Clinics and Grand Rounds in Surgery SK Kochar
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1Clinics and Grand Rounds in Surgery2
3Clinics and Grand Rounds in Surgery
SK Kochar MS Senior Consultant and Head Department of General and Minimal Invasive Surgery Fortis Heart Institute and Multispeciality Hospital Mohali, Punjab Formerly, Senior Adviser and Head, Department of Surgery Army Base Hospital, Delhi Cantt Author of Principles and Practice of Trauma Care: Common Surgical Emergencies
4 Published by
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Clinics and Grand Rounds in Surgery
© 2005, SK Kochar
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2005
9788180614675
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A 14, Section 60, Noida
5Contributors
Clinics and Grand Rounds in Surgery
7Preface
It was stimulating at times, challenging and often frustrating experience to hold surgery clinics for graduates and postgraduates in surgery. My interaction with faculty members of Base and Army Hospital, Delhi Cantt at bedside clinics and during grand rounds convinced me that time has come for surgical community in general and for me in particular to revive the art and craft of clinical surgery. I have almost translated the clinics and grand rounds of department of surgery into a treatise as I felt that this is the only way to learn the art of case presentations and coming to diagnosis in surgical patients.
Although the latest techniques for investigations are described and their contributions recognized, the book is based on the belief that sound surgical practice primarily depends on the skills and knowledge of the surgeon and secondarily on the strength of supporting departments and laboratories. This is not to dilute the rapid useful strides diagnostics have made in the recent past but to stress and refine the art and craft of clinical examination.
I expect that this text will continue to provide the scientific underpinnings of surgery in a clinically useful reference for medical students, surgical house officers and surgeons in practice. This book is a humble tribute to the excellence of our surgical past and a commitment to our surgical future.
I remain indebted to my teachers in surgery, Prof GC Sharma, Dr (AVM) NB Amaresh, Dr (Maj Gen) P Subhas and trainees in surgery who have always inspired me to learn more. Like-minded colleagues, Dr Harikishnan, Dr Rajagopalan, Dr Rajesh Gulia who have contributed the chapters need special mention as few people walk with you when you are on a difficult terrain. To deny the right of honor to Dr (Mrs) Shalini Kochar, my wife, for her constant support for all I do right or wrong will be blasphemy and I am eternally grateful to her. 8Understanding sons do bear the cross for the father and my son Dr Kunal Kochar contributed all the secretarial and editing help.
I am extremely indebted to Dr Mohnish Chhabra, Gastroenterologist and Dr Vijay Singh Rawat, Interventional Radiologist for their contribution of the cast studies.
I am grateful to Mr Shivinder Mohan Singh, Managing Director, Fortis Health Care Limited whose virtuous values have rubbed on me. Sh. JP Vij, Chairman and Managing Director, M/s Jaypee Brothers Medical Publishers (P) Ltd., has been a God sent emissary who has unearthed authors among doctors and I am no exception. Editorial and publishing team of M/s Jaypee Brothers Medical Publishers (P) Ltd., deserves all the praise for their constant support and valuable suggestion besides bringing out the book in time.
SK Kochar