Could blunt trauma lead to a double lumen esophagus?

Introduction And Importance: Esophageal rupture and perforation are serious complications of blunt abdominal trauma. Early diagnosis and intervention is key for patient survival. Studies have reported that mortality of patients with esophageal perforation can be as high as 20-40 % (Schweigert et al.

Surgical and Endovascular Management of Extracranial Carotid Artery Aneurysms, Outcomes From the American College of Surgeons, National Surgical Quality Improvement Program.

Objectives: Extracranial carotid artery aneurysms (ECAA) are rare and consequentially understudied; yet multiple management strategies for ECAA have been pursued. The goal of this study was to compare rates of stroke and cardiac events following surgical or endovascular management of ECAA utilizing the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP).

Methods: The ACS-NSQIP database was queried for patients with both selected procedure codes and diagnostic codes specific for ECAA.

Associate Program Directors in Surgery: A Select Group of Surgical Educators.

Objective: The role of the Associate Program Director (APD) within surgical education is not clearly defined or regulated by the Accreditation Council for Graduate Medical Education, often leading to variations in the responsibilities among institutions. Required credentials are not specified and compensation and protected time are not regulated resulting in large discrepancies among institutions. APDs are brought into the fold of surgical education to parcel out the escalating responsibilities of program director (PD).

Characteristics and Correlates of Word Use in Physician-Patient Communication.

Background: Numerous studies have described and evaluated communication in healthcare contexts, but these studies have focused on broad content and complex units of behavior. Growing evidence reveals the predictive power and importance of precise linguistic characteristics of communication.

Purpose: This study aims to document characteristics, predictors, and correlates of word use within specific linguistic categories by physicians and patients during a healthcare visit.

Dialysis Access Surgery: Does Anesthesia Type Affect Maturation and Complication Rates?

Background: Creation of an arteriovenous fistula (AVF) is the preferred method of establishing long-term dialysis access. There are multiple anesthetic techniques used for patients undergoing this surgery including general endotracheal intubation, laryngeal mask airway, regional anesthesia with nerve blocks, and monitored anesthesia care with local infiltration. It is unclear what effect the method of anesthesia has on AVF creation success rate.

Preoperative carotid duplex findings predict carotid stump pressures during endarterectomy in symptomatic but not asymptomatic patients.

Background: Carotid stump pressure (CSP) is frequently measured to determine the need for shunt use during carotid endarterectomy (CEA). We hypothesized that the preoperative carotid duplex examination correlates with preoperative symptoms and intraoperative CSP.

Methods: Patients undergoing CEA over a 7-year period were identified from our vascular registry.

Rupture of an abdominal aortic aneurysm following nonaccidental blunt abdominal trauma.

A 78-year-old woman presented to our trauma center with an initial, erroneous history of a ground-level fall. Further investigation revealed that the patient had been assaulted by her husband immediately prior to presentation. The initial abdominal examination was benign, and the patient was hemodynamically stable.

A prospective analysis of critical limb ischemia: factors leading to major primary amputation versus revascularization.

In our aging population, primary major amputations (AMP, below-knee or above-knee) continue to be performed despite advances in revascularization. We hypothesized that not only patient comorbidities but also the system of health-care delivery affected the treatment of patients with critical limb ischemia (CLI). A prospective analysis of patients presenting with CLI was undertaken to determine whether patient-specific factors or healthcare delivery factors (system-related) influenced treatment with primary AMP versus lower extremity revascularization (LER).

Chronic ergot toxicity presenting with bilateral external iliac artery dissection and lower extremity rest pain.

Chronic use of ergot alkaloids has been recognized as a rare cause of lower extremity ischemia. Most patients with ergot toxicity present with symptoms of lower extremity claudication. Herein we present a woman with bilateral lower extremity rest pain and a history of chronic ergot use for migraine headaches.