Arriving at a Surgical Diagnosis

This book is a comprehensive guide to clinical diagnosis. Divided into five sections – general surgery, urogenital cases, neurosurgery, trauma, and paediatric surgery – each chapter describes a different disorder or disease.

Each condition is presented in a systematic, step by step manner, beginning with an overview of its physiology, pathology and clinical features, then its symptoms, history-taking, examination and differential diagnosis.

This highly useful manual presents students with an understanding of how to analyse clinical data in order to reach a diagnosis. More than 367 flow charts, tables and photographic illustrations enhance learning.

Key points

• Comprehensive guide to clinical diagnosis
• Numerous disorders described in a systematic approach helping students analyse clinical data to reach a diagnosis
• History-taking presented in questionnaire format
• Includes more than 367 flow charts, tables and photographic illustrations

• Section 1: General Surgery
• General principles of case-taking
• History-taking
• Selected common symptoms in clinical practice
• General examination
• Locoregional examination
• Respiratory system examination 
• Pelvic examination [‘PS/E’, ‘PV/E’, ‘DRE’ and anoscopy (Proctoscopy)]
• Examination of the pregnant patient
• Diagnosis
• Guidelines on documentation of clinical notes
• Sudden loss of consciousness (Sudden unresponsiveness) / cardiorespiratory arrest
• Shock
• Infections / infestations
• Skeletal muscles in the body amenable to physical examination (Applied anatomy) 
• Swelling—basic concepts
• Chronic lymph node swelling 
• Chronic bone swelling
• Chronic vascular swelling
• Chronic circumscribed swelling in the region of the head and face
• Chronic swelling of the jaw
• Chronic circumscribed swelling in the neck
• Goiter and thyroid cancer
• A reducible (/irreducible) swelling in the groin 
• A non-reducible swelling in the groin
• Scrotal swelling / scrotal pain
• Impalpable testicle / intermittently palpable testicle / empty scrotum
• Chronic swelling in the back
• Chronic swelling in the perineum, and gluteal region
• Swellings / bulges related to vulva / vagina /urethra
• Disorders of the female breast
• Disorders of the male breast
• Disorders of the chest wall
• Chronic pain in abdomen
• Acute pain in abdomen
• Lump in abdomen
• Distension of abdomen
• Jaundice
• Portal hypertension
• Difficulty in swallowing i.e. dysphagia, and other symptoms of (chronic) esophageal disorder
• Vomiting of blood—hematemesis
• Anorectal pain, bleeding per rectum, and other manifestations of anorectal disorder 
• Ulcer 
• Sinus / fistula
• (Recurrent attacks of) Discharge from the umbilicus
• Limb pain
• Limb ischemia—acute and chronic peripheral arterial occlusive disease
• Limb gangrene
• Amputation stump
• Tortuous veins in the limbs—varicose veins / chronic venous insufficiency
• Limb edema
• Oral cavity / orofacial pain
• Temporomandibular joint 
• Backache

• Section 2: Urogenital Case
• Urogenital Case

• Section 3: Neurosurgery
• Intracranial space-occupying lesion

Headache

Head injury

• Section 4: Trauma (Essentially Soft Tissue)
• Acute mechanical trauma—general principles
• Head injury
• Facial (Maxillofacial) injury
• Injury to the neck
• Chest injury
• Esophageal injury
  • Perforation
  • Corrosive injury
  • Ingested foreign body
  • Abdominal trauma
  • Urogenital trauma
  • Injury to anorectum, perineum, buttock
  • Spinal trauma
  • Hand injury
  • Vascular injury
  • Burn injury: Thermal, chemical, electrical

• Section 5: Pediatric Surgery
• History-taking in a child
• Surgical examination of the child 
• Respiratory distress in the newborn
• Acute abdominal disorders
• Colic (Colicky pain in abdomen)
• Neonatal intestinal obstruction
• Recurrent pain in abdomen
• Vomiting in the neonate 
• Non-bile-stained vomiting in infancy
• GI bleeding
• Jaundice / cholelithiasis / portal hypertension
• Discharge from the umbilicus
• Anorectal malformation
• Urinary tract infection (UTI) / urinary stones
• Disorders of the lower urinary tract
• Acute scrotum
• Disorders of the external genitalia
• Acute pain in the limb
• Disorders of the mouth
• Swellings / lesions in the face
• Swelling in the neck / notes on selected swellings
• Torticollis (Wry neck)
• Disorders of the breast 
• A big head / hydrocephalus / assessing a VP shunt 
• Spinal dysraphism—spina bifida 
• Foreign bodies

Pramod Shrikrishna Bapat MS
Consultant General Surgeon, Shree Harneshwar Clinic, Talegaon (Dabhade), Pune, Maharashtra, India