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Emergency general surgery

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https://www.readbyqxmd.com/read/28096306/national-multicentre-audit-of-pregnancy-status-in-general-surgery-admissions-in-scotland
#1
Michael S J Wilson, Matilda Powell-Bowns, Andrew G Robertson, Andreas Luhmann, Colin H Richards
BACKGROUND: Documentation of pregnancy status (PS) is an integral component of the assessment of women of reproductive age when admitted to hospital. Our aim was to determine how accurately PS was documented in a multicentre audit of female admissions to general surgery. METHODS: A prospective multicentre audit of elective and emergency admissions was performed in 18 Scottish centres between 08:00 on 11 May 2015 and 07:59 on 25 May 2015. The lower age limit was the minimum age for admission to the adult surgical ward and the upper age limit was 55 years...
January 17, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28093615/the-open-abdomen-route-by-eurahs-introduction-of-the-data-set-and-initial-results-of-procedures-and-procedure-related-complications
#2
A Willms, F Muysoms, C Güsgen, R Schwab, J Lock, S Schaaf, C Germer, I Richardsen, U Dietz
INTRODUCTION: Open abdomen management has become a well-established strategy in the treatment of serious intra-abdominal pathologies. Key objectives are fistula prevention and high fascial closure rates. The current level of evidence on laparostoma is insufficient. This is due to the rareness of laparostomas, the heterogeneity of study cohorts, and broad diversity of techniques. Collecting data in a standardised, multicentre registry is necessary to draw up evidence-based guidelines. MATERIALS AND METHODS: In order to improve the level of evidence on laparostomy, CAMIN (surgical working group for military and emergency surgery) of DGAV (German Society for General and Visceral Surgery), initiated the implementation of a laparostomy registry...
January 16, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28070654/anesthesia-management-of-cesarean-section-in-parturient-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-case-report
#3
Zhimin Liao, Xiaoqin Jiang, Juan Ni
A 24-year-old woman at 29 weeks' gestation, and with psychiatric symptoms, was admitted to hospital and diagnosed as having anti-N-methyl-D-aspartate receptor encephalitis. After 4 weeks of immunotherapy with little effect, an emergency cesarean section was performed at 33(+4) weeks gestation under general anesthesia. The parturient was intubated after rapid sequence induction with etomidate, remifentanil and succinylcholine. Anesthesia was maintained with sevoflurane and remifentanil. Except for low weight, the infant was normal at birth...
January 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28069418/splenic-artery-aneurysm-rupture-in-pregnancy
#4
Joshua Jacobson, Chad Gorbatkin, Stacey Good, Scott Sullivan
CASE PRESENTATION: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Subsequent CT obtained noted the rare but life-threatening diagnosis of ruptured splenic artery aneurysm that resulted in emergent transfer to the operating room with OB/GYN and general surgery...
December 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28062078/-coexistence-of-acute-appendicitis-and-dengue-fever-a-case-report
#5
Juan Fidel Osuna-Ramos, Carlos Silva-Gracia, Gerardo Joel Maya-Vacio, Alejandra Romero-Utrilla, Efrén Rafael Ríos-Burgueño, Jesús Salvador Velarde-Félix
BACKGROUND: Dengue is the most important human viral disease transmitted by mosquitoes. It can be asymptomatic or it can present in any of its 3clinical forms: Dengue fever, dengue haemorrhagic fever and dengue shock syndrome. However, some atypical manifestations have been reported in surgical emergencies caused by acute appendicitis in patients with dengue fever. CLINICAL CASE: We report the case of an 18-year-old Mexican male who presented to the emergency department of the General Hospital of Culiacan, Sinaloa, with symptoms of dengue fever, accompanied by crampy abdominal pain with positive Rovsing and Dunphy signs...
