Gallstones are hard lumps or stones, usually made of cholesterol or sometimes other substances like bilirubin that form in the gallbladder.
The gallbladder is a small organ situation underneath the liver which releases bile (produced by the liver but stored and concentrated in the gallbladder) into the digestive system to help the body breakdown fats into fatty acids for absorption.
Gallstones don’t always produce symptoms and do not always need treating. In fact, the vast majority of people will not experience symptoms as the gallstones themselves do not cause pain.
In certain circumstances however, a gallstone might become trapped, causing intense pain known as biliary colic. The pain usually starts in the upper right part of the abdomen and radiates to the shoulder.
Further complications can arise whereby the gallbladder becomes inflamed - symptoms can include jaundice (a yellowing of the eyes and skin), fever, persistent pain, nausea and vomiting.
The development of gallstones is thought to be due to too much cholesterol or bilirubin in the bile, leading to the formation of stones. In the majority of cases gallstones are made of cholesterol, however if the liver is producing too much bilirubin (often due to damage) this can result in the formation of stones also.
Improper emptying of the gallbladder is also thought to cause stones, as the bile becomes too concentrated.
Risk factors for the development of gallstones include being overweight, a lack of exercise, a diet containing too much cholesterol and fat that is also low in fibre, and rapid weight loss. It stands to reason therefore that maintaining a balanced diet and a healthy weight can help to prevent the development of gallstones. Other risk factors for the disease include liver problems and diabetes.
Gallstones don’t always need treatment and in many cases the best option is to monitor them and only treat them if symptoms appear. If, however they are causing complications it might be necessary to treat them immediatley. Additionally, patients who have conditions which increase the risk of complications, such as portal hypertension (high blood pressure in the liver), cirrhosis of the liver or diabetes may need more urgent treatment.
In most cases, keyhole surgery is performed to remove the gallbladder, in an operation known as a cholecystectomy. Following the operation, patients can lead a normal life without the gallbladder as the liver will continue to produce bile.
A hernia appears as a lump, most commonly in the abdominal or groin area. They occur when an organ, often the bowel, protrudes through the cavity which normally contains it.
Liver cancer is a form of cancer that starts in the liver, as opposed to secondary liver cancer which starts elsewhere in the body and travels to the liver. Most cancer that is found in the liver is secondary cancer, as many cells travelling around the body end up in the liver, making it more susceptible to liver cancer. If the cancer is a secondary cancer in the liver, it will be treated in the same way that the primary cancer would be treated, such as if it is secondary breast cancer in the liver, the cancer will be treated in the same way as breast cancer, as the cells are the same, only they have travelled to the liver.
There are a number of different types of cancer that start in the liver. These include:
The usual symptoms of liver cancer include:
There are a number of different treatment options available for liver cancer, depending on the type of liver cancer it is.
The most common type is surgery, with removal of the tumour attempted at first. Liver function may be able to continue as normal if the liver was healthy to begin with.
Liver transplant may also be required if the cancer has developed in a large amount of the liver. The specialist may decide to use localised treatments such as chemotherapy, radiofrequency ablation, cryoablation, radiation therapy or drug therapy.
To make an appointment with a specialist regarding liver cancer, click here.
The liver is the organ that is responsible for:
Liver surgery is the group of surgical procedures used to treat various liver problems, such as:
The main type of liver surgery is called a hepatectomy which involves the removal of part or all of the liver. This procedure is also known as a liver resection. If the whole liver is removed, then it is replaced with a healthy one – this is known as a liver transplant.
You would require a liver resection or transplant if your liver was partially damaged, or it can no longer perform its normal functions. Other treatment options would have been tried already, as surgery is needed when the underlying condition for liver problems can no longer be controlled non-surgically.
If just part of your liver is damaged, for example because of cancer, then just part of the liver can be removed surgically, leaving the healthy part of the liver intact.
If the patient suffers from liver failure, then a transplant is required, and without one long-term survival is not possible, as unlike other organs such as the kidneys, there is no machine or device (a dialysis machine) that can replicate the functions of what the liver does.
A partial liver resection is performed under general anaesthetic and can take between two to five hours. This procedure is mostly carried out to treat either liver cancer or colorectal cancer. It is often performed alongside other treatments such as chemotherapy or radiation therapy. A resection can only be carried out if there are no major blood vessels compromised in the section that needs to be removed. Providing you do not suffer from other liver problems, such as cirrhosis, then the liver can recover and grow back.
