tag:blogger.com,1999:blog-89143604616973564022011-08-02T00:48:32.510+01:00An educational blog about colorectal surgery (pilonidal sinus, anal fissure, colorectal cancer, ulcerative colitis, crohns disease, haemorrhoids, colonoscopy, diverticular disease, polyps, colectmy etc). Aimed at undergraduate medical students but relevant for patient information and postgraduate education. Text, pictures and podcasts available for download from www.learncolorectalsurgery.comjonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.comBlogger121100tag:blogger.com,1999:blog-8914360461697356402.post-42319822066014000582010-01-15T12:06:00.000Z2010-01-15T12:06:31.638ZA new microsite for all you need to know about <a href="http://www.learncolorectalsurgery.com/herniasite/">inguinal hernias </a>now available. click on the link. Anatomy videopodcast on this region coming soon!<div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-4231982206601400058?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-86470030305132342342010-01-15T12:03:00.002Z2010-01-15T12:03:51.220ZA new page on <a href="http://www.learncolorectalsurgery.com/Conditions_HereditaryColorectalCancer.php">hereditary colorectal cancer </a>now available on www.learncolorectalsurgery.com.<div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-8647003030513234234?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-46316346848997509022009-12-08T17:33:00.000Z2009-12-08T17:38:19.942ZNew anatomy video podcasts of the abdomen with Richard Tunstall now available at <a href="http://www.learncolorectalsurgery.com/Podcasts_AbdoAnatomy.php">http://www.learncolorectalsurgery.com/Podcasts_AbdoAnatomy.php</a><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-4631634684899750902?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-76562256154151275022009-09-10T14:36:00.000+01:002009-09-10T14:39:27.088+01:00Podcasts now becoming available on YouTube. Go to <a href="http://www.youtube.com/">http://www.youtube.com/</a>, search for learncolorectalsurgery and subscribe.<div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-7656225615415127502?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-57450368005281608762009-08-27T07:38:00.000+01:002009-11-02T15:00:22.605Z3 new podcasts available to listen to on <a href="http://www.learncolorectalsurgery.com/">learncolorectalsurgery.com</a><br /><br />Management of <a href="http://www.learncolorectalsurgery.com/Podcasts.php">small bowel obstruction </a>with Gill Tierney<br /><br />Management of <a href="http://www.learncolorectalsurgery.com/Conditions_ColorectalCancer.php">large bowel obstruction </a>with Gill Tierney<br /><br /><a href="http://www.learncolorectalsurgery.com/Podcasts.php">Appendicitis</a> with Nick Watson<div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-5745036800528160876?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-28060447102081566422009-05-13T11:44:00.000+01:002009-05-13T11:58:28.220+01:00<div><br /><div><div><div><a href="http://1.bp.blogspot.com/_qF_nZBpraMk/SgqmSRLf9FI/AAAAAAAAALQ/6MLtl2ofQkY/s1600-h/DSC00192.jpg"><img id="BLOGGER_PHOTO_ID_5335259541353264210" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px; TEXT-ALIGN: center" alt="" src="http://1.bp.blogspot.com/_qF_nZBpraMk/SgqmSRLf9FI/AAAAAAAAALQ/6MLtl2ofQkY/s320/DSC00192.jpg" border="0" /></a><br /><br /><br /><br /><br /><div>Pilonidal sinus disease is treated surgically. There are over 50 operations described, all of which cause some pain and discomfort and have a recurrence rate of 5-30%. Building on the use of glue for fistula in ano I have used fibrin glue to treat pilonidal disease with success, the patients going home the same day and often back to work within 40hours. recurrence rate so far is 10-15%.