Abdomen and pelvis

• Author: R. John Naranja
• Pages: 547-616

ABDOMEN AND PELVIS

19-1

CHAPTER 19

ABDOMEN AND PELVIS

§191 CASE 1: RUPTURED SPLEEN AND LIVER

§19-1.1 Fact Summary

§19-1.2 Clinical Discussion

§19-1.2.1 Relationships of the Organs Involved

§19-1.2.2 Spleen

§19-1.2.3 Liver

§19-1.2.4 Lung

§19-1.3 Forensic Questions and Answers

§19-1.4 Glossary

§19-1.5 Additional Reading

§192 CASE 2: INGESTION OF A CAUSTIC SUBSTANCE

§19-2.1 Fact Summary

§19-2.2 Clinical Discussion

§19-2.3 Forensic Questions and Answers

§19-2.4 Glossary

§19-2.5 Additional Reading

§193 CASE 3: ABDOMINAL STAB WOUND

§19-3.1 Fact Summary

§19-3.2 Clinical Discussion

§19-3.3 Forensic Questions and Answers

§19-3.4 Glossary

§19-3.5 Additional Reading

§194 CASE 4: OPEN BOOK FRACTURE OF THE PELVIS

§19-4.1 Fact Summary

§19-4.2 Clinical Discussion

§19-4.3 Forensic Questions and Answers

§19-4.4 Glossary

§19-4.5 Additional Reading

§195 CASE 5: DELAYED LACERATION OF SPLEEN DUE TO SLIP AND FALL INJURY

§19-5.1 Fact Summary

§19-5.2 Diagnosis

[Editor’s Note: All medical illustrations that appear or are referenced in this chapter are available online – in full-size

and most in four-color – through James Publishing Digital Access.]

ABDOMEN AND PELVIS

Medical Evidence 19-2

§19-5.3 Clinical Discussion

§19-5.3.1 General Anatomy

§19-5.3.2 Physiology/Pathology

§19-5.3.3 Surgery

§19-5.4 Treatment

§19-5.5 Prognosis

§19-5.6 Forensic Questions and Answers

§19-5.7 Glossary

§19-5.8 Additional Reading

§196 CASE 6: PELVIC FRACTURE AND OPEN BLADDER INJURY

FOLLOWING MOTORCYCLE/VEHICLE COLLISION

§19-6.1 Fact Summary

§19-6.2 Diagnosis

§19-6.3 Clinical Discussion

§19-6.3.1 Skeletal Anatomy of Pelvis

§19-6.3.2 Bladder

§19-6.3.2.1 Blood Supply and Drainage of Bladder

§19-6.3.2.2 Nerves of Bladder

§19-6.3.3 Rupture of Bladder

§19-6.3.4 Anterior Abdominal Wall

§19-6.4 Treatment

§19-6.5 Prognosis

§19-6.6 Forensic Questions and Answers

§19-6.7 Glossary

§19-6.8 Additional Reading

§197 CASE 7: FAILURE AND REVISION OF BARIATRIC (WEIGHT REDUCTION) SURGERY

§19-7.1 Fact Summary

§19-7.2 Diagnosis

§19-7.3 Clinical Discussion

§19-7.3.1 Fat

§19-7.3.2 Obesity and Morbid Obesity

§19-7.3.3 Surgical Anatomy Encountered

§19-7.3.3.1 Lower Esophagus and Upper Portion of Stomach

§19-7.3.3.2 Duodenum

§19-7.3.3.3 The Jejunum

§19-7.3.4 Physiology of Absorption in Gut

§19-7.4 Treatment

§19-7.4.1 Bariatric Surgery—Overview

§19-7.4.2 Banded Gastroplasty

§19-7.4.3 Roux-En-Y

§19-7.5 Prognosis

§19-7.6 Forensic Questions and Answers

§19-7.7 Glossary

§19-7.8 Additional Reading

§198 CASE 8: GALLBLADDER REMOVAL (CHOLECYSTECTOMY) WITH COMPLICATIONS

§19-8.1 Fact Summary

§19-8.2 Diagnosis

§19-8.3 Clinical Discussion

§19-8.3.1 Liver, Gallbladder and Bile

§19-8.3.2 Gallstones

§19-8.3.3 Peritoneum and Peritonitis

ABDOMEN AND PELVIS

19-3 Abdomen and Pelvis

§19-8.4 Treatment

§19-8.4.1 Overview

§19-8.4.2 Laparoscopic Cholecystectomy

§19-8.4.3 Open Cholecystectomy

§19-8.5 Prognosis

§19-8.6 Forensic Questions and Answers

§19-8.7 Glossary

§19-8.8 Additional Reading

§199 CASE 9: INGUINAL HERNIA REPAIR NECESSITATED BY JOBRELATED LIFTING INJURY

§19-9.1 Fact Summary

§19-9.2 Diagnosis

§19-9.3 Clinical Discussion

§19-9.3.1 Introduction to Groin Hernias

§19-9.3.2 Anatomy of Anterior Abdominal Wall as It Relates to Hernia Repair

§19-9.3.2.1 Musculature and Membranous Layers

§19-9.3.2.2 Nerves of Anterior Abdominal Wall

§19-9.3.2.3 Blood Vessels of Anterior Wall

§19-9.3.2.4 Miscellaneous Features of Abdominal Wall

§19-9.3.2.5 Landmarks of Anterior Wall

§19-9.3.2.6 Deep Inguinal Ring

§19-9.4 Overview–Repair of Inguinal Hernias

§19-9.4.1 Minimally Invasive Lapaoscopic Herniorrhapphy Using TAPP Approach

§19-9.4.2 Open Hernia Repairs

§19-9.5 Case Specif‌ic Treatment

§19-9.6 Prognosis

§19-9.7 Forensic Questions and Answers

§19-9.8 Glossary

§19-9.9 Additional Reading

§1910 CASE 10: RADICAL PROSTATECTOMY WITH RESULTING

URINARY INCONTINENCE AND IMPOTENCE

§19-10.1 Fact Summar y

§19-10.2 Diagnosis

§19-10.3 Clinical Discussion

§19-10.3.1 Overview

§19-10.3.2 Male Pelvis

§19-10.3.3 Bladder and Sphincter Muscles

§19-10.3.4 Prostate

§19-10.3.5 Benign Prostate Hypertrophy and Transurethral Surgery

§19-10.4 Treatment

§19-10.5 Prognosis

§19-10.6 Forensic Questions and Answers

§19-10.7 Glossary

§19-10.8 Additional Reading

§1911 CASE 11: ALCOHOLISM AND RESULTING ILLNESSES (HEMORRHOIDS,

LIVER DISEASE, DIABETES) AS INCAPACITATING CONDITION

§19-11.1 Fact Summary

§19-11.2 Diagnosis

§19-11.3 Clinical Discussion

§19-11.3.1 Normal Rectal and Anal Anatomy

§19-11.3.2 The Hepatic Portal Vein

§19-11.3.2.1 Cirrhosis of the Liver and Related Maladies

§19-11.3.2.2 Results of Portal Hypertension