CONDITIONS
General surgery is a broad field that adresses multiple medical conditions. This page provides more information on a few of the conditions that Dr Steyn commonly treats.
Feel free to get in touch with the practice and find out if Dr Steyn treats the condition you are concerned with.
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Thyroid disorders like thyroid nodules or cancer might present as a lump or swelling in the neck. The patient may experience difficulty swallowing, changes in voice or hoarseness, neck pain, and in some cases, symptoms of hyperthyroidism (e.g., rapid heartbeat, weight loss, anxiety) or hypothyroidism (e.g., fatigue, weight gain, cold intolerance).
A thyroidectomy involves the partial or complete surgical removal of the thyroid gland. The thyroid gland, located in the neck, produces hormones that regulate various bodily functions, including metabolism, heart rate, temperature, and more. A thyroidectomy is typically performed to treat several conditions related to the thyroid gland.
Indications for a Thyroidectomy:
- Thyroid Cancer: One of the primary reasons for a thyroidectomy is the presence of thyroid cancer. Removing part or all of the thyroid gland is often recommended to eliminate cancerous cells and prevent the spread of the disease to other parts of the body.
- Hyperthyroidism: In cases where medications or other treatments fail to control an overactive thyroid gland, a thyroidectomy might be considered. This condition leads to excessive production of thyroid hormones, causing symptoms like rapid heartbeat, weight loss, anxiety, and tremors.
- Large Goiter: A goiter is an abnormal enlargement of the thyroid gland. When a goiter grows large enough, causing symptoms such as difficulty swallowing, breathing problems, a thyroidectomy might be advised to remove the enlarged portion or the entire gland.
- Recurrent Thyroid Nodules: Nodules or growths within the thyroid gland can be benign or cancerous. If these nodules cause compression of nearby structures, difficulty swallowing, or if there’s suspicion of cancer, surgery may be recommended to remove part or all of the thyroid gland.
- Thyroiditis: Inflammation of the thyroid gland, often due to autoimmune conditions like Hashimoto’s thyroiditis or De Quervain’s thyroiditis, might necessitate a thyroidectomy in cases where inflammation leads to severe symptoms or complications.
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Breast Conditions
A Breast Lump – It can be benign or malignant. The following are examples of the different types of breast lumps that can occur.
Breast Cysts – Fluid-filled sacs that develop in the breast, often benign and can cause discomfort.
Fibrocystic Breast Changes – Lumpy or rope-like breast tissue, typically associated with hormone fluctuations. These are usually not malignant.
Fibroadenoma – A benign tumor in the breast made up of glandular and fibrous tissue. Common in young women.
Gynecomastia – The enlargement of breast tissue in males, often due to hormonal imbalances, medications, or other medical conditions.
Fat Necrosis – Non-cancerous lump caused by injury to the breast tissue, resulting in scar tissue and fatty deposits.
Phyllodes Tumor – A rare tumor that can be benign or malignant and tends to grow quickly in the connective tissue of the breast.
Breast Cancer – Malignant growth in breast tissue, can occur as ductal carcinoma in situ (DCIS), invasive ductal carcinoma, or lobular carcinoma.
Paget’s Disease of the Breast – A rare form of breast cancer affecting the skin of the nipple and often associated with ductal carcinoma.
Breast lumps
Symptoms of breast cancer: a hard mass or irregularity in the breast tissue, dimpling of the skin, orange peel skin, the mass is stuck to the chest wall or skin, bloody nipple discharge. It may or may not be painful and red.
Investigations to make an accurate diagnosis:
- Clinical breast examination by a General Practitioner.
- Imaging: A mammogram, sonar and/or MRI of the breasts.
- Tissue diagnosis: A biopsy of the mass that is sent for analysis and a final diagnosis.
MANAGEMENT PLAN
Lumpectomy
(Removing just the mass) often this is done for benign lumps.
Breast conserving surgery
Surgically removing the mass and some of the surrounding tissue.
Mastectomy
Surgically removing all the breast tissue.
In the case of a malignant mass
A biopsy is taken of the glands/lymph nodes in your armpit, or it can be removed.
Immediate/delayed reconstruction of breasts with a Plastic Surgeon
Many of our patients opt for immediate reconstruction where a mastectomy is performed, along with the immediate reconstruction of the breast/s. In this case Dr Steyn collaborates with a Plastic Surgeon so that both surgeries take place during the same theatre booking.
