ABS General Surgery key terms

Inflammation of the peritoneal lining, typically from bacterial contamination after a perforated viscus or ischemic bowel. It causes guarding, rebound tenderness, and systemic signs, and usually requires operative source control plus antibiotics.

Free air within the peritoneal cavity, most often from a perforated hollow viscus. It appears as free gas under the diaphragm on upright imaging and generally mandates urgent surgical evaluation.

The physical elimination of the underlying cause of an infection, such as closing a perforation, draining an abscess, or resecting dead bowel. Antibiotics alone cannot resolve a surgical infection without it.

Mechanical or functional blockage of intestinal transit causing crampy pain, vomiting, distension, and failure to pass gas or stool. Management depends on level, severity, and evidence of strangulation.

A segment of bowel blocked at two points, trapping a contained loop that cannot decompress. It risks rapid strangulation and perforation and is a surgical emergency.

Compromised blood flow to a segment of bowel, usually from twisted or incarcerated mesentery. It progresses to ischemia, gangrene, and perforation, and demands prompt operative resection.

Intestinal tissue injury from inadequate perfusion, whether arterial, venous, or nonocclusive. It causes pain out of proportion to exam findings and requires early recognition and often resection of necrotic segments.

A metabolic product that rises with tissue hypoperfusion and anaerobic metabolism. Serial levels help detect occult ischemia or shock and guide resuscitation in surgical emergencies.

Life-threatening organ dysfunction caused by a dysregulated host response to infection. It requires early antibiotics, fluid resuscitation, and rapid identification and control of the infecting source.

Sepsis with persistent hypotension requiring vasopressors and elevated lactate despite adequate fluid resuscitation. It carries high mortality and demands aggressive critical care and source control.

Inflammation of the vermiform appendix, usually from luminal obstruction, causing migrating periumbilical-to-right-lower-quadrant pain, anorexia, and localized tenderness. Treatment is appendectomy, often with preoperative antibiotics.

A clinical scoring system for suspected appendicitis using migration of pain, anorexia, nausea, tenderness, rebound, fever, and leukocytosis. Higher scores raise the probability and support operative or imaging pathways.

Inflammation of the gallbladder, most commonly from an obstructing gallstone at the cystic duct. It causes right upper quadrant pain, fever, and a positive Murphy sign, and is treated with cholecystectomy.

Stones within the common bile duct, which can cause biliary colic, jaundice, cholangitis, or pancreatitis. It is usually managed with endoscopic stone removal followed by cholecystectomy.

Bacterial infection of an obstructed biliary tree, classically causing fever, jaundice, and right upper quadrant pain. It is an emergency requiring antibiotics and urgent biliary drainage.

Inspiratory arrest during deep palpation of the right upper quadrant, produced when an inflamed gallbladder meets the examining hand. It supports a diagnosis of acute cholecystitis.

Protrusion of an organ or tissue through a defect in the abdominal wall. It is described by location, reducibility, and contents, and repair is indicated for complications or symptoms.

Irreducible trapping of hernia contents within the defect. It risks obstruction and compromised blood supply and often requires urgent surgical repair.

Failure of a surgical bowel connection allowing luminal contents to escape. It presents with fever, pain, tachycardia, or peritonitis and may require drainage, diversion, or reoperation.

Lumpectomy with clear margins followed by radiation, offering survival equivalent to mastectomy for many early breast cancers. Eligibility depends on tumor size relative to breast volume and other factors.

Identification and removal of the first draining lymph node(s) using dye or radiotracer to stage the axilla. A negative result can spare patients the morbidity of full axillary dissection.

Removal of axillary lymph nodes at levels I and II for regional control and staging. It carries risks of lymphedema, nerve injury, and seroma.

Combined clinical examination, imaging, and tissue sampling used to evaluate a breast complaint. Concordant benign results allow reassurance, while discordance warrants further biopsy.

A localized collection of pus within tissue causing fluctuance, pain, and erythema. Treatment is incision and drainage, with antibiotics reserved for systemic signs or specific risk factors.

Spreading bacterial infection of the deep dermis and subcutaneous tissue producing warmth, erythema, and tenderness without a drainable collection. It is treated with antibiotics and close reassessment.

Rapidly progressive infection destroying fascia and fat, with pain out of proportion, systemic toxicity, and crepitus. It requires urgent wide debridement and broad antibiotics.

Surgical removal of dead, infected, or contaminated tissue to promote healing and control infection. It is repeated as needed until healthy, bleeding tissue remains.

Surgical removal of all or part of the thyroid gland for malignancy, compressive goiter, or refractory hyperthyroidism. Key risks include recurrent laryngeal nerve injury and hypocalcemia from parathyroid compromise.

A branch of the vagus nerve running near the thyroid that supplies most laryngeal muscles. Injury during neck surgery causes hoarseness and, if bilateral, airway obstruction.

Low serum calcium, which after neck surgery usually reflects parathyroid injury or removal. It causes perioral numbness, cramps, and tetany, and is managed with calcium and vitamin D replacement.

A catecholamine-secreting tumor of the adrenal medulla causing episodic hypertension, headache, sweating, and palpitations. Preoperative alpha blockade is essential to prevent intraoperative hypertensive crisis.

Surgical removal of an adrenal gland for functioning tumors or malignancy. Perioperative management requires careful control of hormone excess and steroid replacement when bilateral.

A staged approach for severely injured or physiologically unstable patients, limiting the first operation to hemorrhage and contamination control. Definitive reconstruction follows after correction of hypothermia, acidosis, and coagulopathy.

The interrelated trio of hypothermia, acidosis, and coagulopathy that drives death in severe trauma. Damage control strategies aim to prevent or reverse it.

A rapid bedside ultrasound protocol screening for free fluid in the pericardium and dependent abdominal and pelvic spaces after injury. It guides urgent operative decisions in unstable patients.

Temporary endovascular aortic balloon inflation to slow subdiaphragmatic hemorrhage in a crashing patient. It is a bridge to definitive hemorrhage control and carries ischemic risks.

Systemic treatment given before planned surgery to shrink a tumor, improve resectability, or test tumor biology. It is common in locally advanced breast, rectal, and esophageal cancers.

The presence or absence of tumor cells at the cut edge of a resected specimen. A positive margin raises local recurrence risk and often prompts further surgery or radiation.