Universitat Internacional de Catalunya

Surgical Gastrointestinal System

Surgical Gastrointestinal System
4.5
12079
4
First semester
OB
Main language of instruction: Catalan

Teaching staff


Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:

Dr Josep Maria Badia: jmbadia@uic.es

Dr Carlos Hoyuela: choyuela@uic.es

Dr Pablo de Jesús Palma: ppalma@uic.es

Dra Sara Amador: samador@uic.es

Dr Luis Maria Oms: loms@uic.es

Dr. Napoleón de la Ossa

Dr. Juan José Sánchez

Dra. Laura Lladó

Introduction

The course "Surgical Digestive System" aims students to acquire the knowledge, skills and attitudes necessary for the detection, diagnosis and management of diseases of the digestive system from the surgical point of view. 

The content is coordinated and complements the subjects of "Digestive System Medical" and "Surgical Clinical Practice."

Pre-course requirements

To take this course is essential to have approved:

- Structure and Function: digestive and endocrine system

- Medical Pathophysiology

- Surgical Pathophysiology

- Cell Biology

 

Objectives

To train students in the recognition of major surgical diseases of the digestive system to properly establish its prevention, diagnosis and therapeutic guidance.

To acquire the knowledge and clinical skills needed to identify the main problems of the digestive pathology from the surgical point of view, and guide their surgical diagnosis and treatment.
To acquire the basic surgical skills adjusted to the level of student knowledge 4th.

1. Understand and recognize the effects, mechanisms and manifestations of digestive disease on the structure and function of the human body.

2 Obtain and develop a medical history digestive containing all relevant information.

3 Do a proper physical examination of the abdomen and the digestive system.

4 Be able to develop a trial initial diagnosis and establish a rational diagnostic strategy.

5 Set the diagnosis, prognosis and treatment, applying principles based on the best information available and safe clinic.

6 detect life-threatening situations and make their initial treatment.

7 indicate the most appropriate treatment for the most prevalent acute and chronic and terminally ill patients.

8 Consider and propose preventive measures appropriate to each clinical situation.

9 assume their role in the actions of prevention and protection from diseases, injuries or accidents and the maintenance and promotion of health, both individual and community.

Competencies

  • 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
  • 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
  • 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
  • 16 - Recognize and deal with situations that put life in immediate danger and those that require immediate attention.
  • 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
  • 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
  • 19 - Propose preventive measures appropriate to each clinical situation.

Learning outcomes

1 To master the terminology and medical language of surgical specialties.
2 To know the basis of a proper physical signs of disease and gastrointestinal surgery. The physical examination includes abdominal inspection, palpation, assessing the ability of the muscle wall depression, pain triggered by exploration and its possible origin in peritoneal irritation, detecting masses and their characteristics, detection the visceromegàlies (liver and spleen) and inguinal lymphadenopathy, abdominal auscultation noise and its characteristics. It is also essential knowledge of rectal and vaginal

3. To lintegrate the elements of anamnesis and physical examination as a syndrome that corresponds to the expression of the disease.
4 To understand the different techniques in the diagnosis of digestive diseases.
5 To interpret simple abdominal radiography, esofagogastrointestinal, opaque enema, abdominal ultrasound, CT and magnetic resonance imaging.
6 To know the indications, contraindications and potential complications of gastroscopy, colonoscopy, endoscopic retrograde cholangiography, endoscopic ultrasound and endoscopic sphincterectomy.
7 To understand the surgical treatment of digestive diseases.
8 To know the indications, contraindications and potential complications of most frequent surgical procedures, the postoperative management of gastrointestinal surgery, the indications and the handling of tubes and drainages.
9 To understand, evaluate and know the utilization of sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific information and care.
10 To understand the fundamentals of the relationship between professional and patient health sciences, the transmission of clinical information, informed consent and conflict resolution.

Syllabus

 

