Comprehensive Care for General Surgery Diseases and Disorders

At PACE Hospitals, we offer specialized care for a wide range of surgical conditions affecting different organs and systems. The conditions managed under our General Surgery Department are structured below to help patients easily identify their needs.

Gastrointestinal (GI) Disorders

These conditions affect the stomach, intestines, and related organs.

Appendicitis
Inflammation of the Vermiform Appendix is called appendicitis. The appendix is a tiny organ attached to the large intestine. Appendicitis occurs when the appendix is blocked and gets infected by various microbes, including bacteria, viruses, or parasites in the digestive tract, or due to blockage of the tube that joins the large intestine and appendix or strapping by stool or tumors. The main complication of an appendix is the risk of a burst appendix (ruptured appendix).

Hernias 

A hernia occurs when an internal organ or tissue pushes through a weak spot in the surrounding muscle or abdominal wall. This often appears as a visible swelling or bulge when coughing or straining. Common types of hernia include: inguinal (groin), umbilical (around the navel), incisional (at a previous surgical site), and femoral hernias. Hernias do not heal on their own and may increase in size or cause complications like obstruction or strangulation.

Gallbladder diseases (gallstones, cholecystitis) 

The gallbladder is a small organ that stores bile to help digest fats. Gallstones are hardened deposits that can block the flow of bile, causing severe pain in the upper abdomen, especially after eating fatty foods. When the gallbladder becomes inflamed due to blockage, it leads to cholecystitis, which may cause fever, nausea, and persistent pain. Treatment often involves surgical removal of the gallbladder (cholecystectomy), which is commonly done using minimally invasive techniques.

Intestinal obstruction 

Intestinal obstruction occurs when the normal movement of food and fluids through the intestines is blocked. This can be due to adhesions (scar tissue), hernias, tumors, or twisted intestines. Symptoms generally include severe abdominal pain, vomiting, bloating, and inability to pass stool or gas. It is a serious condition that may require urgent medical attention and in some situations, surgery is also needed.

Peptic ulcer complications 

Peptic ulcers are sores that develop in the inner lining of the stomach or upper intestine, often due to infection or long-term use of painkillers. While many ulcers heal with medication, some can lead to serious complications. Bleeding ulcers may cause vomiting of blood or black-colored stools, while a perforated ulcer creates a hole in the stomach wall, which can lead to sudden, severe abdominal pain and infection. 

Gastroesophageal reflux disease (GERD) 

GERD is a condition where stomach acid flows back into the food pipe, causing a burning sensation in the chest known as heartburn. It may also cause sour taste in the mouth, difficulty swallowing, or a chronic cough. This usually happens when the valve between the stomach and esophagus becomes weak. Most cases are managed with lifestyle changes and medications, but if symptoms are severe or long-lasting, surgery may be recommended to strengthen the valve and prevent acid reflux.

Colorectal diseases (polyps, diverticulitis) 

Colorectal diseases affect the large intestine. Polyps are small growths inside the colon that are usually harmless but can sometimes turn into cancer if not removed early. Diverticulitis occurs when small pouches in the colon wall become inflamed or infected, causing abdominal pain, fever, and changes in bowel habits. 

Inflammatory bowel diseases (Crohn’s disease, ulcerative colitis – surgical cases).

Abdominal Abscess
An abdominal abscess is a collection of infected fluid or pus surrounded by inflamed tissue inside the abdomen. It may be caused by bacteria. If left untreated, the bacteria will multiply, causing inflammation and killing healthy tissue. They mainly occur after surgery, trauma, or conditions involving abdominal infection. An abdominal abscess may lead to the following complications, including septic shock (severe drop in blood pressure after an infection), multiorgan failure, and formation of a fistula (abnormal opening or passage between two organs).

Achalasia
Achalasia is an uncommon swallowing disorder that impacts the esophagus (food pipe: the tube between the throat and the stomach). In people with this condition, the muscles of the esophagus do not contract properly and do not help propel (to drive forward) food down toward the patient's stomach. At the same time, the ring of muscle at the lower oesophageal sphincter (LES—the bottom end of the esophagus) is unable to relax to let food into the stomach. Complications of achalasia include aspiration, choking, esophageal cancer, and malnutrition.