A liver transplant involves the removal of the whole liver. The replacement liver must come from a donor that has a liver that is a close match to one’s own and come either from a deceased donor, or from a living donor (in which case the living donor has a section of their liver surgically removed and it is this section that is used to treat the transplant patient).
If you require a liver transplant, it involves being placed on a waiting list, as there are more in need of a liver transplant than there are livers available. The waiting list is ordered in terms of priority. Most people on the waiting list are able to stay at home until a viable liver becomes available. When preparing for a liver transplant or resection it is important to be as healthy as possible, adopting a balanced diet, taking regular exercise and not drinking or smoking. It is important to be prepared at short notice for surgery.
After a live transplant, there will be some time spent in an intensive care unit (ICU), where a ventilator machine will help you breathe. A stomach entering your nose and stomach will provide fluid and nutrients which are removed after a few days. Painkillers will also be administered. You can expect to leave the hospital after two weeks, after which you return home, but have regular check-ups to ensure the body is not rejecting the new liver.
After a liver resection, patients are generally well enough to leave the hospital within two weeks of the procedure, and recovery time depends on how much of your liver was removed, but does take a number of months.
The pancreas is a large gland in the abdomen, which produces enzymes that aid in digestion. Pancreatic cancer is when abnormal cells develop in the pancreas and multiply out of control. As these cells do not function normally, as they multiply they hinder bodily functions, eventually leading to death if not treated.
Cancer can develop in different parts of the pancreas:
In the early stages, pancreatic cancer may not show any symptoms, making it hard to diagnose. Symptoms such as abdominal pain, indigestion and weight loss can manifest as the cancer develops and grows. Unfortunately, these symptoms are common and can indicate a number of other conditions. Other possible symptoms include:
The causes are not fully understood, but certain risk factors have been identified, such as age (patients are generally 50-80 years old), smoking, and a history of certain conditions (e.g. diabetes, chronic pancreatitis, stomach ulcer and H. pylori infection). There is thought to be a genetic factor in some cases, as in about 1 in 10 cases the patient’s parent or parents also had pancreatic cancer.
Pancreatic cancer is difficult to treat, as it is rarely detected until the tumour has become quite large. Treatment depends on the type, location and size of the tumour, as well as the age and general health of the patient. If it is possible to remove the tumour completely, this is the preferred option, but in cases where this is not possible, different treatment will be recommended to contain the cancer, prevent further growth and minimise the damage it does to the body.
The three main treatments, which may be used individually or in combination are:
Recovering from surgery on the pancreas can be long and painful, and the bowel will stop working for a while, meaning that the patient cannot eat or drink immediately afterwards, and may be referred to a dietician for the duration of the recovery process.
Pancreatitis is the inflammation of the pancreas, which is a gland found behind the stomach. The pancreas is key to the digestion of food, through the production of certain enzymes as well as the production of hormones that aid in the processing of blood glucose levels. There are two types of pancreatitis; acute and chronic. Acute pancreatitis is when the pancreas becomes inflamed suddenly. Chronic pancreatitis is when the pancreas becomes permanently damaged due to inflammation of the pancreas over many years.
The symptoms of acute pancreatitis include:
The symptoms of chronic pancreatitis include:
If you experience frequent abdominal pain, it is important to see a specialist.
Acute pancreatitis is thought to occur when digestive enzymes activate whilst still in the pancreas, causing irritation of the pancreatic cells and hence inflammation. Acute pancreatitis has also been linked to both gallstones, alcohol consumption, infections, and some medications.
Chronic pancreatitis has largely been attributed to long-term alcohol abuse, smoking, hereditary genetic mutations and immune system problems.
In some cases, the cause for a pancreatitis diagnosis is never confirmed.
There are a number of tests used to make a diagnosis, such as:
Treatment for acute pancreatitis looks to support bodily functions until inflammation has subsided. The first step in treating acute pancreatitis is to let the pancreas heal, and for the inflammation to subside. To do so, you must be treated in hospital where you will receive intravenous fluids to replace lost fluids, and medicines to manage pain. Fasting for a few days also helps the pancreas to recover.