January 3, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28061741/economic-analysis-and-patient-satisfaction-associated-with-outpatient-total-ankle-arthroplasty
#6
Tyler Gonzalez, Erica Fisk, Christopher Chiodo, Jeremy Smith, Eric Bluman
BACKGROUND: Total ankle arthroplasty (TAA) is a rapidly growing treatment for end-stage ankle arthritis that is generally performed as an inpatient procedure. The feasibility of outpatient total ankle arthroplasty (OTAA) has not been reported in the literature. We sought to establish proof of concept for OTAA by comparing outpatient vs inpatient perioperative complications, postoperative emergency department (ED) visits, readmissions, patient satisfaction, and cost analysis. METHODS: From July 2010 to September 2015, a total of 36 patients underwent TAA...
December 1, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/28045742/management-of-anticoagulation-with-rivaroxaban-in-trauma-and-acute-care-surgery-complications-and-reversal-strategies-as-compared-to-warfarin-therapy
#7
Sara P Myers, Esmaeel R Dadashzadeh, Jessica Cheung, Louis Alarcon, Matthew Kutcher, Joshua B Brown, Matthew D Neal
BACKGROUND: Rivaroxaban has gained popularity as an anticoagulant (AC) for stroke prevention in nonvalvular atrial fibrillation (afib) and venous thromboembolism (VTE). Although adverse bleeding events are associated with all AC, lack of point of care testing to measure the effect of rivaroxaban in emergent situations has contributed to perceived increased risk amongst physicians. METHODS: To describe a single center experience with trauma and emergency general surgery (EGS) patients taking rivaroxaban and evaluate outcomes compared with patients taking warfarin using a propensity score analysis...
December 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28042407/nodular-fasciitis-of-the-neck-causing-emergency-a-case-report
#8
Serkan Yaşar Çelik, Yelda Dere, Özgür İlhan Çelik, Serhan Derin, Murat Şahan, Özcan Dere
Nodular fasciitis is a benign, reactive, tumor-like lesion composed of fibroblasts and myofibroblasts. It typically occurs in the extremities and the trunk. Head and neck localization is 13-20%. As it grows rapidly, clinicians frequently misdiagnose it as an aggressive or a malignant lesion. Some lesions show moderate cellularity, mild cellular atypia, and mitosis histologically causing pathologists to over-diagnose the lesion as a malignant tumor. It is important to diagnose nodular fasciitis correctly to avoid unnecessary additional surgery and treatment...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28035669/a-randomised-controlled-trial-comparing-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-pre-oxygenation-with-facemask-pre-oxygenation-in-patients-undergoing-rapid-sequence-induction-of-anaesthesia
#9
F Mir, A Patel, R Iqbal, M Cecconi, S A R Nouraei
Pre-oxygenation is an essential part of rapid sequence induction of general anaesthesia for emergency surgery, in order to increase the oxygen reservoir in the lungs. We performed a randomised controlled trial of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) pre-oxygenation or facemask pre-oxygenation in patients undergoing emergency surgery. Twenty patients were allocated to each group. No patient developed arterial oxygen saturation < 90% during attempted tracheal intubation. Arterial blood gases were sampled from an arterial catheter immediately after intubation...