Short-Bowel Syndrome
Short-bowel syndrome is a condition that occurs when the small intestine, or small bowel, is shortened or damaged and cannot absorb sufficient nutrients from the foods a person eats to maintain health. Complications of short bowel syndrome include nephrolithiasis (kidney stones), malabsorption, diarrhea, fluid and electrolyte imbalance, vitamin and trace element derangements, metabolic bone disease(weakening of the bones caused by abnormal levels of the calcium and phosphorus or vitamin D (bone’s building blocks)), biliary disorders (conditions affecting the bile ducts, gallbladder and other structures involved in the production and transportation the bile juice), and small intestinal bacterial overgrowth.

Hepatobiliary & Pancreatic Disorders

Diseases of the liver, gallbladder, bile ducts, and pancreas require surgical care.

Liver Abscess

A liver abscess is a pus-filled mass in the liver that may develop from injury to the liver or from a being within the abdomen (intra-abdominal) infection spread from the portal vein. Bacterial, parasitic, or fungal agents may cause the disease. If these abscesses are not treated, they may cause peritonitis (redness and swelling of the lining of the abdomen) and shock.

Liver tumors

Liver tumors are abnormal growths in the liver and can be either non-cancerous (benign) or cancerous (malignant). Many people may not have symptoms in the early stages, but some may experience abdominal pain, weight loss, or jaundice (yellowing of the skin and eyes). These tumors can affect the normal functioning of the liver over time.

Pancreatitis
Pancreatitis is characterized by inflammation (swelling) of the pancreas and occurs when digestive enzymes begin digesting the pancreas itself. This condition can be acute or chronic and may cause symptoms including fever, nausea, vomiting, and severe belly pain. Either form is serious and may lead to complications such as chronic pain, diarrhea, weight loss, and bile duct blockages.

Pancreatic tumors

Pancreatic tumors are abnormal growths in the pancreas, an organ involved in digestion and blood sugar regulation. These tumors often grow silently and may not show symptoms in the early stages. As they enlarge, they cause symptoms such as abdominal or back pain, reduced appetite, weight loss, and jaundice may appear. The condition can gradually interfere with digestion and metabolic functions.

Bile duct obstruction

Bile duct obstruction refers to a blockage in the tubes that carry bile from the liver to the intestine. When bile flow is blocked, it builds up in the body and leads to symptoms such as yellowing of the skin and eyes, dark urine, pale stools, and itching. This condition can also cause abdominal discomfort and may affect digestion, especially of fatty foods.

Choledocholithiasis

Choledocholithiasis is a condition where stones are present in the common bile duct. These stones can block the flow of bile and lead to symptoms such as severe upper abdominal pain, jaundice, fever, and nausea. The condition may develop when gallstones move from the gallbladder into the bile duct. It can interfere with normal digestion and may lead to complications if not addressed.

Gallbladder Mucocele
A gallbladder mucocele (GBM) is an improper accumulation of clear mucus-like fluid that is replaced with green or brown bile in the gallbladder lumen (cavity of a part or tubular organ). It can be caused by the prolonged blockage of the cystic duct, usually by an impacted gallstone. This condition is also called hydrops of the gallbladder. Most of the time, it would be identified incidentally during cholecystectomy (gallbladder removal) surgery.

Gallbladder Volvulus (Torsion)
Gallbladder volvulus or gallbladder torsion is a rare condition in which the gallbladder twists on its long axis, resulting in compromised blood supply. It occurs more in elderly women; however, diagnosis is generally difficult and is found intraoperatively. It can be treated safely with laparoscopic cholecystectomy.

Post-cholecystectomy Syndrome

This refers to the persistence or recurrence of symptoms such as abdominal pain, nausea, bloating, or indigestion after gallbladder removal (cholecystectomy). It can occur weeks to years after surgery. The causes may include retained bile duct stones, bile duct injury or stricture, sphincter of Oddi dysfunction, or other gastrointestinal issues. Treatment depends on the underlying cause and may involve medications, endoscopic procedures, or, rarely, further surgery.

