Surgery Notes

Which of the following patients generally does not require surgical interventionas a consequence of acute diverticulitis?

A. A 35-year-old man with no history of diverticulitis.

B. A 68-year-old man status 2 weeks post-renal transplantation.

C. A 55-year-old woman with hypertension and diabetes mellitus.

D. A 50-year-old man with pneumaturia.

E. A 46-year-old man with right-sided diverticulitis.

أيٌّ من المرضى التاليين لا يحتاج عادةً إلى تدخل جراحي نتيجةً لالتهاب الرتج الحاد؟

أ. رجل يبلغ من العمر 35 عامًا وليس لديه تاريخٌ سابقٌ للإصابة بالتهاب الرتج.

ب. رجل يبلغ من العمر 68 عامًا، حالته بعد أسبوعين من زراعة الكلى.

ج. امرأة تبلغ من العمر 55 عامًا تعاني من ارتفاع ضغط الدم وداء السكري.

د. رجل يبلغ من العمر 50 عامًا يعاني من استرواح في البول.

هـ. رجل يبلغ من العمر 46 عامًا يعاني من التهاب الرتج في الجانب الأيمن.

Hemorrhoidectomy, the surgical removal of hemorrhoids, is typically indicated in the following situations:

1. **Grade III and IV Hemorrhoids**: When internal hemorrhoids prolapse and cannot be manually reduced, or when they are permanently pr*****ed.
2. **Thrombosed External Hemorrhoids**: When external hemorrhoids become thrombosed (clotted), causing severe pain and not resolving on their own.
3. **Strangulated Hemorrhoids**: When hemorrhoids become incarcerated and strangulated, cutting off blood supply and causing severe pain.
4. **Persistent Symptoms**: When hemorrhoids do not respond to conservative treatments such as dietary changes, medications, or office-based procedures like rubber band ligation.
5. **Large Hemorrhoids**: When hemorrhoids are very large and cause significant discomfort or hygiene issues.
6. **Severe Bleeding**: When hemorrhoids cause significant bleeding leading to anemia or other complications.

Hemorrhoidectomy is considered the gold standard for treating severe or complicated hemorrhoids, but it is usually reserved for cases where other treatments have failed or are not suitable.