Comparing outcomes in patients with exsanguinating injuries, a study found prioritizing circulation over intubation led to significantly lower 24-hour mortality (11.1% vs. 69.2%), reduced odds of mortality within 24h (91%), and at 30 days (89%), along with lower rates of renal failure and higher ARDS incidence. These results highlight the potential benefits of prioritizing circulation […]
Category: Appendix, Gallbladder and Surgical Emergencies
Management of Nontraumatic Spontaneous Renal Hemorrhage through Robotic-Assisted Laparoscopic Nephrectomy
Researchers described three cases of Wünderlich Syndrome (nontraumatic spontaneous renal hemorrhage) treated with robot-assisted laparoscopic nephrectomy. The patients, aged 44 to 53, presented with flank pain and were diagnosed with Wünderlich Syndrome via CT scan. Each patient underwent a retroperitoneal robotic-assisted nephrectomy after conservative treatment failed. Pathological examination revealed angiomyolipoma in one case and renal […]
Effectiveness and Safety of Endoscopic Resection for Gastric Gastrointestinal Stromal Tumors
Researchers investigated the efficacy and safety of endoscopic resection (ER) for gastric gastrointestinal stromal tumors (GISTs) originating from the muscularis propria (MP). The study included 233 patients who underwent ER, with a median tumor size of 12 mm. The complete resection rate was 93.1%, with complications occurring in 4.7% of cases, including perioperative perforations (1.7%) […]
Interval Appendectomy After Antibiotic Treatment for Appendicitis: Is It Necessary?
Researchers discuss the pros and cons of interval appendectomy for patients who have recovered from acute uncomplicated appendicitis after successful antibiotic treatment. Although surgery has traditionally been the standard treatment, recent data suggest that antibiotics are a safe alternative. However, the high rate of recurrent appendicitis (35-50% at 5 years) has led to a debate […]
Reevaluating Interval Appendectomy After Successful Antibiotic Treatment for Appendicitis
Clinicians debate the merits of interval appendectomy for patients who recover from antibiotic treatment for acute uncomplicated appendicitis. Offering this surgery to avoid future appendicitis risks extra costs, disability, and potential complications, even though many patients may never need surgery. Major clinical trials show high rates of negative pathology among interval appendectomies, suggesting surgery is […]
Management of Infected Collections in Acute Pancreatitis: To Drain or Not Drain?
Recent literature advocates for delaying catheter drainage in acute pancreatitis, but critically ill patients with severe disease and infected peri-pancreatic collections may still benefit from drainage procedures. A retrospective review of 72 patients showed high rates of ICU admission, respiratory and renal failure, and in-hospital mortality. Until more research is done, drainage should continue to […]
Primary Anastomosis with Diverting Loop Ileostomy in Acute Complicated Diverticulitis
A study of 16,921 cases of nonelective sigmoidectomy for acute complicated diverticulitis revealed a rising trend in the use of primary anastomosis with diverting loop ileostomy, from 5.3% in 2012 to 8.4% in 2020. Compared to Hartmann’s procedure, primary anastomosis with diverting loop ileostomy was associated with lower rates of major adverse events (24.6% vs […]
Significant Variability in Managing Malignant Gastric Outlet Obstruction in Pancreatic Cancer, with Rising Use of EUS-Gastrojejunostomy
Survey of 290 pancreatologists revealed significant differences in managing malignant gastric outlet obstruction (MGOO) due to pancreatic cancer. Endoscopic stenting (ES) was most common, but EUS-Gastrojejunostomy (EUS-GJ) adoption is increasing. Decision drivers include life expectancy and patient frailty, with lack of standardized algorithms. Availability of EUS-GJ remains suboptimal, attributed to the steep learning curve. Journal […]
Nonoperative Management of Uncomplicated Appendicitis in Adults Linked to Longer Hospital Stays and Higher Costs
Researchers examined 167,125 patients with uncomplicated appendicitis, finding that 82.4% underwent surgical management, while 17.6% underwent nonoperative management (NOM). The NOM group had older patients (53 vs. 43 years), more Medicare recipients (33.6% vs. 16.1%), and higher rates of comorbidities like diabetes (7.8% vs. 5.5%). NOM was associated with longer hospital stays (5.4 vs. 2.3 […]
Post-Discharge Mental Healthcare Reduces Readmissions in Emergency General Surgery Patients with Serious Mental Illness
A study of 88,092 Medicare patients over 65 with serious mental illness (SMI) found that a post-discharge mental health visit (MHV) within 30 days after emergency general surgery (EGS) hospitalization was associated with significantly lower odds of acute care readmission in both operative (odds ratio 0.60) and non-operative (odds ratio 0.67) groups. There was no […]