Anorectal Conditions

These conditions affect the anus and rectum

Hemorrhoids (piles) 

Hemorrhoids, which are also called piles, are enlarged and swollen veins in the lower rectum or around the anus, similar to varicose veins. Piles develop due to increased pressure in this area, often from chronic constipation, prolonged sitting, pregnancy, or straining during bowel movements. Depending on the location, they can be internal (inside the rectum) or external (around the anus). Symptoms may include pain, itching, swelling, and bleeding during or after passing stools. In some cases, they can prolapse (come out of the anus), causing further discomfort.

Anal fissure 

An anal fissure is a small but painful tear in the inner lining of the anus. It commonly occurs when passing hard or large stools, leading to stretching and injury of the anal lining. This condition causes sharp, burning pain during bowel movements, which may continue even after passing stools. There may also be some bright red blood. People who are in discomfort may avoid passing stools, which can increase constipation and delay recovery, resulting in a recurrent cycle.

Anal fistula
An anal fistula is a tiny tunnel that develops between the end of the large intestine (bowel) and the skin near the anus (opening of the bottom). It is usually caused by an infection near the opening of the bottom, which may result in a collection of abscesses (pus) in the nearby tissue. When the pus drains away, it may leave a small channel behind. Anal fistulas may cause unpleasant symptoms, including discomfort and skin irritation.

Perianal abscess 

A perianal abscess is a localised collection of pus that forms near the anus due to infection of small glands present in that area. It usually appears as a painful, swollen lump that may be red and warm to the touch. The pain can be severe and constant, and it may worsen while sitting, walking, or during bowel movements. Fever and general discomfort can also occur. If left untreated, the abscess may burst or lead to the formation of an anal fistula.

Anorectal Abscess
An anorectal abscess is a collection of abscess (pus) in the area of the rectum and anus, commonly caused by trauma, blocked glands in the anal area, sexually transmitted infection, or infection of an anal fissure. Symptoms include constipation, tenderness, fatigue, fever, night sweats, painful redness, and hardened tissue in the area of the opening of the bottom (anus). Complications of this condition may include chronic pain, anal fistula, sepsis (an infection that spreads to the blood), and recurrence.

Rectal prolapse 

Rectal prolapse is a condition in which part or all of the rectum slips out through the anus. It occurs due to weakening of the pelvic floor muscles and supporting tissues. This condition is common among older adults or those with long-term constipation. It may initially appear only during bowel movements but later this can occur even while standing or walking. Patients may include a visible mass outside the anus, discomfort, mucus discharge, and difficulty controlling bowel movements.

Pilonidal sinus 

A pilonidal sinus is a small tunnel or tract in the skin, usually located near the tailbone at the top of the buttocks crease. It often contains hair, dirt, and debris, which can lead to infection and formation of an abscess. The condition is more common in young adults and people who sit for long periods. Symptoms include pain, redness, swelling, and sometimes drainage of pus or blood. Treatment may involve surgical removal of the sinus or draining the abscess, along with good hygiene to prevent recurrence. Risk factors include prolonged sitting, excessive body hair, obesity, family history, poor hygiene, and friction in the affected area.

Breast Disorders

Breast conditions range from benign lumps to infections and cancer. 

Benign breast lumps (fibroadenoma, cysts)

Benign breast lumps are non-cancerous growths commonly found in the breast tissue. Fibroadenomas are solid, smooth, and movable lumps that are often painless and seen in younger women. Breast cysts are fluid-filled sacs that may feel soft or firm and can sometimes become tender, especially before menstruation. These lumps are usually harmless and do not spread, but any new breast lump should be carefully evaluated as they can sometimes cause anxiety and discomfort.

Breast abscess

A breast abscess is a localized collection of pus within the breast tissue caused by bacterial infection, commonly occurring in lactating women. It presents as a painful, swollen lump with redness, warmth and may be associated with fever. It often develops as a complication of mastitis.

Mastitis

This is inflammation of the breast tissue, which is commonly seen in women who are breastfeeding. It occurs when milk ducts become blocked or when bacteria enter the breast, leading to infection. These female patients are generally presented with symptoms like breast pain, swelling, redness, warmth, and sometimes fever and fatigue. The affected area may feel hard or tender, and the condition can make breastfeeding uncomfortable.

