OMSB General Surgery (OEGS) key terms

A surgical incision through the abdominal wall into the peritoneal cavity, performed for emergency or elective access. Named by direction (midline, transverse, paramedian) and closed in layers, with midline incisions carrying higher risk of incisional hernia.

A bundled, evidence-based perioperative pathway combining carbohydrate loading, opioid-sparing multimodal analgesia, early feeding and early mobilisation to shorten hospital stay and reduce complications after major abdominal operations.

A staged approach for physiologically unstable trauma or emergency patients: abbreviated operation to control haemorrhage and contamination, temporary abdominal closure, intensive care resuscitation, then planned definitive reoperation once physiology is corrected.

Leaving the abdominal cavity open with a temporary closure device after laparotomy, used in damage control surgery or severe intra-abdominal sepsis. Allows re-inspection and prevents abdominal compartment syndrome, but creates large fluid losses and risk of fistula.

Sustained intra-abdominal pressure above 20 mmHg with new organ dysfunction, most often after trauma, burns, pancreatitis or massive fluid resuscitation. Managed with decompressive laparotomy and temporary abdominal closure.

Protrusion of abdominal contents through a defect in a surgical scar, caused by fascial failure. Risk factors include wound infection, obesity, smoking and raised intra-abdominal pressure. Repair may be open or laparoscopic, usually with mesh reinforcement.

Surgical division of fibrous bands between abdominal organs and the parietal peritoneum, usually performed laparoscopically or by open surgery for adhesive small bowel obstruction or chronic pain.

Blockage of intestinal transit in the jejunum or ileum, most commonly caused by adhesions, followed by hernia, malignancy and Crohn disease. Presents with colicky pain, vomiting, distension and absolute constipation; managed initially with resuscitation and nasogastric decompression.

Compromise of the blood supply to a segment of bowel, usually at a tight hernia neck or closed-loop obstruction. Signs include constant pain, tachycardia, peritonism and rising lactate; it is a surgical emergency requiring urgent resection.

Obstruction of bowel at two adjacent points, trapping a segment that cannot decompress. It rapidly progresses to strangulation and perforation, so it is an indication for early surgery rather than prolonged conservative management.

Inadequate blood flow to the intestine causing mucosal injury and eventually transmural necrosis. May be arterial, venous or non-occlusive; disproportionate pain, metabolic acidosis and raised lactate are key clues. Requires urgent revascularisation or resection.

A clinical syndrome of severe abdominal pain with signs of peritonism, systemic upset or haemodynamic compromise that suggests a condition requiring urgent operative assessment, such as perforation, ischaemia or uncontrolled sepsis.

Inflammation of the peritoneal lining, classified as primary (spontaneous, often cirrhotic ascites), secondary (perforation or ischaemic bowel) or tertiary (persistent after treatment). Presents with rigidity, rebound tenderness and absent bowel sounds.

Free gas within the peritoneal cavity, usually from a perforated hollow viscus and visible as subdiaphragmatic gas on erect chest radiograph or CT. It is a relative indication for emergency laparotomy, though small amounts can follow recent surgery.

Life-threatening organ dysfunction caused by a dysregulated host response to infection within the peritoneal cavity, typically from perforation or necrosis. Management combines source control, antimicrobial therapy and organ support.

Procedures that eliminate the origin of infection, such as drainage of an abscess, closure of a perforation or resection of necrotic bowel. Without adequate source control, antibiotics alone cannot resolve intra-abdominal sepsis.

Image-guided placement of a catheter into a fluid collection such as an abscess or biloma, used as definitive treatment or as a bridge to surgery. Success depends on a drainable single collection with a safe access route.

Infection occurring within 30 days of surgery (or one year if an implant is present) at the incision or deeper tissues. Classified as superficial incisional, deep incisional or organ/space; prevention includes appropriate prophylaxis and normothermia.

A single preoperative dose of an antimicrobial chosen for the expected flora of the operative site, given within about an hour of incision to reduce surgical site infection. Prolonged postoperative courses are not routinely indicated.

