Indications, key steps, and complications of common general surgery procedures like appendectomy, cholecystectomy, and hernia repair.
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- What is the most common indication for appendectomy?
- Acute appendicitis
- Where does the pain of acute appendicitis classically begin?
- The periumbilical region
- Where does appendicitis pain classically migrate to over several hours?
- The right lower quadrant
- What is McBurney's point?
- A point one-third of the way from the anterior superior iliac spine to the umbilicus, the classic site of maximal tenderness in appendicitis
- What is Rovsing's sign?
- Palpation of the left lower quadrant causes pain in the right lower quadrant
- What imaging study is preferred for suspected appendicitis in a pregnant patient?
- Ultrasound
- On CT, what appendiceal diameter suggests appendicitis?
- Greater than 6 mm
- What is the standard surgical approach for uncomplicated appendicitis today?
- Laparoscopic appendectomy
- What is a major complication of a ruptured (perforated) appendix?
- Peritonitis or intra-abdominal abscess
- Why do perforated appendicitis cases have higher rates of surgical site infection?
- Contamination of the wound by spilled infected material during surgery
- What is the most common indication for cholecystectomy?
- Symptomatic cholelithiasis (biliary colic)
- What is Murphy's sign?
- Inspiratory arrest during palpation of the right upper quadrant
- What are the three components of Charcot's triad?
- Right upper quadrant pain, fever, and jaundice
- What two additional findings, added to Charcot's triad, make up Reynold's pentad?
- Altered mental status and hypotension
- What is the first-line imaging study for suspected gallstones?
- Right upper quadrant ultrasound