</div><br /><div></div><br /><br /><div></div><img id="BLOGGER_PHOTO_ID_5335259702872134978" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px; TEXT-ALIGN: center" alt="" src="http://1.bp.blogspot.com/_qF_nZBpraMk/Sgqmbq4mVUI/AAAAAAAAALY/aRS-qjWTQQk/s320/DSC00193.jpg" border="0" /> <img id="BLOGGER_PHOTO_ID_5335260369647131970" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px; TEXT-ALIGN: center" alt="" src="http://3.bp.blogspot.com/_qF_nZBpraMk/SgqnCe0JXUI/AAAAAAAAALo/HwsHPmSQ3rA/s320/DSC00210.jpg" border="0" /><br />The sinus complex is curetted to remove hairs, debris and granulation tissue.</div><br /><br /><div></div><br /><br /><div><img id="BLOGGER_PHOTO_ID_5335260036626485490" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px; TEXT-ALIGN: center" alt="" src="http://2.bp.blogspot.com/_qF_nZBpraMk/SgqmvGN1kPI/AAAAAAAAALg/lmVR2fVY32c/s320/DSC00197.jpg" border="0" /><br />Fibrin glue is injected into the sinus complex</div><br /><img id="BLOGGER_PHOTO_ID_5335260569563105842" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px; TEXT-ALIGN: center" alt="" src="http://2.bp.blogspot.com/_qF_nZBpraMk/SgqnOHj1CjI/AAAAAAAAALw/ThRYaVtEnm4/s320/DSC00199.jpg" border="0" /><br /><div></div>No dressing is needed and the patient can go home when recovered from the anaesthetic<br /><br /><div><br /><br /><br /><div></div><br /><br /><br /><br /><br /><div></div></div></div></div></div><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-2806044710208156642?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-35056877526610494242009-05-12T14:23:00.000+01:002009-05-12T14:25:01.511+01:00A new video podcast on anal fistula can be seen on <a href="http://www.learncolorectalsurgery.com/Conditions_Fistulainano.php">learncolorectalsurgery.com</a><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-3505687752661049424?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-14440330060536931842009-05-12T14:22:00.000+01:002009-05-12T14:23:47.590+01:00A new video podcast on anal fissure can be seen on <a href="http://www.learncolorectalsurgery.com/Conditions_AnalFissure.php">learncolorectalsurgery.com</a><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-1444033006053693184?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-31727545366776177622009-05-12T14:20:00.000+01:002009-05-12T14:22:29.566+01:00A new podcast on diverticular disease has been added to <a href="http://www.learncolorectalsurgery.com/Conditions_Diverticulardisease.php">learncolorectalsurgery.com</a><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-3172754536677617762?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-57464836759619872812009-05-07T00:44:00.000+01:002009-05-07T00:47:31.634+01:00Listen to the new podcast on screening for colorectal cancer on <a href="http://www.learncolorectalsurgery.com/Conditions_ColorectalCancer.php#cc5">www.learncolorectalsurgery.com</a> <div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-5746483675961987281?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com0tag:blogger.com,1999:blog-8914360461697356402.post-32248000945729171912009-04-28T11:39:00.000+01:002009-04-28T12:04:42.925+01:00<div><div><div><div><div><a href="http://4.bp.blogspot.com/_qF_nZBpraMk/SfbeBAQn9WI/AAAAAAAAAKI/oGpvg6sdoLU/s1600-h/recurrent+pilonidal+sinus+disease.JPG"><img id="BLOGGER_PHOTO_ID_5329691317870523746" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 240px; CURSOR: hand; HEIGHT: 320px" alt="" src="http://4.bp.blogspot.com/_qF_nZBpraMk/SfbeBAQn9WI/AAAAAAAAAKI/oGpvg6sdoLU/s320/recurrent+pilonidal+sinus+disease.JPG" border="0" /></a><br /><br /><br /><br /><br /><br /><br /><div><br /><div><div>45 year old man had pilonidal disease since his early 20s. His first operation was 23 years ago and he has had multiple procedures since. His natal cleft was often painful and discharged pus frequently. He had multiple pits and hard indurated tissue in the natal cleft.