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Perforating dermatoses

Perforating dermatoses (acquired perforating dermatosis, reactive perforating collagenosis, Kyrle disease, perforating folliculitis, elastosis perforans serpiginosa) are skin disorders marked by transepidermal elimination of collagen or elastin, mainly in diabetes and chronic kidney disease.

Perforation of duodenum

Perforation of duodenum: transmural duodenal wall injury, also called duodenal perforation. Main causes are peptic ulcer (H. pylori, NSAIDs), ERCP and other iatrogenic injury, and trauma; mortality 8-25%, higher with peritonitis.

Perforation of large intestine

Perforation of large intestine is a complete breach of the colonic wall that leaks bowel contents into the abdomen, causing peritonitis; common causes include cancer, diverticulitis, and colonoscopy injury.

Perforation of oesophagus

Perforation of oesophagus (esophageal perforation, Boerhaave syndrome when spontaneous), ICD-11 DA20.3: a hole in the oesophageal wall leaking contents into mediastinum; mostly iatrogenic, mortality about 10-15%.

Perforation of small intestine

Perforation of small intestine (ICD-11 ME24.30), also called non-traumatic small bowel perforation: full-thickness breach of the jejunal or ileal wall leaking contents into the abdomen, causing peritonitis; causes include iatrogenic injury, ischemia, malignancy, Crohn disease, and trauma.

Perforator flap

A perforator flap is a reconstructive technique in which skin and fat are transferred on small vessels piercing the muscle, sparing the muscle, most often for breast reconstruction.

Performance status

Performance status (PS), measured by the Karnofsky (KPS, 0–100) or ECOG/WHO (0–5) scales, rates cancer patients' functional ability; a strong prognostic factor and common clinical trial eligibility criterion.

Performance-enhancing substance

Performance-enhancing substance: drugs, hormones, and supplements (steroids, EPO, caffeine, creatine) used to boost athletic performance; regulated by WADA's annually updated Prohibited List under strict liability, with efficacy proven for only 5 of 23 classes.

Perfusion

Perfusion is blood flow through tissue vessels, delivering oxygen and removing carbon dioxide, quantified as ml/min/g. Covers its history (Harvey, Malpighi), autoregulation, bedside and laboratory assessment in shock, and optical, fluorescence, and imaging measurement techniques.

Perfusion computed tomography

Perfusion computed tomography (CT perfusion, CTP) is a CT technique that maps blood flow in tissue, used mainly to select acute stroke patients for reperfusion therapy.

Perfusion imaging

Perfusion imaging is a family of medical imaging techniques that measure capillary-level blood delivery using MRI, CT, or radionuclide tracers, guiding stroke, cardiac, and cancer care.

Perfusion Index

Perfusion index (PI, PPI): pulse-oximetry-derived ratio of pulsatile to non-pulsatile blood flow at the sensor site; values under 0.3% signal very low perfusion, 2–5% good perfusion; predicts fluid responsiveness and anesthetic hypotension.

Perfusion Magnetic Resonance Imaging

Perfusion MRI measures capillary-level blood delivery (ml/100 g/min) using four techniques: DSC and DCE with gadolinium contrast, and non-contrast ASL and IVIM; used for stroke, brain tumors, and dementia.

Perfusion mapping

Perfusion mapping is a family of imaging methods that measure blood flow through tissue, using MRI techniques like DSC, DCE, and ASL, plus CT perfusion.

Perfusionist

Perfusionist: allied health professional who operates the heart-lung machine (cardiopulmonary bypass) during cardiac surgery and runs ECMO and mechanical support; credentialed as CCP by the ABCP (est. 1975), with state licensure in Massachusetts, Maryland, and Texas.

Pergolide

Pergolide is an ergot-derived dopamine receptor agonist developed for Parkinson's disease, withdrawn from human markets over cardiac valve damage and now used mainly in veterinary medicine to treat equine Cushing's disease.

Perhexiline

Perhexiline (Pexsig), a prophylactic antianginal maleate drug acting on fatty acid metabolism via CPT-1/2, requires CYP2D6-based drug monitoring; used for refractory angina in Australia and repurposed for heart failure and cancer.

Periacetabular osteotomy

Periacetabular osteotomy (PAO) is a joint-preserving operation that cuts the pelvis around the acetabulum and repositions the socket to correct hip dysplasia and delay arthritis.

Perianal venous thrombosis

Perianal venous thrombosis (thrombosed external hemorrhoid, perianal hematoma; ICD-11 DB61, ICD-10-CM K64.5) is a clot in a vein of the external anal plexus, causing sudden severe perianal pain; treated conservatively or by excision within 72 hours.

Periannan Senapathy

Periannan Senapathy is an Indian-born molecular biologist who proposed the split gene theory of exon-intron gene origins and wrote the 1994 book Independent Birth of Organisms.

Periaortic lymph nodes

Periaortic (para-aortic, lumbar) lymph nodes: retroperitoneal nodes along the aorta and IVC draining kidney, adrenal, gonads, and uterine corpus; seven imaging subgroups; PET-CT is the most accurate metastasis test.

Periapical abscess with sinus

Periapical abscess with sinus (ICD-11 DA09.61; dental sinus) is a periapical abscess draining pus through a sinus tract to oral mucosa or skin, treated by root canal therapy or extraction.

Periapical abscess without sinus

Periapical abscess without sinus, also called acute apical or dentoalveolar abscess, is pus at a tooth root tip without a draining sinus tract; ICD-10-CM K04.7, ICD-11 DA09.62, treated by root canal treatment rather than antibiotics.

Periapical periodontitis

Periapical periodontitis, also called apical periodontitis (ICD-11 DA09.7), is inflammation of the tissue around a tooth root apex caused by root canal infection, presenting as granuloma, cyst, or abscess and treated by root canal treatment.

Periapical radiography

Periapical radiography is an intraoral dental X-ray technique that captures an entire tooth, from crown to root tip, used to diagnose caries, root pathology, and periapical disease.

Periapical surgery

Periapical surgery, or apicectomy with root-end filling, is a dental procedure that removes the tip of a tooth root to seal it and clear persistent infection.

Periarthritis of wrist

Periarthritis of wrist (ICD-11 FB55.2) is inflammation of tissues around the wrist joints, an enthesopathy mapping to ICD-10 M77.2, covering tenosynovitis, de Quervain disease, and acute calcific periarthritis.

Peribulbar block

A peribulbar block is a regional anesthesia technique for eye surgery, injecting local anesthetic outside the muscle cone of the orbit; it is the most common regional technique for cataract surgery.

Pericapsular nerve group block

The pericapsular nerve group (PENG) block is an ultrasound-guided regional anesthesia technique introduced in 2018 that injects anesthetic between the psoas tendon and ilium to relieve hip fracture pain while largely sparing motor function.

Pericardial effusion

Pericardial effusion is abnormal fluid accumulation in the pericardial sac around the heart, graded by echocardiography as mild, moderate, or large. Causes include viral pericarditis, tuberculosis, and malignancy; severe cases cause cardiac tamponade requiring pericardiocentesis.