SURGERY CLINIC
cod. 08737

Academic year 2012/13
5° year of course - Second semester
Professor
Academic discipline
Chirurgia generale (MED/18)
Field
Clinica generale medica e chirurgica
Type of training activity
Characterising
14 hours
of face-to-face activities
2 credits
hub: -
course unit
in - - -

Integrated course unit module: GENERAL SURGICAL CLINIC (FR)

Learning objectives

The student has to acquire useful knowledge of surgical diseases in order to perform a differential diagnosis between the various disorders and know about surgical therapies.

Prerequisites

The student have to achived before the following exams : Human Anatomy, Physiology, Pathology, Biochemistry, Semiotics and Clinical Methodology, Microbiology, Digestive and Endocrine Diseases, Pharmacology. The attendance to Lecture-style Lessons and the Professionalizing Teaching in General Surgery is mandatory

Course unit content

Know the diseases of surgical interest (see program)

Full programme

Pathology of Shock: General Considerations, Hemorrhagic shock, traumatic shock, septic shock.
Skin burns and chemical burns.
Healing Wounds. Pimple. Abscesses. Phlegmons. Necrosis. Ulcer. Gangrene.
Gas gangrene.
Vascular disease. Clinical case, diagnosis and therapy: atherosclerotic arteriopathy, aneurysms, arterial thrombosis of the lower limbs, chronic arterial disease of the lower limbs, supra-aortic arterial trunks disorders, Varicose veins of the lower limb, thrombophlebitis.
Thyroid. Clinical case, diagnosis and therapy: acute and subacute thyroiditis, goiter colloid-cystic, goiter toxic, thyroid carcinomas. MEN I, MEN II
Parathyroid glands. Hyperparathyroidism: primary and secondary. Carcinoma of the parathyroid glands.
Thorax and lung. wounds and Blunt chest trauma. Spontaneous pneumothorax. Lung abscess. Bronchopulmonary neoplasms. Metastatic tumors of the lung. Mediastinal syndrome. Mediastinitis.
Mammary gland. Anatomy and physiology. Diagnostic and therapy: flogistic diseases, benign neoplasms, breast cancer.
Esophagus. Anatomy and physiology. Clinical case, diagnosis and therapy: motility disorder (achalasia, diffuse esophageal spasm, GERD and esophagitis), congenital malformations, traumatic lesions and caustic injuries, diverticula, diaphragmatic hernia, hiatal hernia, Barrett's esophagus, benign and malignant neoplasia
Acute abdomen
Abdominal trauma. close and open.
Peritoneum. acute diffuse Peritonitis and local circumscribed Peritonitis.. Subphrenic abscesses. Local Pelviperitonitis. Ascites. Hemoperitoneum. retroperitoneal bleeding
Bowel obstruction. Mechanical ileus. Dynamic ileus
Hernias. Clinical case, diagnosis and therapy: inguinal hernia, crural hernia, umbilical hernia, epigastric hernia, incisional hernia, rare hernia.
Stomach. Clinical case, diagnosis and therapy: acute hemorrhagic gastritis, gastric ulcer and duodenal ulcer, pyloric stenosis, congenital, acquired stenosis, gastric precancerous lesions, benign gastric tumors, gastric carcinoids,. Gist gastrointestinal conditions and precancerous lesions, gastrointestinal cancer, cancer of the gastric stump, postprandial syndromes of gastrectomized patients.
Small intestine. Clinical case, diagnosis and therapy: Meckel’s diverticulum, intussusception, Crohn's disease, ischemic bowel disease, aorto-mesenteric compass, bowel ischemia, benign and malignant neoplasia of the small intestine, carcinoid of the small intestine.
Colon. Clinical case, diagnosis and therapy: acute appendicitis, volvulus, ulcerative colitis, diverticular disease, Hirschsprung’s disease, angiodysplasia of the cecum, transient ischemic colitis, pseudomembranous ulcerative colitis, polyposis, adenoma-carcinoma sequence of the large intestine, colon cancer.
Rectum and anal canal. Clinical case, diagnosis and therapy: hemorrhoids, anal fissure, perianal fistulas and abscesses, anal and rectal fistulas, rectal cancer, anal cancer.
Pilonidal cysts and fistulas.
Liver. Clinical case, diagnosis and therapy: parasitic and non parasitic cysts. Amoebic and pyogenic abscesses, trauma, portal hypertension and complications, hepatocellular carcinoma and cholangiocarcinoma (central and hilar).
Gallbladder. Clinical case, diagnosis and therapy: gallbladder stones, gallbladder stones and its complications, acute cholecystitis and its complications, cholecysto biliary and biliary-digestive fistula, benign biliary stricture, benign and malignant tumors of the gallbladder and bile duct cancer.
Pancreas. Clinical case, diagnosis and treatment of: trauma, acute and chronic pancreatitis, pancreatic pseudocysts, exocrine and endocrine pancreas tumors, cystic tumors, periampullary cancer, gastro-entero-pancreatic neuroendocrine tumors.
Spleen. Clinical case, diagnosis and treatment of: trauma, spleen disease of surgical interest.
Digestive bleeding. Upper and lower intestinal tract.
Retroperitoneum. Retroperitoneal tumor.
Adrenal glands. Benign and malignant tumors. Incidentalomas.
Kidney. Trauma. Hydronephrosis. Stones. Cancer: pelvis, ureter, bladder, kidney tumors.
Male genitalia. Phimosis. Paraphimosis. Carcer of the penis. Testicular torsion. Hydrocele. Varicocele. Testicular tumors. Adenomyoma and prostate cancer.
Enterostomy.
Soft tissue tumors.
General information about organ transplantation.
General information on bariatric surgery
Central and peripheral venous access
Overall assessment of the surgical patient
Clinical evaluation of the main body fluids
Diagnostic and therapeutic pathway of the breast cancer
Instrumental diagnostic
Diagnostic and operative digestive endoscopy
Collecting medical history of a oncologic surgical patient
Physical examination of a oncologic patient
Physical examination of an oncologic neck with surgical interest
The diagnostic instrument for cancer staging (TNM)
Diagnosis of sugical diseases in election
Diagnosis of sugical diseases in emergency
Differential Diagnosis
Preparing for surgery
Post-operative monitoring
Evaluation and treatment of wounds
Indication for radical or palliative surgery
Indication and therapy of the mini-invasive surgery
Postoperative staging cancer
Open surgery
Day Surgery
Laparoscopic surgery.

Bibliography

Brunicardi FC et al.: Schwartz - Manuale di Chirurgia, McGraw-Hill 2008
Peracchia A, Okolicsanji L, Roncoroni L: Malattie dell'Apparato Gastrointestinale - 4a ed., McGraw-Hill 2008
Sabiston DC: Trattato di Chirurgia, Delfino Ed.
Dionigi R: Chirurgia, Ed. Masson
Colombo C: Trattato di Chirurgia, Ed. Minerva Medica
Gallone L: Patologia Chirurgica, Casa Ed. Ambrosiana
Stipa S: Manuale di Chirurgia, Monduzzi Ed.
Bellantone R, De Toma G, Montorsi M: Chirurgia Generale, Ed. Minerva Medica, Other...

Teaching methods

Teaching: Lecture-style Lessons, tutorials in department, in ambulatory and in the operating room.

Assessment methods and criteria

The attendance to Lecture-style Lessons and the Professionalizing Teaching in General Surgery is mandatory. Oral exam.

Other information

It is possible to follow optional surgical courses and daily briefing (in the Department room at h 8:15 a.m. o’clock)