Referral to an Oncologist – for malignant (cancerous) lumps or conditions
- Systemic chemotherapy
- Hormone blocking medication
- Radiation of the chest and arm pit
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Nipple Discharge
Nipple Discharge – Unusual discharge from the nipple that may indicate infection, benign tumors, or cancer.
Intraductal Papilloma – A small, benign tumor that forms in a milk duct, often causing nipple discharge.
Ductal Ectasia – Occurs when a milk duct in the breast widens and thickens, causing blockage, pain, or discharge.
Galactorrhea – The production of breast milk in people who are not breastfeeding, often due to hormonal imbalances.
Investigations to make an accurate diagnosis:
- Clinical breast examination by a General Practitioner.
- Imaging: A mammogram, sonar and/or MRI of the breasts.
MANAGEMENT PLAN
Duct ectasia
surgical excision of the affected ducts.
Papilloma
Surgical excision.
Cancer
Excision/mastectomy and oncological treatment.
Galactorrhoea
Test for hormone imbalances.
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Infection and Pain
Infection: Mastitis – Inflammation of breast tissue, often due to an infection (common in breastfeeding women).
Breast Abscess – A collection of pus due to infection, often occurring with mastitis.
Pain: Mondor’s Disease – A rare condition characterized by inflammation of veins in the breast or chest wall, causing pain and a cord-like structure under the skin.
n a milk duct in the breast widens and thickens, causing blockage, pain, or discharge.
Galactorrhea – The production of breast milk in people who are not breastfeeding, often due to hormonal imbalances.
These conditions can be benign in nature, like fibroadenomas, or it can be more serious conditions like breast cancer. Symptoms often overlap, therefore it’s important to seek medical advice for a proper diagnosis and immediate treatment. Regular self-examination is crucial for both men and women. If an abnormality is detected, consult your GP or contact the practice for an appointment.
Read more about breast lumps here:
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APPENDICITIS
Appendicitis is a surgical condition characterised by inflammation of the appendix, a small, finger-shaped pouch attached to the large intestine. When the appendix becomes blocked, it can become infected and inflamed, leading to various symptoms and potential complications if not treated promptly.
Appendicitis is a medical emergency that requires prompt diagnosis and treatment. Recognising the symptoms and seeking medical attention as soon as possible is crucial to prevent complications and ensure a full recovery.
Abdominal Pain
The most common symptom of appendicitis is pain that begins around the navel and then shifts to the lower right abdomen. The pain often worsens quickly, becoming sharper and more intense.
Loss of Appetite
Individuals with appendicitis often experience a loss of appetite accompanied by nausea and sometimes vomiting.
Fever and Chills
A low-grade fever may develop, causing chills.
Change in Bowel Habits
Some people might experience changes in their bowel habits, such as constipation or diarrhoea.
Tenderness
The area around the appendix may become tender to the touch, especially when pressure is applied.
MANAGEMENT PLAN
Medical Evaluation
If appendicitis is suspected, seeking immediate medical attention is crucial. A doctor will perform a physical examination, evaluate symptoms, and may order tests to be done, such as blood tests, an ultrasound, or a CT scan to confirm the diagnosis.
Surgery (Appendicectomy)
The primary treatment for appendicitis is surgery to remove the inflamed appendix, called an appendicectomy. This procedure is often performed laparoscopically, where small incisions are made, and a camera and surgical tools are inserted to remove the appendix. In some cases, an open surgery may be necessary, especially if there’s a risk of complications or if the appendix has already ruptured.
Antibiotics
If the appendix has not ruptured, antibiotics could be prescribed to help treat the infection and prevent it from spreading. However, it is generally recommended that surgery takes place to remove the appendix, to prevent recurrence and further complications.
Pain Management
Pain medications are often prescribed to manage the discomfort before and after surgery.
Post-Surgery Care
If the appendix has not ruptured, antibiotics could be prescribed to help treat the infection and prevent it from spreading. However, it is generally recommended that surgery takes place to remove the appendix, to prevent recurrence and further complications.
RISKS IF LEFT UNTREATED
Appendicitis can lead to serious complications such as a ruptured appendix, causing the infection to spread into the abdominal cavity, leading to peritonitis (inflammation of the abdominal lining). A ruptured appendix requires immediate surgery and intravenous antibiotics to treat the infection.
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HERNIAS
Hernias occur when an organ or tissue pushes through a weak spot in the muscle or connective tissue that surrounds it. The two common types of hernias are inguinal hernias and ventral hernias.
