CODE 87020 ACADEMIC YEAR 2022/2023 CREDITS 11 cfu anno 6 MEDICINA E CHIRURGIA 8745 (LM-41) - GENOVA LANGUAGE Italian TEACHING LOCATION GENOVA PREREQUISITES Propedeuticità in ingresso Per sostenere l'esame di questo insegnamento è necessario aver sostenuto i seguenti esami: MEDICINE AND SURGERY 8745 (coorte 2017/2018) SURGERY I 67505 2017 MODULES Questo insegnamento è composto da: SURGERY II VASCULAR SURGERY MEDICAL IMAGING MUSCOLOSKELETAL DISEASES TEACHING MATERIALS AULAWEB OVERVIEW Surgery course 2 (first semester of 6th year) includes: in the field of general surgery: pathologies of surgical interest in the gastrointestinal tract (from fasting to anus), endocrine system. in the field of specialized surgery: the vascular pathology the pathology of the locomotor system AIMS AND CONTENT LEARNING OUTCOMES After the acquisition of nosography, etiology, pathophysiology, signs and symptoms of the disease, the course is aimed at the development of specific clinical skills through the presentation of clinical cases, diagnostic-therapeutic problems, concerning the most important morbose cases most commonly found in surgical practice. At the end of the course, the student must be able to address the discussion on issues of clinical relevance, showing that he is able to set the differential diagnosis reasoning based on observation, knowledge of epidemiological data, rational use of instrumental and laboratory, on the possibilities of preventing the most common pathologies. The student must demonstrate the ability to make correct therapeutic indications, to be generally oriented on the most common surgical techniques, surgical timing and prognosis, taking into account the psycho-physical and social characteristics of the patient. It is also required to have adequate knowledge of pre and post-operative problems related to both day-surgery and major surgery. AIMS AND LEARNING OUTCOMES Surgery is one of the most engaging, fascinating and exciting medical branches. The evolution of knowledge and operating techniques has led to the progressive identification of various surgical specialties. The technological evolution of surgical devices has led to a radical progress of procedures: today there's a tendency to operate surgery without large incisions, thanks to the introduction of miniinvasive techniques, or even with only one access (single port technique) or through natural orifices (NOTES) that does not provide any abdominal access, achieving no scar surgery. In addition, the evolution of pain therapy techniques along with pharmacological progress allows you to approach "painless surgery". SYLLABUS/CONTENT Surgery 2 General Surgery Program Differential diagnosis between adenocarcinoma, GIST and neuroendocrine tumor Diagnosis and therapy of neuroendocrine tumors: carcinoid Diagnosis and therapy of neuroendocrine tumors: insulinoma, glucagonoma, etc. Differential diagnosis between mechanical ileum and paralytic ileum. Differential diagnosis in a patient with intestinal obstruction Principles of treatment of syndromes Differential diagnosis of arterial and venous intestinal infarction Therapeutic possibilities in the event of intestinal arterial and venous intestinal infarction Clinical presentation of the patient with chronic ischemia Patient framing and stabilization with lower digestive hemorrhage Diagnostic procedure and patient therapy with inferior digestive hemorrhage Differential diagnosis of the patient with pain in the fossa iliaca Principles of therapy in case of appendicitis Diagnostic pathway in a patient with acute pain in the fossa iliaca Staging, therapeutic options (medical, radiological, surgical) in patients with acute diverticulitis Differential diagnosis in sub-occluded patients between colon cancer, chronic inflammatory disease and complications of diverticular disease Colon cancer polyp: when advanced colon neoplasms: therapeutic strategy General Diagnosis, Diagnostics procedures in proctorragie Stage and multimodal treatment of rectum carcinoma Follow-up of rectum carcinoma Differential diagnosis of a perianal mass Anal epidermoid carcinoma, adenocarcinoma, cloacogenic tumors: differences in therapeutic strategy compared to rectum carcinoma Hemorrhoids: Indications for medical and surgical treatment Anal rags: treatment and its pathophysiological bases Differential diagnosis of acute pain in the perianal region Abscess and perianal fistulas: classification and treatment Tumors of peritoneum and of retroperitoneal space: classification Mesothelioma and retroperitoneal sarcomas Differential diagnosis of intra-abdominal masses Jaundice: differential diagnosis Cholestatic jaundice: radiological, endoscopic and surgical therapy Differential diagnosis of cholangitis (with particular attention to suppurative colangitis and primitive colangitis) Abdominal suppression and amebic abscesses Differential diagnosis of hepatic cysts and in particular between simple cysts, cysts from echinococcus and M. of Caroli Liver and biliary neoplasms: classification Differential diagnosis of liver nodules in the healthy and cirrhotic liver Hepato-cell carcinoma: principles of multidisciplinary treatment (radiological, surgical, medical) Intraepathic cholangiocarcinoma: differential diagnosis and treatment principles Secondary colorectal and neuroendocrine liver tumors: multimodal treatment principles. Directions and Limits of Surgery Principles of Hepatic Surgery: Anatomy of surgical and radiological anatomy Complexions of portal hypertension and their treatment Acute pancreatitis: differential diagnosis, severity classification Principles of medical and surgical treatment of acute pancreatitis Acute pancreatitis complications: septic complications, pancreatic pseudocysts. Directions for surgery Diagnosing chronic pancreatitis Chronic pancreatitis: principles of treatment Exocrine pancreas tumors: classification Differential diagnosis of solid and cystic pancreas masses at head and tail levels Staging and prognosis of carcinoma Principles of radical and palliative treatment in exocrine pancreas neoplasms. Complications of surgical therapy Indications for splenectomy in thesaurismosis, in Wehrlof's disease, in hematopoietic diseases General principles of organ transplants Indications, technique and results of kidney and liver transplantation Complications of chronic inflammatory diseases: abscesses, visceral and cutaneous fistulas, toxic megacolones Differential diagnosis in a patient with enterorragia. Differential diagnosis between Crohn's disease and ulcerative colitis Surgical indications in Crohn's Mash and ulcerative colitis TEACHERS AND EXAM BOARD FRANCESCA SANGUINETI MATTEO FORMICA LUIGI MOLFETTA RICCARDO FERRACINI ANDREA ZANIRATO CARLO MARTINOLI Ricevimento: Done by appointment. Please contact Ms. Daniela Baroni (Segreteria Radiologia Universitaria, tel. +39 010 555 5248) or send me an email at: carlo.martinoli@unige.it LILIANA BELGIOIA Ricevimento: By appointment. Contact: liliana.belgioia@unige.it GIANMARIO SAMBUCETI BIANCA PANE GIOVANNI SALVATORE GIUSEPPE SPINELLA GIOVANNI PRATESI FRANCESCO BOCCARDO FRANCO DE CIAN MARCO FRASCIO MARCO CASACCIA MICHELE MINUTO EMANUELA VARALDO PIERO FREGATTI Exam Board FRANCESCO BOCCARDO (President) MARCO CASACCIA (President) FRANCO DE CIAN (President) PIERO FREGATTI (President) MICHELE MINUTO (President) EMANUELA VARALDO (President) ANDREA ZANIRATO (President) RICCARDO FERRACINI MATTEO FORMICA GIOVANNI PRATESI FRANCESCA SANGUINETI GIOVANNI SALVATORE GIUSEPPE SPINELLA MARCO FRASCIO (President and Coordinator of Integrated Course)