Benign Perianal Disease

Topics to review:

- Anal Fissures:
1) describe pathophysiology
2) describe preventative, medical and surgical treatment

- Anorectal abscess:
1) differentiate perianal, ischiorectal, intersphincteric, supralevator and horseshoe abscesses;
2) describe drainage technique of uncomplicated perianal and ischiorectal abscesses

- Hemorrhoids
1) differentiate internal, external hemorroids, rectal prolapse
2) describe treatment of external hemorroids
3) describe treatment options for internal hemorrhoids

Miscellaneous perianal and colorectal conditions
1) pruritis ani
2) proctalgia fugax
3) rectal prolapse
4) fecal incontinence

Recommended Reading:
- Lange Current Diagnosis and Treatment - Anorectum
- Corman's Colorectal Surgery - Proctalgia fugax

Breast Disease

Reading Guide: Breast Disease
- Breast Cancer
- Staging breast cancer
- Inflammatory Breast Cancer
- Paget's disease
- Causes of nipple discharge
- Management of Mastalgia
- Breast Cysts, fibrocystic disease, fibroadenoma

References:
Link to UofA Surgery 101 Breast Cancer Lecture  - Podcast #116
NCCN Breast Cancer Guidelines
Lange Current Diagnosis and Treatment: Breast
Paget's Disease: Kurer's Breast Surgical Oncology
ACS Surgery - Benign Breast Disease

Rome criteria for Irritable Bowel Syndrome

The Rome III criteria system was developed to classify the functional gastrointestinal disorders based on clinical symptoms. Each disorder has its own set of criteria. For example, the Rome III criteria for irritable bowel syndrome (IBS) is as follows:

Symptoms of recurrent abdominal pain or discomfort and a marked change in bowel habit for at least six months, with symptoms experienced on at least three days of at least three months. Two or more of the following must apply:

Pain is relieved by a bowel movement
Onset of pain is related to a change in frequency of stool
Onset of pain is related to a change in the appearance of stool.

Classification of Gastric Carcinoid tumors

Gastric carcinoids are rare tumours. Clinical setting: -  Type I  - Associated with chronic atrophic gastritis with or without pernicious anemia. In autoimmune gastritis progressive destruction of the specialised parietal and chief cell zone leads to atrophy , intestinal metaplasia , hypochlorhydria and hypergastrinemia. - Type II - In Zollinger Ellison syndrome, particularly in patients associated with multiple endocrine neoplasia type 1.           - Type III - Sporadic tumours    - Not related to hypergastrinemia    - In the antrum or corpus    - Larger lesion, may be ulcerated.    - May have an aggressive course.

http://www.ncbi.nlm.nih.gov/pubmed/15362575

Anti fungal therapies

Amphotericin B
Azoles: block Ergosterol synthesis which is an component of fungal cell wall
Echinocandins: Inhibit glucan synthase which is specific for fungal wall (eg: caspofungin)

Link

Colitis Cystica Profunda

http://www.ajronline.org/cgi/reprint/131/3/529.pdf

Laparoscopic Abdominal Wall Reconstruction

Movie link