surgery

#Vascular

Abdominal aortic aneurysm

By Dr. Ahmed Hafez

Definition Abdominal aortic aneurysm (AAA) is defined as an abnormal dilatation of the abdominal aorta with a diameter greater than 3 cm. It is a relatively common aortic pathology that results in significant amounts of morbidity and mortality. Between 1-2% of men undergoing NHS screening (over the age of 65) will be found to have a AAA. The vast majority are infrarenal (i.e below the origin of the renal arteries). Risk factors AAA may be considered a degenerative condition of the aorta though its aetiology is not fully understood. A number of risk factors have been shown to be associated

Continue Reading
comment
#Urology

Acute bacterial prostatitis 

By Dr. Ahmed Hafez

Introduction Acute bacterial prostatitis refers to a an infection involving the prostate that may cause significant systemic upset. It tends to present with urinary symptoms, lower back or pelvic pain +/- symptoms of systemic infection. Urinary pathogens are often implicated, commonly Escherichia coli. Less commonly sexually transmitted infections are isolated as the cause.     Aetiology E.coli is the most commonly isolated pathogen in acute bacterial prostatitis. Pseudomonas aeruginosa, Klebsiella, Enterococcus and Proteus may all be causes. Sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoea, are less commonly isolated. There are a number of specific scenarios to consider: Recent urethral

Continue Reading
comment
#Plastics

Basal cell carcinoma

By Dr. Ahmed Hafez

Summary Basal-cell carcinoma (BCC) is a slow-growing, locally invasive, malignant epidermal (basal layer) skin tumour. Typically, a slow-growing skin lesion (over months / years) which commonly occurs on sun-exposed areas of the body. Eighty percent occur on the head and neck. BCC is the commonest form of skin cancer. It is 4-5x more common than squamous cell carcinoma (SCC). They generally affect middle-aged/elderly individuals, unless there is a genetic susceptibility. BCCs are locally destructive and rarely metastasize. Clinical examination typically demonstrates a flesh- or pink-colored lesion with rolled edges, ulceration and telangiectasia (small blood vessels). Treatment is usually by surgical

Continue Reading
comment
#Orthopaedics

Ankle fractures

By Dr. Ahmed Hafez

Overview Ankle fractures are common lower limb fractures often occurring due to low-energy torsional trauma. They affect women more than men, most commonly those aged 30-60. Ankle fractures account for around 9% of fractures presenting to accident and emergency, representing a significant portion of the trauma workload. Treatment involves restoration of normal anatomical alignment. This may involve conservative management with a walking boot or cast, or involve surgical fixation. Attention must be payed to the risk of venous thromboembolism (VTE) and prophylaxis given where appropriate. Anatomy The ankle is a hinge joint, formed by the malleoli & talus. It is

Continue Reading
comment
#Hepatobiliary

Acute pancreatitis

By Dr. Ahmed Hafez

Introduction Acute pancreatitis refers to an acute inflammatory process involving the pancreas. Pancreatitis occurs due to the uncontrolled release of activated pancreatic enzymes within the pancreas resulting in autodigestion. Patients may suffer a spectrum of disease from mild abdominal discomfort to multi-organ failure. Pancreatitis has an annual incidence of 13-45 cases per 100,000, with trends showing that it is becoming more common. It tends to occur more in men and is commonly secondary to gallstones or alcohol misuse.     Aetiology Alcohol misuse and gallstones are the most common causes of acute pancreatitis. Alcohol misuse and gallstones are responsible for

Continue Reading
comment
#General Surgery

Abdominal incisions

By Dr. Ahmed Hafez

Overview A surgical incision refers to a cut made through the skin to access deeper tissue or facilitate an operation. An abdominal incision refers to a surgical cut made anywhere on the abdomen. This enables access to deeper tissue to facilitate an operation by gaining access to the intra-abdominal or intra-pelvic cavities. There are a number of characteristic incisions that are completed on the abdomen to facilitate open surgery. Many of these have eponymous names. Knowledge of abdominal incisions is important for exams. Kocher This is a subcostal incision that is completed to gain access to the upper abdomen. A

Continue Reading
comment
#ENT

Acoustic neuroma

By Dr. Ahmed Hafez

Overview An acoustic neuroma is a benign Schwann-cell derived tumour, which commonly arises from the eight cranial nerve. An acoustic neuroma, also known as a vestibular schwannoma, is a benign intracranial tumour that is derived from Schwann cells that are one of the major supporting nerve cells in the peripheral nervous system. It is typically a slow growing tumour that arises from the eighth cranial nerve supplying the inner ear. This cranial nerve, also known as the vestibulocochlear nerve, has important functions in both hearing and balance. An acoustic neuroma is typically unilateral and leads to unilateral sensorineural hearing loss

Continue Reading
comment
#Breast surgery

Breast cancer

By Dr. Ahmed Hafez

Introduction Breast cancer is the most common malignancy affecting women in the UK. It may be diagnosed during screening or patients may present with a breast (or axillary) lump. Pain, skin and nipple changes may also prompt presentation. On occasion, patients will present with symptoms of metastatic spread. Management is holistic, with input from members of the multi-disciplinary team (MDT) and centred around the individual patient’s thoughts and wishes. Breast cancer can occur in anyone. It can affect women, trans-women, trans-men, men and non-binary individuals. In men, it is less common and is not within the top 20 cancers affecting

Continue Reading
comment
#L #Refractive errors

Laser eye surgery

By Sama Mohamed

What is laser eye surgery? Laser eye surgery uses a beam of light (a laser) to destroy diseased or unwanted eye tissue. It can reshape your cornea, correcting your vision. In many cases this removes the need for glasses or contact lenses. Like all surgery, it has risks and possible complications. When is laser eye surgery used? Laser eye surgery is most often used to correct vision. People with poor vision often have a misshaped cornea. This is the clear layer at the front of the eye. A misshaped cornea is not the correct shape to focus light on the

Continue Reading
comment
#A #Heart surgery

Aortic valve replacement

By Sama Mohamed

What is an aortic valve replacement? The aortic valve is one of 4 valves in the heart that work together to keep blood flowing in the right direction. If the aortic valve stops working properly, it may need to be replaced. Why is an aortic valve replacement performed? The aortic valve must open fully and close fully with each heartbeat so the heart can pump enough blood around the body. If either function is affected, the heart must work much harder to try and deliver enough blood to the body and it can become overworked. Signs the aortic valve is

Continue Reading
comment
Load More Posts