor. If a single nodule with microcalcifications is found in a young patient (under 40 years old), the possibility of malignancy is greater. Which thyroid ultrasound findings require vigilance for thyroid cancer? Microcalcifications within the nodule Nodule aspect ratio > 1 Nodule presenting as solid hypoechoic Irregular nodule shape Rich blood flow signals within the nodule, etc. Interpretation of thyroid color ultrasound TI-RADS classification results TI-RADS 1: Normal thyroid TI-RADS 2: Benign nodule TI-RADS 3: Nodule is possibly benign TI-RADS 4: Nodule is suspicious for malignancy TI-RADS 5: Nodule is possibly malignant, with 1-2 ultrasound features suggestive of malignancy, such as hypoechogenicity, microcalcifications, aspect ratio > 1, lobulated or irregular margins, etc. TI-RADS 6: Nodule has been proven malignant by biopsy

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SurgeryGeneral Surgery

Small bowel rupture

Small bowel rupture refers to the perforation of the small intestine caused by various external forces, primarily seen in cases of blunt abdominal trauma and falls from height. The main symptoms of small bowel rupture include abdominal pain, abdominal distension, and fever, which may be accompanied by shock.

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SurgeryGeneral Surgery

Gastric volvulus

Gastric volvulus refers to the rotation of the stomach due to various reasons, leading to varying degrees of obstruction at the gastric outlet. It can have an acute or chronic onset. Acute gastric volvulus has a sudden onset and rapid progression, clinically manifesting as pain in the upper abdomen (subdiaphragmatic type) or left chest (supradiaphragmatic type). Chronic gastric volvulus is often a partial torsion without obstruction, and may be asymptomatic or have mild symptoms. This condition is common in neonates and the elderly.

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SurgeryGeneral Surgery

Gastric sarcoma

Gastric sarcoma is a rare non-epithelial malignant tumor originating from the submucosal stroma of the stomach, accounting for approximately 1% to 3% of all gastric malignancies. It includes gastric malignant lymphoma, leiomyosarcoma, fibrosarcoma, angiosarcoma, myxosarcoma, and others. This disease is more common in middle-aged and elderly individuals, with an average age of onset between 50 and 60 years. The main symptoms include upper abdominal discomfort and pain.

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SurgeryGeneral Surgery

Gastroduodenal ulcer with cicatricial pyloric obstruction

Gastroduodenal ulcer cicatricial pyloric obstruction refers to pyloric obstruction caused by recurrent gastroduodenal ulcers, pyloric or duodenal bulb ulcers, leading to scar stenosis, pyloric spasm, and edema in patients with gastroduodenal ulcers. This condition is common in individuals with gastric and duodenal bulb ulcers, primarily presenting with upper abdominal pain and postprandial vomiting.

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SurgeryGeneral Surgery

Typhoid intestinal perforation

Typhoid intestinal perforation is a severe complication of typhoid fever, caused by the invasion of Salmonella typhi into the intestinal tract, leading to intestinal necrosis, ulceration, and subsequent perforation. It is more common in patients from areas with poor sanitation and poverty. The main manifestations include sudden abdominal pain during the course of typhoid fever, predominantly in the right lower abdomen, accompanied by cold sweats, palpitations, dizziness, and a drop in body temperature. After a brief period of symptom relief, there is a recurrence of persistent, unbearable abdominal pain and high fever.

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SurgeryGeneral Surgery

Duodenal injury

Duodenal injury refers to damage to the duodenum caused by abdominal trauma or iatrogenic trauma. Clinically, duodenal injuries are uncommon, but due to its proximity to the liver, gallbladder, pancreas, and major blood vessels, duodenal injury often presents as a complex injury. This condition is more common in young people, with a higher incidence in males than females. Main symptoms include sudden severe abdominal pain, accompanied by nausea, vomiting, abdominal distension, and cessation of flatus. Vomitus may contain blood, and severe vomiting can lead to the expulsion of bile.

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SurgeryGeneral Surgery

Skin abscess

Skin abscesses are diffuse purulent inflammations of the subcutaneous tissue that often develop from folliculitis, boils, carbuncles, or cellulitis. The causative pathogens are mostly Staphylococcus aureus, Streptococcus, and anaerobic putrefactive bacteria. The main symptoms are redness, swelling, heat, and pain of the skin, as well as a localized mass with obvious fluctuation.

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Thyroid ultrasound

Carbuncle

Small bowel rupture

Gastric volvulus

Gastric sarcoma

Gastroduodenal ulcer with cicatricial pyloric obstruction

Typhoid intestinal perforation

Duodenal injury

Skin abscess