Breast cancer

Breast cancer is a condition where abnormal cells grow uncontrollably in the breast tissue. It may present as a painless lump, changes in the shape or size of the breast, skin dimpling, nipple discharge, or inversion of the nipple. In some cases, there may be swelling or pain. The condition can spread to nearby tissues or other parts of the body if it progresses, making early awareness important.

Gynecomastia (male breast enlargement)

Gynecomastia is the enlargement of male breast tissue caused by a hormonal imbalance. It can affect one or both sides of the chest and appear as a soft or firm swelling beneath the nipple. In some cases, it might produce discomfort or sensitivity. This condition can occur during puberty, ageing, or due to certain medications or health conditions, and may lead to cosmetic concerns or emotional discomfort.

Thyroid & Endocrine Disorders

These conditions affect hormone-producing glands such as the thyroid and parathyroid.

Thyroid nodules 

Thyroid nodules are small lumps or growths that develop in the thyroid gland, which is located in the neck. Most nodules are non-cancerous and may not cause any symptoms. However, some can grow large enough to cause swelling in the neck, difficulty swallowing, or breathing problems. A few nodules may produce excess thyroid hormones, which leads to symptoms like weight loss, nervousness, and rapid heartbeat.

Goiter 

Goiter refers to an abnormal enlargement of the thyroid gland. It can occur due to iodine deficiency, hormonal imbalance, or thyroid disorders. A person who is suffering from goiter may notice swelling at the front of the neck. Depending on the cause, it may be associated with normal, decreased, or increased thyroid hormone levels.

Hyperthyroidism 

Hyperthyroidism is a condition where the thyroid gland produces excessive thyroid hormones, leading to an overactive metabolism. Common symptoms include weight loss, rapid heartbeat, sweating, anxiety, tremors, and heat intolerance. While many cases are managed with medications or radioactive iodine therapy, surgery (thyroidectomy) may be recommended in severe cases, large goiters, or when other treatments are not suitable.

Hyperparathyroidism
Hyperparathyroidism is a condition in which one or more parathyroid glands in the neck (near the thyroid gland) are overactive and secrete too much parathyroid hormone (PTH), leading to high blood calcium levels. This condition might cause symptoms including depression, fatigue, kidney stones, bone or joint pain, and excessive urine.

Thyroid cancer 

Thyroid cancer is a condition in which abnormal cells grow uncontrollably within the thyroid. It may manifest as a painless lump or enlargement in the neck that progressively grows in size. Some people may also have trouble swallowing, vocal changes, or a feeling of pressure around their neck. In many cases, it develops slowly, but it can spread to nearby tissues if it progresses.

Skin & Soft Tissue Conditions

These include a wide range of conditions affecting the skin and underlying tissues, such as lumps, infections, and tumors.

Lipomas
Lipomas are non-cancerous, harmless, fatty lumps. Lipomas may appear anywhere where the person has fat cells, commonly growing on the chest, neck, shoulders, arms, and thighs. Sometimes lipomas develop inside the body, and some people may not be aware. Most lipomas do not require to be removed unless they are painful or if patients' appearance bothers them.

Sebaceous cysts

These cysts are closed sacs present under the skin filled with a thick, oily or cheese-like material. They usually develop due to blocked hair follicles or skin glands. These cysts appear as small, round lumps that grow slowly and are usually painless. Sometimes, they may become swollen, red, or infected, causing discomfort. These cysts are commonly found near the face, neck, scalp, or back.

Abscesses

An abscess is a collection of pus that forms within tissues due to infection. It usually appears as a painful, swollen lump that may be red, warm, and tender to touch. Abscesses can occur anywhere in the body, including the skin or deeper tissues. As the infection progresses, the swelling may increase and sometimes discharge pus. It is often associated with pain and may be accompanied by fever in some cases.

Skin tumors 

Skin tumors are abnormal growths that can be either benign (non-cancerous) or malignant (cancerous). Benign tumors, like common moles, are usually harmless and stay in one place. Malignant tumors, such as basal cell carcinoma or the more serious melanoma, result from DNA damage, often caused by UV radiation, and have the potential to invade surrounding tissue or spread to other parts of the body. Early detection through regular skin checks is the most effective way to manage these growths, as most skin cancers are highly treatable when caught early.

