ABPS General Surgery key terms

Resection of the sigmoid colon with an end colostomy and closure of the rectal stump, typically performed for perforated diverticulitis or obstructing cancer when a primary anastomosis is considered unsafe.

Breakdown of a surgical join between two bowel ends that allows luminal contents to spill into the abdomen or chest, producing pain, tachycardia, fever, or sepsis; diagnosed by CT imaging, contrast studies, or reoperation.

Acute colonic pseudo-obstruction: massive dilation of the colon without a mechanical blockage, usually in hospitalized, critically ill, or postoperative patients; carries a risk of cecal perforation and is treated with neostigmine or decompression.

A hernia whose blood supply is compromised, producing ischemia of the incarcerated bowel or omentum; signs include severe pain, tenderness, skin changes, and systemic toxicity, and urgent operative exploration is required.

Injection of dye, radiotracer, or both to identify the first lymph node or nodes draining a tumor; used in breast cancer and melanoma to stage the regional basin and spare patients unnecessary complete lymphadenectomy.

Sharp dissection of the rectum together with its intact mesorectum and enveloping fascia, performed for rectal cancer to remove draining lymphatic tissue and reduce local recurrence.

Chemotherapy, radiation, or both delivered before planned surgery to shrink a tumor, test its biology, and improve the chance of complete resection; standard for locally advanced rectal cancer and many breast cancers.

Branch of the vagus nerve that runs in the tracheoesophageal groove and innervates the vocal cord; injury during thyroid or parathyroid surgery causes hoarseness, and bilateral injury can obstruct the airway.

Bedside ultrasound performed in trauma to look for free fluid in the pericardial sac, Morison's pouch, the splenorenal recess, and the pelvis; it guides immediate decisions about laparotomy or further imaging.

An abbreviated operation that controls hemorrhage and contamination, then leaves the abdomen temporarily closed with packing or a negative-pressure dressing for resuscitation in intensive care and planned re-exploration.

Resuscitative endovascular balloon occlusion of the aorta: a balloon catheter inflated in the aorta to slow bleeding below the diaphragm, used as a temporary bridge to definitive hemorrhage control in exsanguinating patients.

The combination of hypothermia, acidosis, and coagulopathy in massive hemorrhage; each worsens the others and together they predict death, so treatment targets warming, perfusion, and balanced blood product replacement.

Sustained intra-abdominal pressure above 20 mmHg accompanied by new organ dysfunction, seen after trauma, pancreatitis, or massive fluid resuscitation; treatment is decompressive laparotomy with temporary abdominal closure.

Acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure, developing within a week of a known insult, with a PaO2/FiO2 ratio of 300 or less on positive end-expiratory pressure.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, identified clinically as a rise in the SOFA score of at least two points; treatment requires antibiotics, source control, and fluid resuscitation.

A stent-graft delivered through the femoral arteries to exclude an abdominal aortic aneurysm from the circulation; recovery is faster than with open repair, but lifelong imaging surveillance is needed to detect endoleak.

Open removal of atherosclerotic plaque from the carotid bifurcation to prevent stroke in patients with symptomatic high-grade stenosis; risks include perioperative stroke, cranial nerve injury, and neck hematoma.

Progressive accumulation of air in the pleural space with mediastinal shift and impaired venous return; signs include hypotension, distended neck veins, and absent breath sounds, and immediate needle or finger decompression is required.

Placement of a tube into the pleural space to drain air, blood, or fluid and allow the lung to re-expand; complications include malposition, injury to intercostal vessels, and re-expansion pulmonary edema.

Superficial leg vein commonly harvested as a conduit for coronary and peripheral bypass; its diameter, wall quality, and length make it useful, though wound complications and later graft stenosis are common.

A bundled, evidence-based perioperative pathway including preoperative counseling, carbohydrate loading, multimodal analgesia, early feeding, and early mobilization, which shortens hospital stay and reduces complications.

A validated risk-assessment tool that combines patient and operative factors to estimate perioperative venous thromboembolism risk and guide the choice and duration of prophylaxis.

Infection occurring at or near the operative site within 30 days of surgery, or 90 days after implant placement; classified as superficial incisional, deep incisional, or organ space; prevention includes timely antibiotics and normothermia.

A six-category scale describing a patient's preexisting systemic health before anesthesia, used to communicate risk and compare case mix; it does not by itself predict a specific postoperative outcome.

An inherited hypermetabolic reaction to volatile anesthetics and succinylcholine, marked by rising carbon dioxide, muscle rigidity, and hyperthermia; treatment is stopping the trigger, active cooling, and giving dantrolene.

Neurologic excitation followed by depression and cardiovascular collapse caused by excessive absorption or accidental intravascular injection of local anesthetic; management includes airway support and intravenous lipid emulsion.

Clamping of the hepatoduodenal ligament to interrupt portal inflow during liver surgery; intermittent release limits ischemic injury to the remnant liver during parenchymal transection.

Removal of the pancreatic head, duodenum, distal bile duct, and often the distal stomach, followed by three reconstructions; performed for tumors of the pancreatic head and periampullary region.

Selection criteria for liver transplantation in hepatocellular carcinoma: one tumor 5 cm or smaller, or up to three tumors each 3 cm or smaller, without vascular invasion or extrahepatic spread.

Leakage of pancreatic juice from a pancreatic anastomosis or cut surface, defined by drain amylase levels and clinical course; a leading cause of morbidity, sepsis, and death after pancreatic resection.

Thickening of the pyloric muscle in infancy causing nonbilious projectile vomiting at about three to six weeks of age; ultrasound confirms the diagnosis and pyloromyotomy is curative.

Telescoping of one segment of bowel into the adjacent segment, causing obstruction and ischemia; young children present with colicky pain and bloody stools, and treatment is enema reduction or surgery.

A graft of epidermis and part of the dermis taken from a donor site, used to cover burns and other wounds; the donor site re-epithelializes, and the graft contracts more than a full-thickness graft.

A block of tissue moved with its artery and vein and reattached to recipient vessels by microvascular anastomosis; used to reconstruct large defects of the breast, head and neck, and extremities.

A conversation in which the diagnosis, proposed operation, alternatives, and material risks and benefits are explained so the patient can choose voluntarily; it requires decision-making capacity and freedom from coercion.

A structured team briefing and verification of patient identity, procedure, site, allergies, antibiotic timing, and equipment before incision and again before closure, intended to reduce avoidable surgical errors.

A regularly scheduled peer-review conference where complications and deaths are presented and analyzed to identify knowledge gaps and system failures and to improve future patient care.