Abdominal Exploration: Finding What Is Wrong

Abstract

Not uncommonly—especially with the increased use of diagnostic imaging—when opening the abdomen, the surgeon knows what to expect inside; the clinical picture or ancillary tests direct the surgeon to the disease process. In some instances, however, the surgeon explores the unknown, led on only by the signs of peritoneal irritation, assuming that the peritoneal cavity is flooded with blood or pus. Usually, the surgeon speculates about the predicted diagnosis but always remains ready for the unexpected. This is what makes emergency abdominal surgery so exciting and demanding—the ever-looming catastrophe and the anxiety about whether you are able to tackle it competently. Yes, even in the days of computed tomography (CT) and magnetic resonance imaging (MRI), the abdomen can be full of surprises.

Asher Hirshberg, MD, contributed to this chapter in the first edition of the book.