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CASE 13 Surgery Presentation
CASE PRESENTATION ,[object Object],[object Object],[object Object],[object Object]
DIFFERENTIAL DIAGNOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Citation: Schwartz’s Principles of Surgery, 8 th  edition, 2005
DIFFERENTIAL DIAGNOSIS (CONT.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Citation: Schwartz’s Principles of Surgery, 8 th  edition, 2005
ADDITIONAL TESTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POSSIBLE SCENARIOS Scenario Management Large extraluminal mass in the abdomen CT with oral and IV contrast to determine if fluid-filled. If abscess, FNA and percutaneous CT-guided catheter drainage If not, biopsy. No mass is found Further investigate non-malignant causes of CEA increase Solitary 2 cm mass is found in the right lobe of the liver Surgical resection Widely disseminated diffuse mass effect is seen throughout the abdomen and pelvis First line therapy: 5-fluorouracil and leucovorin. Second line: irinotecan. Surgery for palliative care in the case of obstructions and adhesions, or diagnostic/staging purposes.
PROGNOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],(J Clin Oncol 1997 Mar;15;938, Am J Gastroenterol 1997 Mar;92;490 in J Watch 1997 Apr 15;17(8);65)
PROGNOSIS (CONT) ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Second Year Surgery Case Presentation

  • 1. CASE 13 Surgery Presentation
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. POSSIBLE SCENARIOS Scenario Management Large extraluminal mass in the abdomen CT with oral and IV contrast to determine if fluid-filled. If abscess, FNA and percutaneous CT-guided catheter drainage If not, biopsy. No mass is found Further investigate non-malignant causes of CEA increase Solitary 2 cm mass is found in the right lobe of the liver Surgical resection Widely disseminated diffuse mass effect is seen throughout the abdomen and pelvis First line therapy: 5-fluorouracil and leucovorin. Second line: irinotecan. Surgery for palliative care in the case of obstructions and adhesions, or diagnostic/staging purposes.
  • 7.
  • 8.