By Alan G. Chalmers MBChB, MRCP, FRCR (auth.), John Brittenden, Damian J.M. Tolan (eds.)
Radiology of the submit Surgical Abdomen offers a finished review of all belly operations regarding the gastrointestinal tract, pancreas, hepatobiliary and genitourinary platforms. each one bankruptcy is totally illustrated with artists' drawings and radiological photos of standard submit operative anatomy. The issues linked to every one technique are defined along imaging examples. Written by way of specialists within the box, Radiology of the submit Surgical Abdomen presents the reader with key instructing issues emphasising differentiation among basic post-operative anatomy and complications.
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The liver parenchyma can be injured during laparoscopic cholecystectomy if the gallbladder lies partially or completely embedded in the liver, for example, intrahepatic gallbladder. The spleen can be damaged during port site insertion in the left upper quadrant or during mobilization of the splenic flexure during left-sided colonic resections during laparoscopic adrenalectomy. The kidney can be mobilized and damaged during right or left colonic mobilization if the wrong surgical plane is inadvertently dissected.
When necrosis develops, mural irregularity, hypoenhancement, and intramural gas may be found. Progression to mural necrosis can be averted by image-guided percutaneous cholecystostomy to decompress the gallbladder. Gangrenous cholecystitis usually develops as a complication of untreated cholecystitis and typically results from gallbladder wall ischemia developing secondary to excessive gallbladder distension. CT signs to look for include: • Absent, discontinuous, or irregular mural enhancement • Intraluminal membranes that appear as linear densities within the gallbladder lumen • Gas within the gallbladder wall or lumen imaging, it is important to liaise with the surgeon to correlate this with the clinical status of the patient and the likelihood that this may be infected.
The small bowel, for example, is at high risk of damage if not adequately retracted away from the surgical field during colonic resection (Fig. 34). Bladder injury can result from access-related events or diathermy (Fig. 36), whereas pancreatic injury (Fig. 37) typically occurs during colonic or upper GI tract mobilization. Late common bile duct injury can occur if excessive energy is transferred via the cystic duct as it is dissected. Care must also be taken to place the earthing pad away from sites of metalwork, such as joint prostheses, and on a surface area wide enough to safely carry the energy away from the patient.