Once the pancreas has recovered, doctors can get to work on treating the underlying cause of pancreatitis. Frequently, such additional treatments can include:
For those suffering from chronic pancreatitis, then further treatments might be needed, including:
Appendicitis is an inflammation of the appendix, which is a small pouch of tissue attached to the colon, located in the lower right abdomen. It is formed at the junction of the small and large intestines.
A sudden pain around the middle of the abdomen that moves to the lower right abdomen or a pain in the lower right abdomen (where the appendix is located) are common symptoms of appendicitis. Other symptoms include nausea, vomiting, loss of appetite, diarrhoea and a fever. A pain that becomes worse all of a sudden and spreads across the abdomen is a sign that the appendix may have burst and requires immediate medical attention.
Appendicitis is caused by a blockage or obstruction in the appendix that leads to infection. The appendix gets filled with a build-up of mucus, causing swelling.
Appendicitis is very hard to prevent, although there is evidence that it is less prevalent in people with high fibre diets.
Appendicitis can lead to the appendix rupturing, which is a very dangerous complication and it is important to prevent the condition reaching this stage.
A ruptured appendix spreads potentially life-threatening infection. Peritonitis occurs when the peritoneum (tissue which lines the abdomen) becomes infected and can cause long-term problem and even death.
In most cases, the appendix is removed by surgery. The operation is referred to as an appendectomy and is performed to prevent the appendix from bursting. The operation is performed as either open or keyhole surgery.
Keyhole surgery is preferred over open surgery and will be carried out where possible. Keyhole, or laparoscopic, surgery is less invasive than open surgery and has shorter recovery times. Several small incisions are made in the abdomen, which is then inflated with a gas to make it easier to perform the surgery. The operation is done with the aid of a laparoscope, which is a small tube with a camera that relays images back to the surgeon.
In cases where the patient has previously had abdominal surgery or the appendix has already burst in might not be possible to perform keyhole surgery. In these cases, open surgery might be preformed, which consists of a single, much larger cut in the lower right abdomen.
If the appendix has burst and an abscess has formed, it will be necessary to drain the abscess before performing an appendectomy.
Gallstones are hard lumps or stones, usually made of cholesterol or sometimes other substances like bilirubin that form in the gallbladder.
The gallbladder is a small organ situation underneath the liver which releases bile (produced by the liver but stored and concentrated in the gallbladder) into the digestive system to help the body breakdown fats into fatty acids for absorption.
Gallstones don’t always produce symptoms and do not always need treating. In fact, the vast majority of people will not experience symptoms as the gallstones themselves do not cause pain.
In certain circumstances however, a gallstone might become trapped, causing intense pain known as biliary colic. The pain usually starts in the upper right part of the abdomen and radiates to the shoulder.
Further complications can arise whereby the gallbladder becomes inflamed - symptoms can include jaundice (a yellowing of the eyes and skin), fever, persistent pain, nausea and vomiting.
The development of gallstones is thought to be due to too much cholesterol or bilirubin in the bile, leading to the formation of stones. In the majority of cases gallstones are made of cholesterol, however if the liver is producing too much bilirubin (often due to damage) this can result in the formation of stones also.
Improper emptying of the gallbladder is also thought to cause stones, as the bile becomes too concentrated.
Risk factors for the development of gallstones include being overweight, a lack of exercise, a diet containing too much cholesterol and fat that is also low in fibre, and rapid weight loss. It stands to reason therefore that maintaining a balanced diet and a healthy weight can help to prevent the development of gallstones. Other risk factors for the disease include liver problems and diabetes.
Gallstones don’t always need treatment and in many cases the best option is to monitor them and only treat them if symptoms appear. If, however they are causing complications it might be necessary to treat them immediatley. Additionally, patients who have conditions which increase the risk of complications, such as portal hypertension (high blood pressure in the liver), cirrhosis of the liver or diabetes may need more urgent treatment.
In most cases, keyhole surgery is performed to remove the gallbladder, in an operation known as a cholecystectomy. Following the operation, patients can lead a normal life without the gallbladder as the liver will continue to produce bile.
A hernia appears as a lump, most commonly in the abdominal or groin area. They occur when an organ, often the bowel, protrudes through the cavity which normally contains it.
A hernia occurs when part of the internal organs or tissue pushes through a weakness in the muscle wall. An inguinal hernia is said to occur when part of the bowel or fatty tissue pushes into the groin at the top of the thigh. It is also the most common type of hernia, particularly in a male. Inguinal hernias are rare in females.