</div><div> </div><div> </div><div><br /> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div>To cure the recurrent disease, radical excision of the affected area and coverage of the defect with a rhomboid flap was performed.</div><div> </div><div> </div><div> </div><div><a href="http://2.bp.blogspot.com/_qF_nZBpraMk/SfbegQkgQ9I/AAAAAAAAAKQ/orU7tbFY7JY/s1600-h/rhomboid+flap+marked+out.JPG"><img id="BLOGGER_PHOTO_ID_5329691854824817618" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 240px; CURSOR: hand; HEIGHT: 320px" alt="" src="http://2.bp.blogspot.com/_qF_nZBpraMk/SfbegQkgQ9I/AAAAAAAAAKQ/orU7tbFY7JY/s320/rhomboid+flap+marked+out.JPG" border="0" /></a><br /><br /><br /><div> </div><div> </div><div> </div><div> </div><div>First the flap is marked out on the skin</div><br /><br /><br /></div><br /><br /><div></div><br /><br /><div><br /><br /><br /><br /><br /></div><br /><br /><div></div><div><br /><br /><br /><a href="http://1.bp.blogspot.com/_qF_nZBpraMk/SfbfCE346dI/AAAAAAAAAKg/h5PWOr74uzs/s1600-h/diseased+area+removed+and+flap+mobilized.JPG"></a><a href="http://3.bp.blogspot.com/_qF_nZBpraMk/SfbgBuYUMbI/AAAAAAAAAKw/qsO0l1Yym34/s1600-h/diseased+area+removed+and+flap+mobilized.JPG"><img id="BLOGGER_PHOTO_ID_5329693529274069426" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 240px; CURSOR: hand; HEIGHT: 320px" alt="" src="http://3.bp.blogspot.com/_qF_nZBpraMk/SfbgBuYUMbI/AAAAAAAAAKw/qsO0l1Yym34/s320/diseased+area+removed+and+flap+mobilized.JPG" border="0" /></a><br /><br /><br />The skin is incised along the lines and the diseased area removed leaving a large defect<br /></div><br /><br /><div></div><br /><br /><div></div><br /><br /><div></div><br /><br /><div></div><br /><br /><div></div><br /><br /><div></div><br /><div></div><br /><a href="http://3.bp.blogspot.com/_qF_nZBpraMk/Sfbg57Q323I/AAAAAAAAALA/VuVxQCMj7x0/s1600-h/flap+drawn+across+defect.JPG"><img id="BLOGGER_PHOTO_ID_5329694494805187442" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 240px; CURSOR: hand; HEIGHT: 320px" alt="" src="http://3.bp.blogspot.com/_qF_nZBpraMk/Sfbg57Q323I/AAAAAAAAALA/VuVxQCMj7x0/s320/flap+drawn+across+defect.JPG" border="0" /></a><br /><div></div><br /><br /><div></div><br /><br /><div></div><br /><br /><div></div><br /><br /><div>The rhomboid flap is mobilized and sutured in place.<a href="http://1.bp.blogspot.com/_qF_nZBpraMk/Sfbg-ZO3bkI/AAAAAAAAALI/17odaUCVjw4/s1600-h/flap+sutured+.JPG"><img id="BLOGGER_PHOTO_ID_5329694571569311298" style="FLOAT: right; MARGIN: 0px 0px 10px 10px; WIDTH: 240px; CURSOR: hand; HEIGHT: 320px" alt="" src="http://1.bp.blogspot.com/_qF_nZBpraMk/Sfbg-ZO3bkI/AAAAAAAAALI/17odaUCVjw4/s320/flap+sutured+.JPG" border="0" /></a></div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div> </div><div>The patient was kept in for 2 days nursed on his side or prone.</div></div></div></div></div></div></div></div><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-3224800094572917191?