Hinchey Classification
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Hinchey Classification
Hinchey Classification is used to describe perforations of the colon due to diverticulitis. The classification was developed by Dr. E John Hinchey (1934–present), a general surgeon at the Montreal General Hospital and professor of surgery at McGill University. Diverticulosis (the presence of bowel diverticula) is an essentially ubiquitous phenomenon. With age, all people develop out-pouching of the bowel wall as pressure from the inside of the bowel pushes the mucosa outwards. The pouches (diverticula) occur where there is a gap between or weakness within the muscle fibres of the bowel wall, classically at sites of vessel protrusion into the wall. Although the majority of diverticula are asymptomatic, the most commonly noticed symptom of diverticula is bloody stool. When diverticula (singular: diverticulum) become sites of inflammation the condition is termed "diverticulitis" and occurs when the diveritcula become infected. This classically causes lower abdominal pain, changes ...
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Colon (anatomy)
The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being removed by defecation. The colon is the longest portion of the large intestine, and the terms are often used interchangeably but most sources define the large intestine as the combination of the cecum, colon, rectum, and anal canal. Some other sources exclude the anal canal. In humans, the large intestine begins in the right iliac region of the pelvis, just at or below the waist, where it is joined to the end of the small intestine at the cecum, via the ileocecal valve. It then continues as the colon ascending the abdomen, across the width of the abdominal cavity as the transverse colon, and then descending to the rectum and its endpoint at the anal canal. Overall, in humans, the large intestine is about long, which is about one-fifth o ...
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Diverticulitis
Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—which can develop in the wall of the large intestine. Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days. There may also be nausea; and diarrhea or constipation. Fever or blood in the stool suggests a complication. Repeated attacks may occur. The causes of diverticulitis are unclear. Risk factors may include obesity, lack of exercise, smoking, a family history of the disease, and use of nonsteroidal anti-inflammatory drugs (NSAIDs). The role of a low fiber diet as a risk factor is unclear. Having pouches in the large intestine that are not inflamed is known as diverticulosis. Inflammation occurs in between 10% and 25% at some point in time, and is due to a bacterial infection. Diagnosis is typically by CT scan, though blood tests, colonoscopy, or a lower gastrointestinal se ...
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Montreal General Hospital
The Montreal General Hospital (MGH) (french: Hôpital Général de Montréal) is a hospital in Montreal, Quebec, Canada established in the years 1818-1820. The hospital received its charter in 1823. It is currently part of the McGill University Health Centre (MUHC) and is located on Mount Royal, at the intersection of Pine Avenue (Avenue des Pins) and Côte-des-Neiges Road. It has six pavilions: A, B, C, D, E and Livingston (L); plus a research centre in a separate building next to the L pavilion. The first MGH was built at the corner of Craig Street (today St. Antoine) and St. Lawrence Boulevard and only had 24 beds. Having outgrown this space, it moved to a new 72-bed building on Dorchester Boulevard (now René-Lévesque) at St. Dominique Street; today this facility is a long-term care centre. In 1924, the hospital merged with the Western General Hospital (currently the D & E wings of the former Montreal Children's Hospital) building at the corner of Tupper Street and Atwater A ...
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McGill University
McGill University (french: link=no, Université McGill) is an English-language public research university located in Montreal, Quebec, Canada. Founded in 1821 by royal charter granted by King George IV,Frost, Stanley Brice. ''McGill University, Vol. I. For the Advancement of Learning, 1801–1895.'' McGill-Queen's University Press, 1980. the university bears the name of James McGill, a Scottish merchant whose bequest in 1813 formed the university's precursor, University of McGill College (or simply, McGill College); the name was officially changed to McGill University in 1885. McGill's main campus is on the slope of Mount Royal in downtown Montreal in the borough of Ville-Marie, with a second campus situated in Sainte-Anne-de-Bellevue, west of the main campus on Montreal Island. The university is one of two members of the Association of American Universities located outside the United States, alongside the University of Toronto, and is the only Canadian member of the Glob ...