Symptoms of an inguinal hernia are a swelling or a lump in the groin or an enlarged scrotum. There may also be associated pain or discomfort, pain when coughing or lifting, or a dragging sensation in the groin. A bulge either side of the pubic bone could also be a sign of an inguinal hernia.
The hernia may be pushed back in when lying down, however complications can occur whereby the hernia gets stuck or trapped and obstructs the bowel, or the hernia becomes strangulated, whereby the blood supply gets cut off. This is potentially very serious, even life-threatening and requires immediate attention. Symptoms of a strangulated hernia include vomiting and nausea, fever, sudden pain, a bulge that turns red or purple, or an inability to pass stools or gas.
In males the testicles descend during development via a small opening in the groin. This process leads to a weakness in the abdominal wall and is the cause for inguinal hernias. In a boy there is usually a sac which accompanies the testis. Generally it is supposed to close but occasionally the sac remains, leading to a hernia.
In adults, undue straining such as heavy lifting, violent coughing or prolonged straining on the toilet may cause the hernia to develop due to the underlying weakness in the groin. Loss of elastic tissue due to the ageing process also leads to inguinal hernias. It is not unusual for hernias to occur in both groins.
Avoiding undue pressure in the abdomen by straining when passing stool or urinating or carrying and moving heavy loads can reduce the risk of an inguinal hernia, however many hernias may be unavoidable as they have no apparent cause. Strain on the abdominal muscles can be reduced by maintaining a healthy weight, eating a high-fibre diet and stopping smoking.
Surgery is the usual treatment for inguinal hernias. In some patients a non-surgical option, such as a hernia truss, may be appropriate. Occasionally it may be appropriate to wait and watch and monitor the hernia. Surgery becomes an emergency for hernias that cause severe pain or that have developed complications. Strangulation, where the bowel has become trapped, is one such complication and it requires immediate treatment to restore the blood supply via surgery.
Laparoscopy is a minimally invasive surgical technique which allows the surgeon to operate without the need for deep or large incisions in the skin. This means the recovery period is generally shorter, there is less pain after the operation, and scarring is reduced significantly for the patient. This technique is also known as keyhole surgery.
Laparoscopy can be used to both treat and diagnose a range of conditions across specialties such as surgery, gynaecology, gastroenterology, and urology. Laparoscopy may be used in investigation, to check symptoms and attempt to reach a diagnosis, for example in cases of ovarian cysts, fibroids, pelvic inflammatory disease, and appendicitis. Laparoscopy can also be used to take a biopsy (a small sample of tissue) meaning it can be used to investigate certain cancers, e.g liver cancer, ovarian cancer, pancreatic cancer, and many more.
As a surgical technique, laparoscopy is especially useful as it allows for minimal scarring and a shorter recovery period, which is advantageous to the patient. Laparoscopy can be used as a surgical technique in many situations, such as:
Laparoscopy is performed under general anaesthetic. The surgeon makes small incisions in the abdomen and inserts a laparoscope, which is a small camera attached to the end of a thin tube, allowing the surgeon to see inside the abdomen through a projection on a TV monitor in front of them. The surgeon uses small instruments to perform surgery, looking at the TV monitor for a clear view of the area they need to operate on.
Generally, you will be asked not to eat or drink anything for 6-12 hours before the procedure. You will also be asked to stop taking blood-thinning medication a few days before the procedure takes place. If you are a smoker, your surgeon may advise you not to smoke for a few days before the procedure, as smoking can delay the healing process.
As laparoscopy is a minimally invasive procedure, you can generally go home either on the same day or the day following surgery. Someone will need to accompany you home as you will be advised not to drive for the 24 hours following the procedure.
Recovery from laparoscopy depends on the type of procedure performed. After diagnostic laparoscopy, for example, you may be able to resume normal activity after five days. If surgery is more minor, for example ulcer repair, normal activity may be resumed in around three weeks. Major surgery, such as hysterectomy or organ removal (e.g kidney) typically takes longer – up to 12 weeks. Your surgeon or doctor will advise you on how to clean your stitches and keep wounds clean.
Expect to feel tired or somewhat drained after surgery for a few days, but this should pass as your body uses less and less energy as the recovery process goes on. If you experience any pain, you can take over-the-counter medication pain relief to reduce it.