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com9tag:blogger.com,1999:blog-8914360461697356402.post-48300007591837287732009-04-23T09:38:00.000+01:002009-04-24T16:58:57.394+01:00<a href="http://3.bp.blogspot.com/_qF_nZBpraMk/SfAs0wQRJXI/AAAAAAAAAKA/Y1r-PXjtD8M/s1600-h/DSC00816.JPG"><img id="BLOGGER_PHOTO_ID_5327807643997250930" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px" alt="" src="http://3.bp.blogspot.com/_qF_nZBpraMk/SfAs0wQRJXI/AAAAAAAAAKA/Y1r-PXjtD8M/s320/DSC00816.JPG" border="0" /></a><br /><div>A man in his 30s presented with a history of 18 years of crohns disease confined to his colon and rectum with a watering can anus. He was unresponsive to medical treatment and continued to smoke<br /><br /><div><br /><br /><br /><br /><div><br /><div><div></div><div></div><div><a href="http://4.bp.blogspot.com/_qF_nZBpraMk/SfAqpKstRVI/AAAAAAAAAJY/3dwbVWbXPM0/s1600-h/IMG_0085.JPG"><img id="BLOGGER_PHOTO_ID_5327805245914170706" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 240px; CURSOR: hand; HEIGHT: 320px" alt="" src="http://4.bp.blogspot.com/_qF_nZBpraMk/SfAqpKstRVI/AAAAAAAAAJY/3dwbVWbXPM0/s320/IMG_0085.JPG" border="0" /></a> </div><div></div><div>The colon was fully mobilized and extensive excision of peranal skin affected by multiple fistulae performed. The colon, rectum and anus were removed from the perineum.<br /><br /><br /></div><div style="CLEAR: both; TEXT-ALIGN: left"><a href="http://1.bp.blogspot.com/_qF_nZBpraMk/SfAq1RFh0CI/AAAAAAAAAJg/ZqFv8YnqGX0/s1600-h/IMG_0087.JPG"><img id="BLOGGER_PHOTO_ID_5327805453787320354" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px" alt="" src="http://1.bp.blogspot.com/_qF_nZBpraMk/SfAq1RFh0CI/AAAAAAAAAJg/ZqFv8YnqGX0/s320/IMG_0087.JPG" border="0" /></a><br /><br /><br /><br /><br /></div><div>This left a big defect!</div><div><br /><br /><br /><br /></div><div></div><div><br /><br /></div><div></div><div></div><div></div><div></div><div></div></div><div><div><a href="http://4.bp.blogspot.com/_qF_nZBpraMk/SfArdIIdLVI/AAAAAAAAAJo/YJEXw5KjGS8/s1600-h/IMG_0092.JPG"><img id="BLOGGER_PHOTO_ID_5327806138578447698" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px" alt="" src="http://4.bp.blogspot.com/_qF_nZBpraMk/SfArdIIdLVI/AAAAAAAAAJo/YJEXw5KjGS8/s320/IMG_0092.JPG" border="0" /></a><br />A vertical rectus abdominis flap was raised based on inferior epigastic vessels (forceps pointing to these)<br /></div><div></div><div><br /><br /><br /><br /></div><div></div><div><br /><br /><br /></div><div></div><div>The flap was rotated around and placed in perineum to fill the defect. </div><div><a href="http://1.bp.blogspot.com/_qF_nZBpraMk/SfAr2teAMxI/AAAAAAAAAJw/NkOScAWIdrc/s1600-h/IMG_0109.JPG"><img id="BLOGGER_PHOTO_ID_5327806578097664786" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px" alt="" src="http://1.bp.blogspot.com/_qF_nZBpraMk/SfAr2teAMxI/AAAAAAAAAJw/NkOScAWIdrc/s320/IMG_0109.JPG" border="0" /></a> </div><img id="BLOGGER_PHOTO_ID_5327807068713707426" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 240px; CURSOR: hand; HEIGHT: 320px; TEXT-ALIGN: center" alt="" src="http://2.bp.blogspot.com/_qF_nZBpraMk/SfAsTRJ-56I/AAAAAAAAAJ4/ypqH9A1lSf0/s320/IMG_0113.JPG" border="0" />The patient went home 9 days after the operation with all healed<br /><br /><br /><br /><br /><div style="CLEAR: both; TEXT-ALIGN: left"><a href="http://picasa.google.com/blogger/" target="ext"><img style="BORDER-RIGHT: 0px; PADDING-RIGHT: 0px; BORDER-TOP: 0px; PADDING-LEFT: 0px; BACKGROUND: 0% 50%; PADDING-BOTTOM: 0px; BORDER-LEFT: 0px; PADDING-TOP: 0px; BORDER-BOTTOM: 0px; -moz-background-clip: initial; -moz-background-origin: initial; -moz-background-inline-policy: initial" alt="Posted by Picasa" src="http://photos1.blogger.com/pbp.gif" align="middle" border="0" /></a></div></div></div></div></div><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8914360461697356402-4830000759183728773?l=learncolorectalsurgery.blogspot.com' alt='' /></div>jonlundhttp://www.blogger.com/profile/04331399866420892274noreply@blogger.com3