Cellulitis 

Cellulitis is a bacterial infection of the skin and underlying tissues. It usually occurs when bacteria enter through a cut, wound, or crack in the skin. The affected area becomes red, swollen, warm, and painful, and the person may also develop fever. It generally affects the legs and requires prompt treatment with antibiotics to prevent spread.

Wounds and non-healing ulcers 

Wounds and non-healing ulcers are injuries or sores that do not heal properly within a normal time. They are often seen in conditions like diabetes, poor blood circulation, or infection. These wounds may remain open, become painful, and are at risk of infection. Proper wound care and treatment of the underlying cause are important for healing.

Trauma & Emergency Surgical Conditions

This category includes acute injuries and life-threatening conditions that require immediate surgical attention.

Abdominal trauma
Abdominal trauma is damage to the abdomen, which may result from motor vehicle collisions (MVCs), assaults, falls, or recreational accidents. This injury may damage the internal organs in the abdomen area, resulting in internal bleeding and causing injuries or bruises to the spleen, liver, bowel, and intestines. The most common signs and symptoms in patients include pain, tenderness, hypovolemia (Insufficient fluid (blood) volume circulating in the body), gastrointestinal bleeding, and evidence of peritoneal irritation (irritation or inflammation of the lining of the abdominal cavity).

Internal bleeding 

Internal bleeding happens when blood vessels inside the body get damaged, causing blood to leak into areas like the abdomen or chest without any visible signs on the skin. It can result from injuries, medical conditions like ulcers or blood thinners, and leads to symptoms like dizziness, fast heartbeat, low blood pressure, or severe pain, requiring urgent medical care to stop the bleeding.

Splenic injuries 

Splenic injuries involve damage to the spleen, an organ located in the upper left side of the abdomen that helps filter blood and fight infections. These injuries usually happen from blunt trauma, like road accidents or falls. They can vary from minor bruising to a complete rupture of the spleen. Symptoms include pain in the upper left abdomen, pain that spreads to the left shoulder, and signs of internal bleeding, such as dizziness or weakness.

Intestinal Perforation
If there is a hole in the intestine, this is known as an intestinal perforation, commonly caused by trauma, inflammation, infection, instrumentation, malignancy (cancerous), ischemia, and obstruction. Perforation and subsequent leakage of intestinal contents can lead to peritonitis (redness and swelling of the lining of the abdomen) and, eventually, sepsis (overactive and extreme response of the body to infection) if left untreated. Surgery can be undertaken if necessary for the control of leakage, and it is important to discuss potential complications of surgery with patients and their families.

Vascular Conditions (Basic Surgical Care)

These conditions involve blood vessels, particularly in the limbs. General surgeons provide initial and basic surgical care.

Varicose veins 

Varicose veins are enlarged, twisted veins that usually appear in the legs due to weakened or damaged vein valves. These faulty valves cause blood to pool instead of flowing smoothly back to the heart. They may appear like bulging, bluish veins under the skin. This can come with symptoms like pain, swelling, itching, a feeling of heaviness in the legs or a burning sensation. The condition often gets worse with prolonged standing. If left untreated, it may lead to complications like skin changes or ulcers.

Diabetic foot ulcers 

These are open sores or wounds that develop on the feet of individuals with diabetes, usually due to poor blood circulation and nerve damage (neuropathy). Because of reduced sensation, minor injuries may go unnoticed and worsen over time. These ulcers commonly occur on pressure points such as the sole or toes and may become infected if not treated early. They are a serious complication of diabetes and can lead to deeper tissue damage or even amputation in severe cases.

Peripheral vascular disease 

Peripheral vascular disease (PAD) refers to the narrowing or blockage of blood vessels outside the heart and brain, most commonly affecting the arteries supplying the legs. It is usually caused by atherosclerosis, where fatty deposits build up in the vessel walls and reduce blood flow. This can lead to symptoms such as leg pain during walking (claudication), numbness, coldness in the limbs, or slow-healing wounds. In advanced cases, reduced blood supply can result in tissue damage or ulcers.

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