Laparoscopy is a minimally invasive technique which is used as an alternative to traditional open surgery. Open surgery may be necessary in certain situations and your surgeon will speak to you regarding your options before making a decision as to which type of surgery will be performed.
A lipoma is a benign lump that forms under the skin, usually made from fatty tissue. They usually grow slowly and are situated between the skin layer, and the muscle layer beneath.
Lipomas are more common in middle age, are usually painless, and most commonly appear on the upper back, shoulders and abdomen.
The cause of lipomas is unknown. It is believed that they may be genetic, so if your parents or other members of the family had lipomas, then you may also be prone to developing them. They can often appear after an injury, though the reason they form is unknown.
As previously mentioned, lipomas are usually painless, though can cause some pain if they press on nearby nerves. They appear as soft, doughy lumps ranging in size from around the size of a pea to as big as a grapefruit. The lumps may move slightly if pressed.
Although people of any age can develop lipomas, they are more prevalent in adults aged between 40 and 60 years of age.
People with the following conditions are more at risk of developing one or more lipomas:
Lipomas don’t usually cause any problems if left alone, however they can be treated if required.
The most common way of treating lipomas is to have them surgically removed. This can be done by either a dermatologist, or by a plastic surgeon.
Surgery involves making an incision to remove the fatty tissue, before suturing the opening. Though there is a risk that the lipoma may return, it is uncommon.
Another treatment option to reduce the size of the lipoma is liposuction, where a needle is used to remove some of the fat from within the lipoma.
Finally, steroid injections may be used to treat the lipoma. The steroid injection works to shrink the lipoma, though this treatment doesn’t completely remove the lipoma.
Liver cancer is a form of cancer that starts in the liver, as opposed to secondary liver cancer which starts elsewhere in the body and travels to the liver. Most cancer that is found in the liver is secondary cancer, as many cells travelling around the body end up in the liver, making it more susceptible to liver cancer. If the cancer is a secondary cancer in the liver, it will be treated in the same way that the primary cancer would be treated, such as if it is secondary breast cancer in the liver, the cancer will be treated in the same way as breast cancer, as the cells are the same, only they have travelled to the liver.
There are a number of different types of cancer that start in the liver. These include:
The usual symptoms of liver cancer include:
There are a number of different treatment options available for liver cancer, depending on the type of liver cancer it is.
The most common type is surgery, with removal of the tumour attempted at first. Liver function may be able to continue as normal if the liver was healthy to begin with.
Liver transplant may also be required if the cancer has developed in a large amount of the liver. The specialist may decide to use localised treatments such as chemotherapy, radiofrequency ablation, cryoablation, radiation therapy or drug therapy.
To make an appointment with a specialist regarding liver cancer, click here.
The liver is the organ that is responsible for:
Liver surgery is the group of surgical procedures used to treat various liver problems, such as:
The main type of liver surgery is called a hepatectomy which involves the removal of part or all of the liver. This procedure is also known as a liver resection. If the whole liver is removed, then it is replaced with a healthy one – this is known as a liver transplant.
You would require a liver resection or transplant if your liver was partially damaged, or it can no longer perform its normal functions. Other treatment options would have been tried already, as surgery is needed when the underlying condition for liver problems can no longer be controlled non-surgically.
If just part of your liver is damaged, for example because of cancer, then just part of the liver can be removed surgically, leaving the healthy part of the liver intact.
If the patient suffers from liver failure, then a transplant is required, and without one long-term survival is not possible, as unlike other organs such as the kidneys, there is no machine or device (a dialysis machine) that can replicate the functions of what the liver does.
A partial liver resection is performed under general anaesthetic and can take between two to five hours. This procedure is mostly carried out to treat either liver cancer or colorectal cancer. It is often performed alongside other treatments such as chemotherapy or radiation therapy. A resection can only be carried out if there are no major blood vessels compromised in the section that needs to be removed. Providing you do not suffer from other liver problems, such as cirrhosis, then the liver can recover and grow back.
A liver transplant involves the removal of the whole liver. The replacement liver must come from a donor that has a liver that is a close match to one’s own and come either from a deceased donor, or from a living donor (in which case the living donor has a section of their liver surgically removed and it is this section that is used to treat the transplant patient).