Structured estimation of a patient's likelihood of complications or death after surgery, combining functional capacity, comorbidity indices such as ASA class and tools like the Revised Cardiac Risk Index or cardiopulmonary exercise testing.

Combining analgesics with different mechanisms, such as paracetamol, NSAIDs, local anaesthetic blocks and opioids, to improve pain relief while reducing opioid dose and related adverse effects. A core element of enhanced recovery pathways.

An abnormal epithelialised connection between two surfaces, such as bowel to skin (enterocutaneous) or bowel to bowel. Management follows the SNAP framework: sepsis control, nutrition, anatomy definition and planned repair.

A tract from bowel to skin that leaks intestinal content, often after surgery, radiation or inflammatory disease. High-output fistulas cause dehydration and electrolyte loss; treatment prioritises sepsis control, skin protection and nutritional support before elective closure.

The systematic ABCDE approach to the injured patient: airway with cervical spine protection, breathing, circulation with haemorrhage control, disability and exposure. Life-threatening problems are treated as they are found before the secondary survey.

Bedside ultrasound scanning of pericardial and dependent abdominal and pelvic windows to detect free fluid in the unstable trauma patient. It is rapid and repeatable but cannot identify the organ of injury.

A strategy for major haemorrhage using permissive hypotension, balanced blood component transfusion over crystalloid, and rapid control of bleeding. It aims to prevent the lethal triad of hypothermia, acidosis and coagulopathy.

Removal of all or part of the thyroid gland for malignancy, compressive goitre or refractory hyperthyroidism. Key risks are recurrent laryngeal nerve injury, hypocalcaemia from parathyroid devascularisation and postoperative haematoma causing airway compromise.

Damage to the nerve running in the tracheo-oesophageal groove during thyroid or parathyroid surgery, causing hoarseness from vocal cord paresis. Bilateral injury can produce stridor and airway obstruction requiring immediate re-intubation.

Bleeding into the neck after thyroid surgery that can obstruct the airway within hours. It is an emergency: the wound is opened at the bedside to release the haematoma, then the patient is returned to theatre for definitive haemostasis.

Removal of a breast tumour with a clear margin while preserving the remaining breast, usually combined with radiotherapy. Oncoplastic techniques allow larger resections with acceptable cosmesis; contraindications include multicentric disease and prior chest irradiation.

Identification and removal of the first draining lymph node(s) using blue dye or radiolabelled tracer, to stage the axilla in clinically node-negative breast cancer with less morbidity than full dissection.

Removal of axillary lymph node levels I and II for proven nodal metastasis or after positive sentinel biopsy in selected patients. It risks lymphoedema, seroma, shoulder stiffness and intercostobrachial nerve numbness.

Chronic swelling from impaired lymphatic drainage, commonly of the arm after axillary surgery or radiotherapy. Managed with compression garments, skin care, exercise and manual lymphatic drainage; cellulitis is a frequent complication.

Surgical removal of the appendix, usually laparoscopically, for acute appendicitis or as an interval procedure. Uncomplicated disease may sometimes be managed with antibiotics, but recurrence and missed neoplasia remain concerns.

A clinical scoring system for suspected acute appendicitis using migratory pain, anorexia, nausea, tenderness, rebound, fever and leucocytosis. It stratifies patients towards observation, imaging or surgery, though imaging remains common in equivocal cases.

Resection of the sigmoid colon with an end colostomy and closure of the rectal stump, used for complicated diverticulitis or emergency left-sided obstruction. Reversal is major surgery and often not performed.

Failure of a bowel join with spillage of contents, typically presenting around days five to seven with pain, tachycardia, ileus, peritonitis or sepsis. It requires urgent imaging, source control and often reoperation with or without takedown of the anastomosis.

A surgically created opening of bowel onto the abdominal wall, either ileostomy or colostomy, to divert faeces. Complications include high output, dehydration, skin excoriation, prolapse, retraction and parastomal hernia.

Protrusion of abdominal contents through the inguinal canal, classified as indirect (lateral to inferior epigastric vessels, through the deep ring) or direct (medial, through Hesselbach's triangle). Tension-free mesh repair is standard in adults.