Inguinal hernias
are the most common type and typically occur when a part of the intestine protrudes through a weak area or opening in the abdominal muscles. These hernias often appear as a bulge in the groin or scrotum and may cause discomfort or pain, especially when lifting heavy objects, coughing, or straining during bowel movements. They’re more prevalent in men than women and might require surgery to prevent complications.
Ventral Hernias
Ventral hernias occur at any location in the abdominal wall, usually at the site of a previous surgical incision. They might appear as bulges, causing pain or discomfort, and can lead to complications if not treated. These hernias can develop due to weakened abdominal muscles from previous surgeries, injury, or strain.
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Gallbladder removal
Gallbladder removal or a cholecystectomy is a surgical procedure involving the removal of the gallbladder. The gallbladder is a small organ located beneath the liver, primarily responsible for storing bile produced by the liver. Bile aids in the digestion of fats in the small intestine.
Indications for a Cholecystectomy Procedure:
- Gallstones: One of the most common reasons for a cholecystectomy, is the presence of gallstones. These are hardened deposits of digestive fluid that can form in the gallbladder. Gallstones can cause intense pain (known as biliary colic), blockage of the bile ducts, inflammation of the gallbladder (cholecystitis), or other complications.
- Cholecystitis: Inflammation of the gallbladder can occur due to gallstones blocking the bile ducts or due to other factors. Acute cholecystitis often results in severe abdominal pain, fever, nausea, and vomiting. If left untreated, it can lead to serious complications such as infection or perforation of the gallbladder.
- Biliary Dyskinesia: This condition involves impaired gallbladder function, leading to poor emptying of bile from the gallbladder. It can cause symptoms similar to that caused by gallstones, such as abdominal pain and discomfort.
- Gallbladder Polyps or Tumors: Although rare, the presence of polyps (growths) or tumors in the gallbladder might necessitate surgical removal.
- Pancreatitis: In some cases, gallstones can block the pancreatic duct, leading to inflammation of the pancreas (pancreatitis). If this occurs recurrently or severely, removing the gallbladder might be recommended to prevent future episodes.
Two Primary Surgical Approaches
Laparoscopic Cholecystectomy
This minimally invasive technique involves making several small incisions in the abdomen where specialised instruments and a tiny camera (laparoscope) are inserted. The surgeon views the internal organs on a monitor and removes the gallbladder using small instruments
Open Cholecystectomy
In certain situations where laparoscopic surgery isn't feasible or safe, an open cholecystectomy may be performed. This involves making a larger incision in the abdomen to directly access and remove the gallbladder.
After a cholecystectomy, patients usually experience relief from the symptoms caused by gallstones or gallbladder issues. The body can function normally without the gallbladder, as bile continues to be produced by the liver and flows directly into the small intestine. However, some individuals may experience changes in digestion, particularly with the breakdown of fats, as the storage capacity of bile is reduced. Dietary adjustments, as advised by a dietician, are recommended post-surgery to manage these changes.
A cholecystectomy is a common and generally safe procedure, but as with any surgery, there are potential risks and complications. It’s important to discuss the procedure, risks, benefits, and post-operative care with a healthcare professional.
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A burning sensation in the upper abdomen and in the chest resulting from acid reflux into the esophagus, causing irritation and inflammation of the lining of the esophagus. This condition is common and can affect people of all ages, though it’s more prevalent in adults. A surgeon would normally perform a gastroscopy procedure to ascertain the severity of the condition and thereafter construct a pro-active treatment plan for the patient.
Known Symptoms:
Heartburn: A burning sensation in the chest, often after eating or at night, is the hallmark symptom of GERD.
Regurgitation: Sour-tasting liquid coming into the mouth or a sensation of food re-entering the mouth from the stomach.
Difficulty Swallowing: Known as dysphagia, it may feel as if food is sticking in the throat or chest.
Chronic Cough: A persistent cough, especially at night.
Hoarseness or a Sore Throat: Irritation of the throat caused by acid reflux may lead to these symptoms.
Chest Pain: Chest discomfort that might be mistaken for a heart-related issue, though it is quite different from a heart attack and can be ruled out with an EKG or other tests.
MANAGEMENT PLAN
Dietary Changes
Avoiding trigger foods and drinks like spicy or fatty foods, caffeine, chocolate, alcohol, and acidic foods.
Eating Habits
Eating smaller, more frequent meals and avoiding lying down immediately after eating can reduce reflux.
Weight Management
Losing excess weight can lessen pressure on the stomach and reduce symptoms.
Elevating the Head of the Bed
Raising the head of the bed by 6 to 8 inches can help prevent nighttime reflux. One could also add pillows under the neck and torso area as an alternative.