If you require a liver transplant, it involves being placed on a waiting list, as there are more in need of a liver transplant than there are livers available. The waiting list is ordered in terms of priority. Most people on the waiting list are able to stay at home until a viable liver becomes available. When preparing for a liver transplant or resection it is important to be as healthy as possible, adopting a balanced diet, taking regular exercise and not drinking or smoking. It is important to be prepared at short notice for surgery.
After a live transplant, there will be some time spent in an intensive care unit (ICU), where a ventilator machine will help you breathe. A stomach entering your nose and stomach will provide fluid and nutrients which are removed after a few days. Painkillers will also be administered. You can expect to leave the hospital after two weeks, after which you return home, but have regular check-ups to ensure the body is not rejecting the new liver.
After a liver resection, patients are generally well enough to leave the hospital within two weeks of the procedure, and recovery time depends on how much of your liver was removed, but does take a number of months.
Lymph nodes, also known as lymph glands, are small glands found throughout the body and form a part of the lymph system. The lymph system is a network of organs and vessels the carries a fluid around the body between tissue and the blood. The fluid contains white blood cells called lymphocytes.
The lymph system plays an integral part of the immune system, fighting against disease and infections.
Lymph nodes can be found on their own, or in groups. You can feel groups of lymph nodes in the neck, groin and underarms. You generally cannot feel most lymph nodes in the body, however, if they are swollen in the neck, you are able to feel them.
Lymph nodes help to fight disease and they do so by filtering the lymph fluid and trapping any bacteria or viruses that pass through them. They are then destroyed by the lymphocytes, in an effort to destroy such substances before they infect other parts of the body. When lymph nodes are swollen, it usually means that they are exposed to bacteria and viruses and fighting an infection.
It means that they are likely fighting an infection. However, more rarely, swollen lymph nodes could be caused by an underlying condition such as cancer. Swollen lymph nodes can feel tender or painful.
Depending on which lymph nodes are swollen, it can help determine what the problem might be.
Neck:
Armpit:
Groin:
Collarbone:
If you are concerned at all, then you should see a doctor, however, it is recommended that you see a doctor if:
Adenopathy is a term that refers to swelling of a gland, typically the lymph nodes (lymphadenopathy). A lymph node is an oval or kidney-shaped organ that forms part of the lymphatic system - a network of nodes, organs and lymphatic vessels situated all over the body. The lymph node’s primary function is to fight infection. The lymphatic system is in fact a vital part of the immune system, helping to identify sources of infection and preventing other parts of the body becoming infected also.
Lymph nodes are located all over the body and consequently, swelling can appear in a number of locations. Common signs of a lymphadenopathy are swelling in the neck, groin, and armpits and under the chin. The swelling can be accompanied by tenderness in the lymph nodes, fever, sore throat and runny nose.
If the swelling has been present for two to four weeks and the lymph nodes continue to get bigger, or the nodes are hard and rubbery and don’t move when pressed, it may be an indication of something more serious. Symptoms might also include night sweats.
Swollen lymph nodes can have multiple underlying causes. Usually, a common infection like measles, common colds, tonsillitis, ear infections, and strep throat is the root cause of lymphadenopathy. Less commonly, certain STIs, tuberculosis, infection from a cat scratch or toxoplasmosis can lead to swelling of the lymph nodes. HIV infection is also a potential underlying cause.
Aside from infections, occasionally autoimmune conditions like rheumatoid arthritis and lupus will cause swollen lymph nodes. In rare instances, swelling of the lymph nodes can indicate cancers such as leukaemia (cancer of the blood and bone marrow) or lymphoma, cancer of the lymph system.
Swelling can also result as a side effect of certain medications. Anyone concerned about the cause of lymph node swelling should see a doctor to establish the cause.
Lymph nodes are not treated directly, rather the underlying condition is treated. If the underlying cause is an infection, then the lymph nodes will normally return to normal after the infection clears up.
If swollen lymph nodes are caused by an autoimmune disorder or cancer, then the underlying conditions are targeted.
If the lymph nodes themselves are tender or painful, the symptoms are often treated with over-the-counter pain medication, plenty of rest and warm compressions to help with the swelling.
The pancreas is a large gland in the abdomen, which produces enzymes that aid in digestion. Pancreatic cancer is when abnormal cells develop in the pancreas and multiply out of control. As these cells do not function normally, as they multiply they hinder bodily functions, eventually leading to death if not treated.
