Abdominal organ injuries during colonoscopy, though rare, can be serious and life-threatening. Splenic and hepatic injuries are the most common, requiring intervention. Conservative management is possible for pancreatitis. Risk factors include difficult colonoscopy, intra-abdominal adhesions, and excessive force during the procedure. Clinicians should be vigilant for symptoms such as abdominal pain and distension post-colonoscopy. Proper […]
Category: Appendix, Gallbladder and Surgical Emergencies
High Success Rate of Colonic-Enteric Lumen-Apposing Metal Stents for Small-Bowel Obstruction
Colonic-enteric lumen-apposing metal stents (LAMS) showed high technical success (100%) and clinical success (92.3%) in managing small-bowel obstruction (SBO) in patients who are not surgical candidates due to malignancy. Adverse events occurred in 15.4% of patients, including bleeding, diarrhea, and postprocedure sepsis. Patients were able to resume enteral nutrition in 84.6% of cases. Further research […]
Creating Trauma Survivorship Centers: A Financial Win-Win
Establishing a Center for Trauma Survivorship (CTS) is not cost prohibitive, but a revenue generator for institutions. A post-and pre-cohort study found that CTS patients had more follow-up visits and surgeries, resulting in a $7,752 increase in net revenue per patient. The creation of dedicated centers improves patient outcomes and institution’s financial health. Journal Article […]
Extreme gradient boost machine learning model accurately predicts mortality risk in primary appendiceal cancer patients
Researchers developed a novel machine learning algorithm using extreme gradient boost to predict 1-, 5-, and 10-year mortality risk in patients with primary appendiceal cancer. The model exhibited high prediction accuracy, with a maximum area under the curve of 0.909 for the 10-year model. Variables such as disease grade, histology, lymph node involvement, and distant […]
Enhanced digital education improves patient understanding of consent for laparoscopic cholecystectomy
Using a digital education platform alongside standard verbal consent significantly increased patient knowledge of risks and benefits of laparoscopic cholecystectomy (LC) immediately after the intervention, as well as in delayed assessments. Patient retention of acquired knowledge was also higher in the intervention group. Satisfaction with the consent discussion did not differ between groups. This study […]
Similar Outcomes of Anastomosis vs. Colostomy After Sigmoid Colectomy for Volvolus
Outcomes between primary anastomosis and end colostomy following emergency sigmoid colectomy for sigmoid volvulus were compared using ACS-NSQIP data. Results showed no significant differences in major complications, mortality, hospital stay, or readmission rate. Patients with colostomy had a higher likelihood of being discharged to a care facility. Overall, there were no statistically significant disparities in […]
Overprescribing opioids for emergency surgery patients does not improve postoperative outcomes
Patients undergoing emergency surgery in Michigan were prescribed an average of 9.6 opioid pills, but only consumed 4.6 pills on average. Larger prescriptions were associated with higher consumption, but did not lead to reduced pain, higher satisfaction, improved quality of life, or less regret about undergoing surgery. These findings suggest that opioids may be excessively […]
Long-term Pancreatic Complications from Trauma: Unique Pathology in Focal Duct Stenosis
Patients with focal stenosis of the main pancreatic duct without pancreatic cancer may have unique pathology including fibrosis, inflammation, and calcifications. Blunt trauma, such as from motor vehicle accidents, can cause long-term complications in the pancreas, leading to obstructive changes. Awareness of this distinctive pathology is crucial for pathologists to accurately diagnose and understand the […]
Increased Odds of Post-Operative Endoscopic Retrograde Cholangiography in Subtotal Cholecystectomy Patients
Researchers conducted a retrospective review of laparoscopic cholecystectomies at a large center. Among 1222 cases, 7% were subtotal cholecystectomies (SC). SC patients were more likely to be male, older, have higher ASA class, and experience longer hospital stays. SC increased the odds of requiring endoscopic retrograde cholangiography (ERC) postoperatively. Reconstituting SC lowered the odds of […]
What hospital factors impact outcomes for gastrointestinal bleeding?
Among Medicare fee-for-service beneficiaries hospitalized for gastrointestinal bleeding, larger hospital size, greater case volume, increased staffing levels, and availability of advanced capabilities were associated with lower 30-day mortality. Patients treated at hospitals with multiple advanced specialized capabilities had a 22% reduction in mortality risk, compared to those without these services, although length of stay increased […]