Delayed Presentation of a Post-traumatic Suprascapular Artery Pseudoaneurysm.

Thyrocervical trunk pseudoaneurysms are a rare entity among pseudoaneurysms, mostly caused by trauma. We present the case of a 74-year-old male who suffered a traumatic pseudoaneurysm of the supra-scapular artery after a rib and scapular fracture. The patient was treated with various interventions along the treatment algorithm, including ultrasound-guided thrombin injection, coil embolization, and surgical excision.

Combined Interventional Radiology and Surgical Cut-Down Approaches for Retained Gallstones.

Symptomatic retained gallstones are a rare but potentially morbid condition. Post-cholecystectomy patients presenting with vague complaints or perihepatic abscesses should be considered for retained gallstones. Traditional treatment was incision and drainage or exploratory laparotomy with washout.

Toxic Clostridioides (formerly Clostridium) difficile colitis: No longer a diarrhea associated infection.

Background: Clostridioides difficile infection (CDI) is traditionally taught to be an antibiotic associated diarrheal infection. This diagnosis is based on the presence of clinical symptoms (usually defined as more than 3 watery, loose or unformed stool within 24 h) coupled with a diagnostic test. There is now a new presentation of CDI, including progression to toxic megacolon, in patients without diarrhea.

The utility of impedance cardiography in hemodynamic monitoring of patients with sepsis.

Background: Commonly used biochemical indicators and hemodynamic and physiologic parameters of sepsis vary with regard to their sensitivity and specificity to the diagnosis. The aim of this preliminary study was to evaluate non-invasive impedance cardiography as a monitoring tool of the hemodynamic status of patients with sepsis throughout their initial volume resuscitation to explore the possibility of identifying additional measurements to be used in the future treatment of sepsis.

Methods: Nine patients who presented to the emergency room and received a surgical consultation during a 3-month period in 2016, meeting the clinical criteria of sepsis defined by systemic inflammatory response syndrome in the 2012 Surviving Sepsis Campaign Guidelines, were included in this study.

Have outcomes improved in trauma patients age 90 years and older over the past decade: Experience at a level II trauma center.

Introduction: Managing trauma in the elderly is challenging and requires a multidisciplinary team approach. The aim of this study is to characterize and compare outcomes in patients 90 years and older in the last two decades.

Methods: Retrospective review of trauma patients 90 years and older admitted from 1996 to 2015.

Filling the void: a low-cost, high-yield approach to addressing incidental findings in trauma patients.

Background: Incidental findings are prevalent in imaging but often go unreported to patients. Such unreported findings may present the potential for harm as well as medico-legal ramifications.

Methods: A chart review of trauma patients was undertaken over a year.

Effect of a mandatory research requirement on categorical resident academic productivity in a university-based general surgery residency.

Background: Our general surgery residency (46 residents, graduating 6 categoricals per year) offers the opportunity for 2 categorical residents at the end of their second year to choose a 2-year research track. Academic productivity for the remaining categorical residents was dependent on personal interest and time investment. To increase academic productivity within the residency, a mandatory research requirement was implemented in July 2010.

Increasing use of less-invasive hemodynamic monitoring in 3 specialty surgical intensive care units: a 5-year experience at a tertiary medical center.

Introduction: Less-invasive hemodynamic monitoring (eg, esophageal doppler monitoring [EDM] and arterial pressure contour analysis, FloTrac) is increasingly used as an alternative to pulmonary artery catheters (PACs) in critically ill intensive care unit (ICU).

Hypothesis: The decrease in use of PACs is not associated with increased mortality.

Methods: Five-year retrospective review of 1894 hemodynamically monitored patients admitted to 3 surgical ICUs in a university-affiliate, tertiary care urban hospital.

Implementation of an intern boot camp curriculum to address clinical competencies under the new Accreditation Council for Graduate Medical Education supervision requirements and duty hour restrictions.

Importance: Today's general surgery interns are faced with increased duty hour restrictions and stringent competency-based supervision milestone requirements (ie, from direct to indirect supervision). Working within these constraints, we instituted a unique 2-month intern curriculum (boot camp) incorporating knowledge-based, experiential, and practical components.

Objectives: To describe our curriculum and the effect on resident performance and teaching faculty and nursing staff perceptions.

Development and implementation of an interactive, objective, and simulation-based curriculum for general surgery residents.

Objective: A Steering Committee of residents and faculty initiated a systematic approach to curriculum development, focusing on competency-based education and emphasizing both resident and faculty engagement in the didactic process.

Setting: Integrated General Surgery Residency Program at the University of Connecticut School of Medicine, Farmington, Connecticut.

Participants: Postgraduate year (PGY) 1 through 5 general surgery categorical and preliminary residents.