presence of air in the intrapleural space with

presence of air in the intrapleural space, with secondary lung collapse. PNEUMOTHORAX

v. Rupture of the visceral pleura with air leakage from the lung parenchyma

Diagnosis v. Symptoms - chest pain , dyspnea and nonproductive cough v. An early

Indication for surgery v Iipsilateral or contralateral recurrence v Bilateral spontaneous pneumothorax v Persistent

Etiology v 1) closed loop obstruction is caused by a fecalith and swelling of

Presentation vcrampy, intermittent abdominal pain-either periumbilical or diffuse and difficult to localize vfollowed shortly

Diagnosis v. History and Physical Examination v. Laboratory Studies v. Imaging Studies

Indication of surgery v. Suspicious appendicitis

Etiology v. Congenital in etiology v. Repeated increases in intra-abdominal pressure

Presentation v. Asymptomatic vfrank peritonitis v. Pain v. Palpable mass

Indication for surgery v. The treatment of all hernias, regardless of their location or

inflammation of the gall bladder ACUTE CHOLECYSTITIS

Presentation vpain in the right upper quadrant vlow grade fever, diarrhea, vomiting and nausea

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presence of air in the intrapleural space, with secondary lung collapse. PNEUMOTHORAX

v. Rupture of the visceral pleura with air leakage from the lung parenchyma

Diagnosis v. Symptoms - chest pain , dyspnea and nonproductive cough v. An early sharp pain followed by a steady pain. v. Usually decrease gradually and resolve during the 24 hours following the episode v. PE- decrease in chest wall movement on the affected side ; percussion - hyper-resonant ; auscultation - breath sounds are diminished or absent ; pleural friction rub v. CXR and CT

Indication for surgery v Iipsilateral or contralateral recurrence v Bilateral spontaneous pneumothorax v Persistent air leak >4– 5 days or failure to completely reexpand the lung v Tension pneumothorax v Spontaneous hemopneumothorax v Contralateral pneumonectomy v Lifestyle and profession at risk: professional divers, flying personnel, pilots, spending time in remote areas with no access to medical care

APPENDICITIS

Etiology v 1) closed loop obstruction is caused by a fecalith and swelling of the mucosal and submucosal lymphoid tissue at the base of the appendix v (2) intraluminal pressure rises as the appendiceal mucosa secretes fluid against the fixed obstruction v (3) increased pressure in the appendiceal wall exceeds capillary pressure and causes mucosal ischemia v (4) luminal bacterial overgrowth and translocation of bacteria across the appendiceal wall result in inflammation, edema, and ultimately necrosis

Presentation vcrampy, intermittent abdominal pain-either periumbilical or diffuse and difficult to localize vfollowed shortly thereafter with nausea v. Classically, the pain migrates to the right lower quadrant as transmural inflammation of the appendix leads to inflammation of the peritoneal lining of the right lower abdomen. This usually occurs within 12– 24 hours of the onset of symptoms vlow-grade fever up to 101°F (38. 3°C)

Diagnosis v. History and Physical Examination v. Laboratory Studies v. Imaging Studies

Indication of surgery v. Suspicious appendicitis

INGUINAL HERNIA

Etiology v. Congenital in etiology v. Repeated increases in intra-abdominal pressure

Presentation v. Asymptomatic vfrank peritonitis v. Pain v. Palpable mass

Indication for surgery v. The treatment of all hernias, regardless of their location or type, is surgical repair v疝氣手術可以減少因疝氣導致的不適與疼痛感，改善生活品質。並可避免脫垂之腸道組織壞死。