December 30, 2016: Anaesthesia
https://www.readbyqxmd.com/read/28030504/hospitals-with-higher-volumes-of-emergency-general-surgery-patients-achieve-lower-mortality-rates-a-case-for-establishing-designated-centers-for-emergency-general-surgery
#10
Gerald O Ogola, Adil Haider, Shahid Shafi
BACKGROUND: Higher volume has been associated with lower mortality for several surgical diseases. It is not known if this relationship exists in the management of Emergency General Surgery (EGS). Our hypothesis was that EGS patients treated at hospitals with higher EGS volume experienced lower mortality rates than those treated at low-volume hospitals. METHODS: This was a retrospective analysis of 2010 National Inpatient Sample data, maintained by the Agency for Healthcare Quality and Research as a representative national sample of inpatients...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030492/stapled-versus-handsewn-a-prospective-emergency-surgery-study-shapes-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#11
Brandon R Bruns, David S Morris, Martin Zielinski, Nathan T Mowery, Preston R Miller, Kristen Arnold, Herb A Phelan, Jason Murry, David Turay, John Fam, John S Oh, Oliver L Gunter, Toby Enniss, Joseph D Love, David Skarupa, Matthew Benns, Alisan Fathalizadeh, Pak Shan Leung, Matthew M Carrick, Brent Jewett, Joseph Sakran, Lindsay O'Meara, Anthony V Herrera, Hegang Chen, Thomas M Scalea, Jose J Diaz
BACKGROUND: Data from the trauma patient population suggests handsewn anastomoses (HS) are superior to stapled (ST). A recent retrospective study in emergency general surgery (EGS) patients had similar findings. The aim of the current study is to evaluate HS and ST anastomoses in EGS patients undergoing urgent/emergent operations. METHODS: The study was sponsored by the AAST Multi-Institutional Studies Committee. Patients undergoing urgent/emergent bowel resection for EGS pathology were prospectively enrolled from 7/22/2013-12/31/2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28017297/prevalence-and-predictors-of-depression-among-general-surgery-residents
#12
Dana T Lin, Cara A Liebert, Micaela M Esquivel, Jennifer Tran, James N Lau, Ralph S Greco, Claudia M Mueller, Arghavan Salles
BACKGROUND: Recent resident suicides have highlighted the need to address depression among medical trainees. This study sought to identify the prevalence and predictors of depression among surgical residents. METHODS: Surgical residents at a single institution were surveyed. Depression and personal traits were assessed using validated measures; participant demographics were also obtained. RESULTS: 73 residents completed the survey (response rate 63%)...
December 5, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28012774/-intermittent-left-bundle-branch-block-reversal-to-normal-conduction-during-general-anesthesia
#13
Ana Maria Oliveira Correia da Silva, Emília Alexandra Gaspar Lima da Silva
BACKGROUND AND OBJECTIVES: Transient changes in intraoperative cardiac conduction are uncommon. Rare cases of the development or remission of complete left bundle branch block under general and locoregional anesthesia associated with myocardial ischemia, hypertension, tachycardia, and drugs have been reported. Complete left bundle branch block is an important clinical manifestation in some chronic hypertensive patients, which may also be a sign of coronary artery disease, aortic valve disease, or underlying cardiomyopathy...
December 21, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28012327/incarcerated-and-eventrated-abdominal-wall-hernia-reconstruction-with-autologous-double-layer-dermal-graft-in-the-field-of-purulent-peritonitis-a-case-report
#14
Gábor Martis, Máté Rózsahegyi, János Deák, László Damjanovich
INTRODUCTION: Double-layer dermal grafts are used for the management of complicated abdominal wall hernias in obese, high risk patients. The method has not yet been used in case of emergency in septic/dirty environment. CASE REPORT: A 76-year old female patient (BMI 36.7kg/m(2)) was admitted with mechanical bowel obstruction and sepsis caused by a third time recurred, incarcerated and eventrated abdominal wall hernia. During the emergency surgery perforation of the terminal ileum and the ascending colon was detected, along with a feculent peritonitis and extended abdominal wall necrosis...
December 6, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28008467/readmissions-after-laparoscopic-cholecystectomy-in-a-uk-district-general-hospital
#15
Olugbenga Awolaran, Tabitha Gana, Nehemiah Samuel, Kenneth Oaikhinan
INTRODUCTION: Laparoscopic cholecystectomy is the gold standard for the treatment of symptomatic gallstones and its practice as day case where possible is considered the standard over the last decade. However, readmission after surgery is recognised as a new problem. AIM: The aim of this cohort observational study was to investigate the readmission rate in a district general hospital and identify the causes of readmission in order to explore ways by which this can be reduced or managed more cost effectively...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28004310/high-body-mass-index-and-use-of-fentanyl-iontophoretic-transdermal-system-in-postoperative-pain-management-results-of-a-pooled-analysis-of-six-phase-3-3b-trials
#16
Eugene R Viscusi, Li Ding, J Bradley Phipps, Loretta M Itri, Philip R Schauer
INTRODUCTION: Postoperative pain management can be challenging in patients with a high body mass index (BMI) especially as a result of poor venous access and delayed ambulation that can result in serious complications. Fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-controlled analgesic method available for use in acute postoperative pain. The primary objective of these analyses was to determine if there were any differences between patients with high BMI (>40 kg/m(2)) and lower BMIs (<30 kg/m(2) and 35-40 kg/m(2)) in terms of efficacy or safety...