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Diverticulosis
Diverticulosis is the condition of having multiple pouches (diverticulum, diverticula) in the colon (anatomy), colon that are not inflamed. These are outpockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. Diverticula do not cause symptoms in most people. Diverticular disease occurs when diverticula become clinically inflamed, a condition known as diverticulitis. Diverticula typically occur in the sigmoid colon, which is commonplace for increased pressure. The left side of the colon is more commonly affected in the United States while the right side is more commonly affected in Asia. Diagnosis is often during routine colonoscopy or as an incidental finding during CT scan. It is common in Western countries with about half of those over the age of 60 affected in Canada and the United States. Diverticula are uncommon before the age of 40, and increase in incidence beyond that age. Rates are lower in Africa; the reasons for this rema ...
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Bowel
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as feces. ''Gastrointestinal'' is an adjective meaning of or pertaining to the stomach and intestines. Most animals have a "through-gut" or complete digestive tract. Exceptions are more primitive ones: sponges have small pores ( ostia) throughout their body for digestion and a larger dorsal pore (osculum) for excretion, comb jellies have both a ventral mouth and dorsal anal pores, while cnidarians and acoels have a single pore for both digestion and excretion. The human gastrointestinal tract consists of the esophagus, stomach, and intestines, and is divi ...
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Mucosa
A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is mostly of endodermal origin and is continuous with the skin at body openings such as the eyes, eyelids, ears, inside the nose, inside the mouth, lips, the genital areas, the urethral opening and the anus. Some mucous membranes secrete mucus, a thick protective fluid. The function of the membrane is to stop pathogens and dirt from entering the body and to prevent bodily tissues from becoming dehydrated. Structure The mucosa is composed of one or more layers of epithelial cells that secrete mucus, and an underlying lamina propria of loose connective tissue. The type of cells and type of mucus secreted vary from organ to organ and each can differ along a given tract. Mucous membranes line the digestive, respiratory and reproductive trac ...
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Peritonitis
Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or the entire abdomen may be tender. Complications may include shock and acute respiratory distress syndrome. Causes include perforation of the intestinal tract, pancreatitis, pelvic inflammatory disease, stomach ulcer, cirrhosis, or a ruptured appendix. Risk factors include ascites (the abnormal build-up of fluid in the abdomen) and peritoneal dialysis. Diagnosis is generally based on examination, blood tests, and medical imaging. Treatment often includes antibiotics, intravenous fluids, pain medication, and surgery. Other measures may include a nasogastric tube or blood transfusion. Without treatment death may occur within a few days. About 20% of people with cirrhosis who are hospitalized have peritonitis. Signs and symptoms Abd ...
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Laparoscopic
Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.MedlinePlus > Laparoscopy Update Date: 21 August 2009. Updated by: James Lee, MD // No longer valid Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location. Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery perform ...
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Laparotomy
A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy. Origins and history The first successful laparotomy was performed without anesthesia by Ephraim McDowell in 1809 in Danville, Kentucky. On July 13, 1881, George E. Goodfellow treated a miner outside Tombstone, Arizona Territory, who had been shot in the abdomen with a .32-caliber Colt revolver. Goodfellow was able to operate on the man nine days after he was shot, when he performed the first laparotomy to treat a bullet wound. Terminology The term comes from the Greek word λᾰπάρᾱ (lapara) 'the soft part of the body between the ribs and hip, flank' and the suffix ''-tomy'', from the Greek word τομή (tome) '(surgical) cut'. In diagnostic laparotomy (most often referred to as an exploratory laparotomy and abbreviated ex-lap), the nature of the disease is unknown, and laparotomy is deemed the best way ...
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Stoma (medicine)
In anatomy, a stoma (plural stomata or stomas) is any opening in the body. For example, a mouth, a nose, and an anus are natural stomata. Any hollow organ can be manipulated into an artificial stoma as necessary. This includes the esophagus, stomach, duodenum, ileum, colon, pleural cavity, ureters, urinary bladder, and renal pelvis. Such a stoma may be permanent or temporary. Surgical procedures that involve the creation of an artificial stoma have names that typically end with the suffix "-ostomy", and the same names are also often used to refer to the stoma thus created. For example, the word "colostomy" often refers either to an artificial anus or the procedure that creates one. Accordingly, it is not unusual for a stoma to be called an ostomy (plural ostomies), as is the norm in wound, ostomy, and continence nursing. Gastrointestinal stomata Stomata are created in particular in surgical procedures involving the gastrointestinal tract (GIT) or gastrointestinal system ( ...
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