The use and modification of clinical pathways to achieve specific outcomes in bariatric surgery.

Clinical pathways are promoted for standardizing patient care and decreasing resource use without compromising outcome. Once established, we hypothesized that clinical pathways can then be used to modify patient care to achieve specific goals. Our aim was to evaluate a clinical pathway for the bariatric surgical patient that was initially designed to standardize care and later altered to modify the postoperative course.

Postoperative short bowel syndrome.

Background: Unanticipated massive resection after intraabdominal procedures is an increasing cause of short bowel syndrome (SBS). Our aim was to determine the frequency and potential mechanisms of postoperative SBS.

Study Design: We reviewed retrospectively the clinical course of 210 adult patients with SBS evaluated over a 20-year period.

Patent urachus with bladder eversion.

An infant was born at term after having received a diagnosis of omphalacele on prenatal ultrasound scan. She did not have an omphalacele but rather had a patent urachus with bladder eversion onto the abdominal wall. The remainder of the genitourinary tract was normal, and it was possible to pass a soft catheter through the urethra and out of the evaginated bladder.