December 21, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/28004249/delayed-perforation-occurring-on-the-24th-day-after-endoscopic-submucosal-dissection-for-early-gastric-cancer
#17
Satoru Homma, Kazuaki Tokodai, Minami Watanabe, Kai Takaya, Eiji Hashizume
Delayed perforation occurs after 0.5% of endoscopic submucosal dissection (ESD) procedures for early gastric cancer (EGC). This complication can occur within a few hours or days after ESD. There are few reports in the English literature concerning patients who developed delayed perforation after ESD for EGC. An 81-year-old woman was referred to the emergency department of our hospital on the 24th day after ESD because of abdominal pain. We diagnosed her with delayed perforation with peritonitis after ESD for EGC using computed tomography (CT) and esophagogastroduodenoscopy (EGD)...
December 21, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27998859/-effect-of-magnesium-sulphate-infusion-on-emergence-agitation-in-patients-undergoing-esophageal-carcinoma-with-general-anesthesia-a-randomized-double-blind-controlled-trial
#18
Min Xie, Xiang-Kui Li, Jie Chen
OBJECTIVE: To evaluate the safety and effectiveness of magnesium sulphate for reducing the incidence of the emergence agitation in patients undergoing surgery for esophageal carcinoma with general anesthesia. METHODS: This randomized, double-blind, controlled clinical trial was conducted in patients undergoing elective radical resection of esophageal carcinoma in Sichuan Provincial People's Hospital between October, 2015 and March, 2016. The patients underwent surgeries under general intravenous anesthesia, and after anesthesia induction, the patients were infused with magnesium sulphate at the rate of 0...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27995001/evaluation-of-the-patients-with-colorectal-cancer-undergoing-emergent-curative-surgery
#19
Fikri Kundes, Metin Kement, Kenan Cetin, Levent Kaptanoglu, Aytaç Kocaoglu, Mehmet Karahan, Serkan Fatih Yegen, Ali Emre Atici, Osman Civil, Mehmet Eser, Tebessum Cakir, Nejdet Bildik
BACKGROUND: The aim of our study is to evaluate perioperative and mid-term oncologic outcomes of the patients with colorectal cancer, who underwent emergent curative surgery. METHODS: The study included all patients with colorectal cancer, who underwent surgery for curative intent between 1 January 2012 and 31 December 2014 in General Surgery Department of Kartal Training and Research Hospital. The patients were divided into two groups according to the type of admission (emergent or elective)...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27994299/evaluation-of-risk-factors-of-surgical-wound-dehiscence-in-adults-after-laparotomy
#20
Goran Aksamija, Adi Mulabdic, Ismar Rasic, Lejla Aksamija
OBJECTIVES: The percentage of patients with difficult and prolonged healing of the wound is still high, while the immediate complications such as wound dehiscence occurs in up to 3 % of all treated patients in abdominal surgery. The aim of study was to analyze the risk factors and comorbidities in the group patients undergoing laparotomy and associated with early postoperative wound dehiscence. METHODS: The retrospective study included all patients treated surgically at Clinic of General and Abdominal surgery, Clinical Center of the University of Sarajevo in the period from January 1, 2013 until January 1, 2016, with clinically verified surgical wound dehiscence...
October 2016: Medical Archives
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