Surgical Digestive Description
Esophageal-gastric pathological anatomy. 
Benign diaphragm and esophagus pathology. Diaphragmatic hernias. Reflux surgery. 
Trauma of the esophagus and stomach. Traumatisms and structural anomalies of the esophagus and stomach. Mechanical pathology: acute dilation, Boerhave syndrome, gastric valve, bezoar. Strange bodies and perforations.
Metabolic or bariatric surgery. Physiopathological bases, indications, techniques and complications.
Esophageal neoplasms. Clinic, diagnosis and surgical / oncological management.
Gastroduodenal neoplasms. Gastrointestinal tumor surgery. 
Techniques, indications and complications of esophageal and gastro-duodenal surgery.
Benign colon surgery. Surgical treatment of inflammatory bowel disease and other non-neoplastic diseases.
Diverticulosis. Diverticular colon disease. Other intestinal diverticulosis. Meckel's Diverticle.
Colorectal cancer. Colon and rectum tumors. Anal canal cancer
Intestinal occlusion: paralytic and mechanical. Diagnostic and treatment algorithm.
Diagnostic and therapeutic strategies in colo-rectal cancer
Acute abdomen and acute appendicitis. Etiology, medical-surgical management and complications.
Peritonitis of infectious cause. Secondary peritonitis. Postoperative peritonitis. Abdominal compartment syndrome. Temporary abdominal closure.
 Differential Diagnosis of Acute Abdomen. Forms of presentation, diagnostic-therapeutic algorithms
Management of secondary peritonitis. Abdominal compartment syndrome.
Introduction to laparoscopic surgery
Digestive radiology. Techniques, indications, diagnostic algorithms.
AP Liver 2. Liver and liver tumors. Pseudotumors and benign tumors. Malignant tumors: hepatocarcinoma, cholangiocarcinoma, angiosarcoma. Benign and malignant tumors of the biliary tree. Pathological anatomy of the gallbladder and exocrine pancreas. 
Gastrointestinal radiology. Indications of diagnostic imaging techniques of gastrointestinal diseases.
Benign anorectal pathology. Hemorrhoids, perianal infection, fissure, solitary straight ulcer, rectal prolapse
Hepato-Splenic infection. Hepatic abscess, hidatidosis, splenic abscess.
Gallbladder lithiasis. Cholecystectomy. Cholecystitis and acute colangitis.
Anatomy and congenital anomalies of the pancreas. Acute pancreatitis: etiology, diagnosis, treatment. Surgical indications for acute pancreatitis.
Pancreatic cancer. Exocrine tumors, cystic tumors. Endocrine pancreatic tumors.
Acute pancreatitis. Congenital abnormalities. Acute pancreatitis: etiology, diagnosis, treatment. Surgical indications for acute pancreatitis.
Chronic pancreatitis. Treatment of pancreatic insufficiency. Surgical indications for chronic pancreatitis. Pancreatic transplant.
Pancreatic cancer. Exocrine tumors, cystic tumors. Endocrine pancreatic tumors.
Liver surgery. Primary and secondary hepatic tumors.
Liver transplant. Indications, technique, complications and results.
Surgical pathology of the biliary tract. Vesicular and neoplasm neoplasm.
Pathology of the abdominal wall. Hernias.
Abdominal trauma.

Teaching and learning activities

In person



CM: The master class is the scenario in which a teacher in a classroom knowing transmits the entire group of students. The format, however, allows the introduction of activities in small groups within the classroom and deployment strategies that encourage active student participation.

MC: The case method is the process of solving clinical cases or of the profession. Group activities that are solved with the active participation of the professor after the deliberation of the students.

ABP: The problem-based learning has similarities with the case method but differs in that students are responsible to find a solution to the problem. The teacher acts as a tutor to facilitate the process of learning from their metacognitive skills. Also performed in groups.

LH: The skills lab is done in small groups, is an area in which students can develop basically communication skills and physical examination based on models, robots, real sick patient simulators. It is also an area for more practical knowledge of complementary examinations and therapeutic measures.

Attendance to LHs are compulsory.

Evaluation systems and criteria

In person



 

 

Evaluation criteria

We ask the student punctuality, attention and active participation in class. Attendance is not mandatory, but is highly recommended, especially when active learning methods are used. In clinical skills laboratories presence control can be implemented.

The assignature is approved at 5.00.

Theory: formed by the weighted sum of the notes of the two exams.


- Participation, attendance and punctuality: 10%
- Midterm Exam* (25%): multiple-choice test of theoretical issues, radiologic images, microscopic or macroscopic resolution of clinical cases and questions have four possible answers. There may be some short question of free text.

The exam is all about the subject to date. Omission of a midterm test means loss of the percentage of the test.


- Final Exam * (65%): multiple-choice test of theoretical issues, radiologic images, microscopic or macroscopic and resolution of clinical cases. The questions have four possible answers. There may be some short question of free text.

The final exam is about all matter of course.
(*) In the multiple-choice test is scored with 1 point for each question correct; each question with wrong answer will deduct one third of the value of the question.


- Second call. The evaluation of the 2nd call may consist of a review of short questions in an examination or test of theoretical issues, radiologic images, microscopic or macroscopic and resolution of clinical cases. The questions have four possible answers. The exam is second call on all matter of course. The value of the exam will be 100%. The maximum mark in the second call will be 7.50.


Final grade
- Expression with a decimal numerical grade from 0 to 10
- Qualitative Rating: suspense, pass, good, excellent honors.

After contact with the course delegation, a public and joint review of the exam can be carried out.

The review will vote individually with the student on request within the established periods.

 

 

Bibliography and resources

  • Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, and Loscalzo, Eds. HARRISON PRINCIPIOS DE MEDICINA INTERNA. 17a edición. McGraw Hill, 2009. ISBN: 970-10-6788-6.
  • Farreras-Rozman. MEDICINA INTERNA. 17ª edición.  Elsevier, 2011. IBSN: 84-8086-487-7
  • Peter J. Morris (Editor), William C. Wood (Editor).Oxford Textbook of Surgery.
  • Parrilla Paricio P, Jaurrieta Mas E, Moreno Azcoitia Eds. Cirugía AEC. Manual de la Asociación Española de Cirujanos. Madrid, 2005. Ed Panamericana.
  • F. Brunicardi , Dana Andersen, Timothy Billiar, David Dunn John Hunter, Jeffrey Matthews, Raphael E. Pollock Schwartz's Principles of Surgery, Ninth Edition.

Evaluation period

E: exam date | R: revision date | 1: first session | 2: second session:
  • E1 23/01/2023 16:00h

Teaching and learning material