Gastric necrosis and perforation following treatment of Dieulafoy's lesion with embolization of multiple gastric arteries: A case report.

Diagnosis, management, and treatment of Dieulafoy's lesion have been complicated since its first mention in 1884. With increased awareness over the decades, Dieulafoy's lesions are being managed differently based on the physician's expertise. Herein, we report a case of a 58-year-old female who was found to have a Dieulafoy's lesion on endoscopy, with her treatment complicated by gastric necrosis and perforation after multiple embolizations and limited surgical resection.

USMLE Scores and Clinical Rotation Role in Predicting ABSITE Performance Among Surgery Interns.

Background: The American Board of Surgery In-training Examination (ABSITE) is an important marker of medical knowledge. It is unclear what factors predict or improve these scores. We evaluated demographics, United States Medical Licensing Examination (USMLE) step 1 and 2 scores, and surgical rotations during the intern year to determine if there were any correlations with the ABSITE performance.

Obscure gastrointestinal bleeding localization using preoperative super-selective mesenteric angiography and intraoperative methylene blue injection: A case report and literature review.

Introduction: Currently available diagnostic tests for localizing the source of gastrointestinal bleeding include esophagogastroduodenoscopy, colonoscopy, push enteroscopy, video capsule endoscopy, deep enteroscopy, nuclear scan, angiography, radiographic contrast studies of the small bowel, intraoperative enteroscopy, and computed tomography scanning. Despite these diagnostic modalities obscure gastrointestinal bleeding (OGIB) can be difficult to localize, making surgical intervention challenging.

Presentation Of Case: We report the case of a 78-year-old patient who presented with OGIB, melena and passing bright red blood per rectum, with a hemoglobin of 4.

Rare documented case report of a retroperitoneal hernia as a complication to an anterior retroperitoneal spinal exposure.

Introduction: Anterior retroperitoneal spinal exposures are widely used today for spinal surgeries. Incisional hernias are a documented complication of anterior spine exposures; however, there are no documented cases of hernias into the dissected retroperitoneal space. We presented this exceptionally rare patient's complication to underscores the critical importance of preserving the peritoneum as a biologic barrier during retroperitoneal spine exposures.

Comparative durability and costs analysis of ventricular shunts.

Objective: Ventricular shunt (VS) durability has been well studied in the pediatric population and in patients with normal pressure hydrocephalus; however, further evaluation in a more heterogeneous adult population is needed. This study aims to evaluate the effect of diagnosis and valve type-fixed versus programmable-on shunt durability and cost for placement of shunts in adult patients.

Methods: The authors retrospectively reviewed the medical records of all patients who underwent implantation of a VS for hydrocephalus at their institution over a 3-year period between August 2013 and October 2016 with a minimum postoperative follow-up of 6 months.

Racial and Socioeconomic Disparities in Hysterectomy Route for Benign Conditions.

Background: The aim of this paper was to explore disparities associated with the route of hysterectomy in the University of Pittsburgh Medical Center (UPMC) health system and to evaluate whether the hysterectomy clinical pathway implementation impacted disparities in the utilization of minimally invasive hysterectomy (MIH).

Methods: We performed a retrospective medical record review of all the patients who have undergone hysterectomy for benign indications at UPMC-affiliated hospitals between fiscal years (FY) 2012 and 2014.

Results: A total number of 6373 hysterectomy patient cases were included in this study: 88.

Implementation of Hysterectomy Pathway: Impact on Complications.

Objective: Hysterectomy is one of the most common surgical procedures in the United States. For women who need hysterectomy, it is important to ensure that minimally invasive hysterectomy procedures are used appropriately to reduce surgical complications and improve value of care. Although we previously demonstrated a reduction in total abdominal hysterectomy rates after the implementation of hysterectomy pathway treatment algorithm in 2012, this study focuses on exploring the effect of pathways implementation on surgical outcomes.

Changes in Hysterectomy Trends After the Implementation of a Clinical Pathway.

Objective: To investigate the effect of hysterectomy pathway implementation on the proportion of total abdominal hysterectomy (TAH) procedures performed between fiscal years 2012 and 2014.

Methods: We conducted a retrospective medical record review. All hysterectomy surgeries performed for benign indications at University of Pittsburgh Medical Center hospitals from fiscal year 2012 to fiscal year 2014 were identified through various systems including Medipac and EpicCare.