Management of Acute Upper Gastrointestinal Disease While at Sea.

Management of complex acute surgical pathology in austere environments necessitates rapid evaluation and resource appropriate management to avoid time-associated morbidity and potentially mortality. Obstructive upper gastrointestinal (UGI) pathologies can be particularly challenging and associated with significant morbidity. Herein, we present six patients with UGI obstructions encountered over the course of an 8-mo deployment onboard a US Navy Aircraft Carrier.

Use of porcine small intestinal submucosa in Ehlers-Danlos syndrome Type IV.

Ehlers-Danlos syndrome (EDS) Type IV results in inadequate production of type III collagen and can lead to devastating vascular, gastrointestinal, and uterine complications. A case is presented of spontaneous colonic perforation in a patient with EDS Type IV complicated by multiple intestinal fistulas managed with porcine small intestinal submucosa. Early success with this technique would suggest additional applications in a variety of complicated gastrointestinal problems.