Egyptian Board General Surgery key terms

A staged operative strategy in which a bleeding or contaminated abdomen is packed and temporarily closed to end the operation quickly, allowing correction of hypothermia, acidosis, and coagulopathy in intensive care before planned re-exploration.

The self-reinforcing combination of hypothermia, metabolic acidosis, and coagulopathy that develops after major hemorrhage and predicts death unless hemorrhage control and active rewarming are achieved rapidly.

A pre-agreed system for delivering balanced blood components, red cells, plasma, and platelets in fixed ratios, with rapid laboratory support and a defined activation trigger, to treat hemorrhagic shock and limit dilutional coagulopathy.

Deliberately accepting a systolic pressure below normal, typically around 80 to 90 mmHg, until surgical hemorrhage control is achieved, aiming to avoid dislodging clots while preserving perfusion of vital organs.

Organ dysfunction caused by sustained intra-abdominal pressure above 20 mmHg with new impairment of ventilation, renal function, or perfusion, treated by decompressive laparotomy and temporary abdominal closure.

A prioritized sequence of airway, breathing, circulation, disability, and exposure with adjuncts, designed to identify and treat immediately life-threatening injuries before a full history or detailed examination is undertaken.

A rapid bedside ultrasound examination of pericardial, perihepatic, perisplenic, and pelvic windows to detect free fluid after blunt trauma, guiding immediate decisions about laparotomy or further imaging.

A burn resuscitation estimate giving crystalloid volume as 4 mL per kilogram body weight per percent total body surface area burned in the first 24 hours, half in the first 8 hours from injury, then titrated to urine output.

Thermal or chemical damage to the airway and lung from smoke, steam, or combustion products, suspected from facial burns, soot, hoarseness, or enclosed-space fire, often requiring early intubation and higher fluid needs.

Failure of a surgical join between two hollow viscus ends with escape of luminal contents, presenting with pain, fever, tachycardia, ileus, or peritonitis, and managed by drainage, diversion, or reoperation depending on severity.

Separation of a sutured surgical wound, ranging from superficial skin opening to full-thickness fascial disruption with evisceration, favored by poor nutrition, raised intra-abdominal pressure, infection, and technical failure.

Infection arising within 30 days of surgery, or within 90 days where an implant is placed, at the incision or deeper operative space, classified as superficial, deep, or organ-space and reduced by asepsis and appropriate prophylaxis.

A single preoperative dose of an antibiotic chosen for the expected organisms and given within about 60 minutes before incision, timed to produce peak tissue levels during the operation and usually not continued beyond 24 hours.

The defined area of draped patient and sterile gowns and gloves within which only sterilized instruments and materials may contact the operative site, maintained by strict rules of movement and visual monitoring.

A bundled perioperative pathway using preoperative counselling, carbohydrate loading, opioid-sparing analgesia, avoidance of unnecessary drains and catheters, early feeding, and early mobilization to shorten hospital stay and complications.

Sequestration of isotonic fluid into the interstitial and peritoneal compartments after surgery, trauma, or sepsis, causing intravascular depletion that requires balanced crystalloid replacement guided by clinical response.

Tall peaked T waves, flattened P waves, and widened QRS complexes signalling dangerous elevation of serum potassium, requiring calcium, insulin with glucose, and definitive removal of the potassium source.

A life-threatening exaggeration of thyrotoxicosis with fever, tachyarrhythmia, agitation, and heart failure, treated with beta blockade, thionamide, iodine given after the thionamide, steroids, and supportive care.

Damage to the nerve in the tracheoesophageal groove during neck surgery, causing hoarseness from vocal cord paresis, or stridor and airway obstruction when both sides are affected.

Excess parathyroid hormone secretion, usually from a single adenoma, producing hypercalcemia with low or normal phosphate, and treated by focused parathyroidectomy after localization when criteria are met.

A catecholamine-secreting tumour of the adrenal medulla causing paroxysmal hypertension, headache, sweating, and palpitations, requiring alpha blockade before beta blockade and before any surgical handling.

Identification and removal of the first draining node or nodes using blue dye, radiolabelled tracer, or both, to stage the regional basin with less morbidity than complete clearance when the nodes are clinically negative.

Systemic or radiation treatment given before planned curative surgery, aiming to shrink the tumour, test biological response, and increase the chance of clear margins or breast-conserving resection.

Systematic description of cancer extent by primary tumour size and invasion, regional nodal involvement, and distant metastasis, which determines prognosis and selects the treatment pathway.

Complete removal of a tumour with microscopically negative margins, as opposed to R1 with microscopic residual disease or R2 with macroscopic residual disease, and the goal of curative oncological operations.

The three factors that promote thrombosis: stasis of blood flow, endothelial injury, and hypercoagulability, used to explain risk and to plan mechanical and pharmacological prophylaxis in surgical patients.

Raised pressure within a closed fascial compartment that compromises capillary perfusion, causing pain out of proportion, pain on passive stretch, and tense swelling, requiring urgent fasciotomy.

Chronic limb-threatening ischaemia with rest pain, ulceration, or gangrene due to severe arterial occlusive disease, requiring revascularization by bypass or angioplasty to avoid amputation.

The ratio of systolic pressure at the ankle to that at the brachial artery, normally about 1.0, with values below 0.9 suggesting arterial disease and falsely high values occurring in calcified vessels.

Progressive thickening of the pyloric muscle in infancy causing non-bilious projectile vomiting, visible gastric waves, and a palpable olive, with hypochloraemic alkalosis corrected before pyloromyotomy.

Telescoping of one bowel segment into the next, usually ileocolic in infants, causing colicky pain, vomiting, and redcurrant-jelly stool, treated by air or contrast enema reduction if there is no peritonitis.

Twisting of the spermatic cord that cuts off blood supply to the testis, presenting with sudden severe scrotal pain and a high-riding testis, requiring immediate surgical exploration and bilateral fixation.

Free gas within the peritoneal cavity, shown on erect chest or computed tomography as gas under the diaphragm and usually indicating perforated hollow viscus that requires urgent surgical assessment.

Bacterial infection of an obstructed biliary tree producing fever, jaundice, and right upper quadrant pain, sometimes with shock and confusion, requiring antibiotics and urgent biliary drainage by endoscopy or percutaneous route.

A grading of chronic liver disease using bilirubin, albumin, prothrombin time, ascites, and encephalopathy, used to estimate operative risk and prognosis before hepatic resection or transplantation.

A prognostic index from bilirubin, international normalized ratio, creatinine, and sodium that ranks waiting-list urgency for liver transplantation and predicts short-term mortality in cirrhosis.

Insufflation of carbon dioxide into the peritoneal cavity to create working space, usually at 12 to 15 mmHg, which reduces venous return and can cause hypercapnia, vagal bradycardia, or gas embolism.

A documented discussion in which a competent patient voluntarily agrees to a procedure after understanding its nature, purpose, material risks, alternatives, and the consequences of declining, free from coercion.

A serious patient-safety incident that is wholly preventable, such as wrong-site surgery or retained surgical item, which triggers mandatory reporting and root-cause analysis rather than blame.

The number of patients who must receive an intervention to prevent one additional adverse outcome, calculated as the reciprocal of the absolute risk reduction and used to weigh clinical benefit.