Damage Control Laparotomy in Surgical Sepsis
Fig. 4.1 The progression of an intra-abdominal infection Fig. 4.2 The persistent septic shock cycle Fig. 4.3 Paradigm shift in management of patients with an abdominal infection and septic shock…
CRITICAL CARE
Acute Appendicitis
Gastrointestinal origin Appendicitis Mesenteric adenitis Intussusception Terminal ileitis Cecal diverticulitis Epiploic appendagitis Typhlitis Inflammatory bowel disease Constipation Urogenital Ureteral stone Urinary tract infection Gynecologic Tubo-ovarian abscess Ovarian torsion Ectopic pregnancy…
Esophageal Perforation
Type Causes Clinical findings Anatomic External compression from an aberrant right subclavian artery Pyriform sinus Singing, yelling, trumpet playing, recent endoscopy Marked mediastinal and cervical subcutaneous emphysema Anastomotic Leakage at…
Liver Abscesses
Fig. 22.1 A 52-year-old Mexican male who presented with RUQ pain and jaundice with pyogenic abscess Treatment The initial treatment of any patient suspected of having a possible liver abscess…
Gastric Outlet Obstruction
Fig. 18.1 Evaluation of peptic ulcer disease (PUD)-associated benign GOO The classically described test for GOO (i.e., “gastric retention”) is the saline load test described by Goldstein et al. in…
Acute Biliary Disease
Fig. 20.1 Acute gangrenous cholecystitis (operative photograph) On the other hand, even before the modern era of antibiotics and other interventions, acute cholecystitis did often enough certainly resolve spontaneously. In…
Bile Duct Injury
Fig. 21.1 (a–c) Algorithm for management of suspicion of BDI Epidemiology and Background Definitions BDI is a broad term used to describe a transection of, an excision of, a leak…
Peptic Ulcer Disease for the Acute Care Surgeon
Medications/dose/frequency Duration PPI + Clarithromycin 500 mg bid + Amoxicillin 1,000 mg bid 10–14 days PPI + Clarithromycin 500 mg bid + Metronidazole 500 mg bid 10–14 days PPI +…
The Careful Art of Resuscitation
I II III IV Blood loss (ml) Up to 750 750–1,500 1,500–2,000 >2,000 Blood loss (% blood volume) Up to 15 15–30 30–40 >40 Pulse rate (per minute) <100…
Surgical Site Infections
Superficial incisional SSI Infection occurs within 30 days after the operation •and infection involves only skin or subcutaneous tissue of the incision •and at least one of the following: –Purulent…