Cancer can develop in different parts of the pancreas:
In the early stages, pancreatic cancer may not show any symptoms, making it hard to diagnose. Symptoms such as abdominal pain, indigestion and weight loss can manifest as the cancer develops and grows. Unfortunately, these symptoms are common and can indicate a number of other conditions. Other possible symptoms include:
The causes are not fully understood, but certain risk factors have been identified, such as age (patients are generally 50-80 years old), smoking, and a history of certain conditions (e.g. diabetes, chronic pancreatitis, stomach ulcer and H. pylori infection). There is thought to be a genetic factor in some cases, as in about 1 in 10 cases the patient’s parent or parents also had pancreatic cancer.
Pancreatic cancer is difficult to treat, as it is rarely detected until the tumour has become quite large. Treatment depends on the type, location and size of the tumour, as well as the age and general health of the patient. If it is possible to remove the tumour completely, this is the preferred option, but in cases where this is not possible, different treatment will be recommended to contain the cancer, prevent further growth and minimise the damage it does to the body.
The three main treatments, which may be used individually or in combination are:
Recovering from surgery on the pancreas can be long and painful, and the bowel will stop working for a while, meaning that the patient cannot eat or drink immediately afterwards, and may be referred to a dietician for the duration of the recovery process.
Pancreatitis is the inflammation of the pancreas, which is a gland found behind the stomach. The pancreas is key to the digestion of food, through the production of certain enzymes as well as the production of hormones that aid in the processing of blood glucose levels. There are two types of pancreatitis; acute and chronic. Acute pancreatitis is when the pancreas becomes inflamed suddenly. Chronic pancreatitis is when the pancreas becomes permanently damaged due to inflammation of the pancreas over many years.
The symptoms of acute pancreatitis include:
The symptoms of chronic pancreatitis include:
If you experience frequent abdominal pain, it is important to see a specialist.
Acute pancreatitis is thought to occur when digestive enzymes activate whilst still in the pancreas, causing irritation of the pancreatic cells and hence inflammation. Acute pancreatitis has also been linked to both gallstones, alcohol consumption, infections, and some medications.
Chronic pancreatitis has largely been attributed to long-term alcohol abuse, smoking, hereditary genetic mutations and immune system problems.
In some cases, the cause for a pancreatitis diagnosis is never confirmed.
There are a number of tests used to make a diagnosis, such as:
Treatment for acute pancreatitis looks to support bodily functions until inflammation has subsided. The first step in treating acute pancreatitis is to let the pancreas heal, and for the inflammation to subside. To do so, you must be treated in hospital where you will receive intravenous fluids to replace lost fluids, and medicines to manage pain. Fasting for a few days also helps the pancreas to recover.
Once the pancreas has recovered, doctors can get to work on treating the underlying cause of pancreatitis. Frequently, such additional treatments can include:
For those suffering from chronic pancreatitis, then further treatments might be needed, including:
Radiofrequency is a minimally invasive procedure which can be used to treat varicose veins. It is performed under local anaesthetic, and uses the application of heat to damage tissue, meaning scar tissue forms. This closes the varicose vein and cuts it off, meaning it is destroyed. This type of treatment can be used on large varicose veins.ç
Varicose veins can be considered unsightly by some, and many wish to have them removed. Varicose veins can also be painful and cause discomfort. Several types of procedure are available for the treatment of varicose veins, and different ones will be indicated depending on the patient and the size of the vein. As radiofrequency is able to destroy larger veins, it may be indicated in patients who have veins of significant size.
The procedure is performed while the patient is awake, as a local anaesthetic is given to numb the particular area where treatment will be applied. Radiofrequency (an electrical current) is passed through a catheter injected into the vein, which heats up the vein wall and damages it. This causes the vein to close off.
Radiofrequency is generally a successful procedure, and the vein closes off in most patients. One advantage of radiofrequency is that it is less painful than traditional varicose vein surgery, which removes the vein itself.
Some side effects may include burns on the skin, pain after recovery, or clotting in the vein. However, these risks are minimal and usually get better over time.
Before the treatment, a medical history will be taken to see if the patient is suitable, and where the procedure should be performed. Medication will also be discussed, and those who take aspirin or blood-thinners (such as ibuprofen) as long-term medication will be told to stop several days before the procedure.
