freromos

Cirujano General y Cirujano Oncólogo Colombia 🇨🇴

[Rafael Sirera @ProfSirera]

Ever wondered why surgeons obsess over a tiny “ligament” that’s actually a clever muscle hybrid hanging from your diaphragm?

It quietly divides your gut’s bleeding zones and keeps your small bowel from twisting into chaos!

The Ligament of Treitz—more accurately termed the suspensory muscle of the duodenum—marks the precise anatomical transition from the duodenum to the jejunum at the duodenojejunal flexure.

Far from a simple collagenous ligament as its name suggests, this fibromuscular structure comprises a superior portion of skeletal (striated) muscle fibres arising from the right crus of the diaphragm, blending into connective tissue near the coeliac artery, and an inferior part of smooth muscle fibres originating from the third and fourth duodenal segments.
This unique composition allows it to suspend and stabilise the flexure, widening the angle during contraction to facilitate smooth passage of intestinal contents into the mobile jejunum.

Clinically, it serves as a critical landmark: bleeding proximal to the ligament is classified as upper GI (often presenting as haematemesis or melaena), while distal bleeding counts as lower GI (typically haematochezia).
Surgeons rely on it during laparotomy to identify the jejunum for procedures like feeding jejunostomy or measuring bowel length.

[Elio Fabio Sánchez C. @elfasaco]

Felicitaciones Dr @freromos ! Hoy culminó esta etapa con la presentación de su trabajo de grado! Los mejores deseos para los nuevos retos! @MedicinaPUJ @liliana62010843 #CirugiaOncologica

[freromos @freromos]

@TylerLarsenMD @RecuerdameBot mañana miércoles 17 agosto a las 10 am. Mi hora actual es 23:20 hora Bogota Colombia.

[freromos @freromos]

Reforzar conceptos base. Que buena ilustración y precisión 👐

[Alberto @almagoch]

Cicatrización de una #anastomosis:
• Halsted 1882 - El contenido de colágeno en la submucosa le da su resistencia.
• 3 fases: Inflamación, Proliferación y Remodelación
• Lembert 1826 - La serosa sostiene mejor los puntos que las capas musculares.
> Fuga en recto y esófago

[freromos @freromos]

@NatalyAgu21

[Jorge_G_Criado @JorgeGCriado1]

Yo: Me voy a llevar el portátil por si me da tiempo en la guardia a revisar una cosa...
La guardia:

[J. Emilio Lira Vera @jemiliolive]

Es característica la relación AST/ALT >1.5 en la enfermedad hepática por alcohol.
Esto sucede porque existe deficiencia de piridoxina (B6) en las personas con consumo riesgoso de alcohol, y la B6 es imprescindible para la formación de ALT.
#livertwitter

[María Paula Forero, MD @mpauforero]

➡️Pancreatic cyst and their risk of malignancy

#SoMe4Surgery #LatinSurgery #MedTwitter #illustration #illustrationartist #Illustrator #illustrations @medart_mak @Medillustrates @salo75 @Cirbosque

[Esteban FV @Efuentesval]

Engrosamiento ileocecal en pruebas de imagen☢

➡️Qué hacer a continuación 👉

[Steven Bollipo @stevenbollipo]

Where there is an issue, we need more tissue! #gipath
Biopsies - when, where, what and how many?
When not you biopsy?
#colonoscopy
@ESGE_news guidelines #GItwitter
A thread 🧵

[E-AHPBA @EAHPBA]

REGISTER FOR OUR FREE WEBINAR

“LAPAROSCOPIC MAJOR HEPATECTOMY – THE STATE OF THE ART”

@ILLS_LAPLIVER @MedicalBowa @BOWAMEDICALUK

https://t.co/CqaDy1lewt

[UEGJ @UEGJournal]

📌 IPMN #pancreas

🔸diagnosis
🔸 management
🔸 surveillance

Review: https://t.co/w70qcZvQik

@my_ueg @WileyHealth #GITwitter #MedEd @AmerGastroAssn @YouppiePancreas @IHPBA

[Colorectal Disease @ColorectalDis]

#CoDiSundays Vol.5📙

Colorectal anastomosis donuts 🍩 are a 🔥hot topic🔥

This week @ColorectalDis and @escp_tweets remember:

The Reverse Smile Trick: How to Transform a Double-stapled into a Single

video from @AntoninoSpin

Do not miss it

👇

https://t.co/8nbuTLlSfU

[JCOG @JCOG_official]

🆕JCOG0603
"Hepatectomy Followed by mFOLFOX6 Versus Hepatectomy Alone for Liver-Only Metastatic Colorectal Cancer (JCOG0603): A Phase II or III Randomized Controlled Trial" was published in JCO!

https://t.co/ldSdpqST7T

#ColorectalCancer #JCO @ASCO @ASCO_pubs #JCOG

[Keith Siau @drkeithsiau]

Causes of palpable lymph nodes in the neck #4KMedEd

[BJS @BJSurgery]

In May's BJS: Comprehensive classification of anatomical variants of the main biliary ducts @AmyLightnerMD @bplwijn @des_winter @ksoreide @MalinASund @evanscolorectal @nfmkok @robhinchliffe1 @young_bjs

[Enrique de-Madaria @DeMadaria]

Severity criteria for acute pancreatitis, acute cholecystitis and acute cholangitis #TheAmylaseSchool
#UEGambassador @my_ueg #HiloAEG @aegastro @gastromx @sage_gastro @almagoch @OPGEgastro @aecirujanos @SEEDendoscopia @lelecapurso @MarcBesselink

[SIQ de la AEC @SIQ_aecirujanos]

En las #diverticulitis la PCR puede tener un papel junto a clínica +imagen, pero la procalcitonina no ha demostrado utilidad. Como referencia para repaso las recientes guías de la @WSESurgery👇 @InesRPsurg
@montsejuvany https://t.co/BuzIzMRV2F

[AmJSurgery @AmJSurgery]

The release of the posterior lamella is the key for posterior component separation technique: A cadaveric exploration study ⤵️! #SoMe4Surgery @herbchen @pferrada1 @PipeCabreraV @gdkennedy88 @BrenessaL @erikaanewman @DanaTelem @cirbosque @WomenSurgeons @SocietyofBAS @DChu80

[Enrique de-Madaria @DeMadaria]

ERCP in acute pancreatitis, should we run, or ERCP can be delayed? What's the evidence from Randomized Controlled Trials (RCTs)???
Don't miss this @aegastro #HiloAEG @my_ueg #UEGambassador Twitter thread #PancreasTwitter #TheAmylaseSchool

Look at the final summary figure!