After the procedure, the surgeon places a dressing on the area which has been treated. This dressing must be worn for at least 24 hours. After these 24 hours are up, the patient then should wear compression stockings for at least two weeks. Some mild pain may be experienced, which can be relieved using over-the-counter painkillers.
A follow-up ultrasound will be taken around a week after the procedure, to check the vein is closed and to see if a deep vein thrombosis has developed. This occurs rarely but it is a possibility and it is important for the surgeon to check.
Patients are advised not to partake in strenuous activity for a few weeks afterwards, but light activity is encouraged and the patient will be able to return to work soon after the procedure.
The spleen is a small, fist-sized organ located underneath left rib cage, close to the stomach. The spleen is a key component of the immune system as it contains white blood cells that kill bacteria and fight infections. The spleen also filters out old red blood cells from the bloodstream.
Spleen removal surgery is called a partial splenectomy if just part of the spleen is removed, or a splenectomy if the whole spleen is removed.
The reasons you might need a splenectomy include:
Splenectomies can either be performed laparoscopically (keyhole surgery) or as open surgery. Most are carried out laparoscopically.
During a laparoscopic splenectomy, a special instrument guided by a camera is inserted via small incisions and allows the surgeon to access the abdomen and spleen without the need to make large cuts and scars. General anaesthetic is still required for this type of splenectomy.
Open surgery involves a large cut being made in the abdomen, to allow the extraction of the spleen. Open surgery is usually chosen if the spleen is very damaged or large and will often be done in an emergency case. General anaesthetic is also required.
Before surgery, you may be advised to stop taking certain medications, avoid eating and drinking, receive certain vaccines to prevent infection after the spleen is removed, and it may be necessary to have a blood transfusion to ensure that you have enough blood cells post-splenectomy.
After a laparoscopic splenectomy, the small incisions are either stitched together or glued. Often patients are able to leave the same day or the following day. If the patient does return the same day, it is necessary for them to be accompanied by a family member or friend.
After an open surgery splenectomy, it will be necessary to stay in hospital for two to six days. It is normal to feel some pain, which can be managed with painkillers. During the hospital stay, you will be given some exercises to keep moving, to avoid blood clots. You can expect to recover and return to normal activities within six weeks.
Once you have healed fully, the other organs in the body are able to take over the functions that the spleen performed, however, you can be more prone to infection and sickness.
An umbilical hernia is a type of hernia, which refers to when part of the internal organs protrude through a weakness in the surrounding cavity.
In the case of an umbilical hernia, abdominal fat or part of the bowel passes through an area around the navel.
Umbilical hernias are very common, particularly in babies and are characterised by a bulge around the navel that might get bigger when laughing or coughing. They are usually painless in infants and children, however, in adults who develop an umbilical hernia, the swelling may also be accompanied by pain and discomfort.
An umbilical hernia develops as a result of a weakness in the abdominal wall at the navel. If the hole through which the umbilical cord passes through during pregnancy doesn’t close properly after birth, it can cause a hernia either at birth or later on in life. In adults, too much pressure in the abdominal cavity can increase the possibility of an umbilical hernia.
There is little that can be done to prevent umbilical hernias at birth, however, there are certain risk factors for adults. Anything that increases pressure in the abdominal cavity, such as obesity, straining while moving or lifting heavy objects, a persistent heavy cough, ascites (fluid in the abdomen, and having multiple pregnancies (i.e. twins, triplets, etc.), can increase the risk of an umbilical hernia.
In infants, an umbilical hernia very often clears up on its own – the hernia goes back in and the muscle reseals over it. In adults, an umbilical hernia will generally get worse over time.
In most cases, it is advised to wait until a child has reached four of five years of age to see if the hernia disappears before considering surgery, except in cases where the hernia is very large or there are other complications.
In most adults, umbilical hernias are treated with surgery to push the abdominal tissue back into place and seal the abdominal wall. Complications can include obstruction where a section of bowel gets stuck outside the abdomen and can cause nausea, vomiting and pain and discomfort. Strangulation, whereby the blood supply to the section of bowel forming the hernia is cut off, is a potentially serious complication and needs emergency treatment to prevent the trapped tissue from dying.
Upper gastrointestinal (GI) surgery is surgery performed to treat pathologies of either the upper gastrointestinal tract (small bowel), gall bladder, liver, pancreas or oesophagus.
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Prof Kocher is a world class physician in every dimension of the term. Highly recommended.